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breech transverse position

Towards the end of pregnancy your health care provider will pay close attention to the presentation of the fetus (how our baby is positioned in your uterus.) The most common and ideal presentation of the fetus is cephalic presentation also known as the occiput anterior position, in which the baby’s head points down into the pelvis while facing the mother’s back. This is the best position for birth because the smallest part of the baby’s head leads first through the birth cannel. According to the Cleveland Clinic, most baby’s settle in this position between weeks 32 and 36. Other fetal positions can make vaginal delivery tricky or even dangerous.

At my 36 week appointment Baby #2 was presenting transverse (sideways). Babies presenting transverse cannot be born vaginally. While the health and safety of my baby is my top priority, natural vaginal birth is very important to me. So what is a mama to do if she’s 36 weeks pregnant and her baby is not in the cephalic presentation? I asked the moms on First Time Mom’s facebook page if anyone had tips for flipping babies and received a lot of helpful suggestions to research. Here are some options to consider under the guidance of your health care provider if your baby’s presenting breech or transverse late in your third trimester.

Physical Activity Practicing safe movement and stretches while pregnant will help both mom and baby physically prepare for birth. During my first pregnancy I regularly practiced prenatal yoga with the lovely Emily Masnoon and it made a world of difference. My yoga practice helped me manage many physical prenatal discomforts and benefited my connection with the little sweetheart growing in my belly. My practice also helped me prepare for a positive labor experience. Simple things like practicing good posture can help babies move into better birthing positions. Sometimes a mama can move and groove her baby into the right position by walking, rotating her hips while sitting on an exercise ball, doing handstands in a swimming pool, holding a downward facing dog pose, etc. To learn more about fetal positioning and helpful activities to do during pregnancy and labor check out Spinning Babies and The Miles Circuit.

Chiropractic Care Expecting mothers can greatly benefit from chiropractic care during pregnancy. Chiropractic care addresses the health and alignment of one’s spine, discs, bones, and the related nerves without the use of drugs. breech transverse babyThe Webster Technique is particularly helpful for pregnant women because this chiropractic approach was developed focusing on “weight baring individuals including the pregnant population throughout pregnancy.” The Webster Technique addresses the alignment and balance of the pelvis and the related soft tissue. In many cases pregnant women with babies presenting breech have their babies turn after receiving Webster chiropractic treatments. This is because an aligned and balanced pelvis gives baby more room to settle head-down in the pelvis. Note, as is the case with all treatments, results do vary and not all babies “flip” for mama’s receiving chiropractic care. Still from what I’ve heard and researched, receiving Webster treatments are certainly worth consideration whether or not you have a baby that needs to flip.

Acupuncture Acupuncture is commonly used as a treatment for infertility, but in some cases it is also used to help babies settle into the cephalic presentation prior to birth. Moxibustion is a specific acupuncture technique that uses mugwort and heat to facilitate healing or circulation. This technique has been successfully used as a treatment for babies presenting breech or transverse; however more studies need to be done to affirm its effectiveness. Authors of an on-going study evaluating the use of moxibustion as a treatment for breech presentation say, “When combined with acupuncture, moxibustion may result in fewer births by caesarean section; and when combined with postural management techniques may reduce the number of non-cephalic presentations at birth, however, there is a need for well-designed randomized controlled trials to evaluate moxibustion for breech presentation which report on clinically relevant outcomes as well as the safety of the intervention.” (Cehalic version by moxibustion for breech presentationCoyle ME1Smith CAPeat B). Before considering this approach be sure to consult your health care provider and seek a licensed and Board certified acupuncturist; see www.nccaom.org.

Essential Oils Some suggest using essential oils to help encourage a baby to flip. Rubbing peppermint essential oil in a rainbow motion on the top of one’s belly “cools” the skin, causing the baby to turn away and towards mamas pelvis. The International Federation of Professional Aromatherapists recommends using a dilution of 1% or less for all skin applications of essential oils during pregnancy. Note, essential oils are potent substances and should be used with knowledge and caution. As with all of these suggestions consult your health care provider first.

External Cephalic Version (ECV) External Cephalic Version, also known as external version, is probably the most common approach to correcting breech and transverse presentations. It is a procedure in which a trained medical professional externally rotates the baby into the cephalic presentation. The success rate of ECV’s in the United States is 58%. Yet some medical professionals would argue that ECV is under used in the United States where expecting mothers are more likely to have an elective C-section. There are risks involved with ECV, which is why this procedure is typically not performed until the mother is full term. Both baby and mother are closely monitored during an ECV and the procedure is only done in a facility equipped for emergency C-sections. Most of the mom’s commenting about their ECVs on the FTM facebook page noted that it was quite a painful procedure. For some it worked and their babies stayed head down, for others they still ended up having C-sections because their babies flipped back to breech. Still the benefits of vaginal birth over C-sections for both baby and mom are significant, making External Cephalic Version an important option for mother’s with traverse or breech babies who need to flip.

So you may be wondering did my baby flip? When we discovered Baby #2 was still transverse at my 36 week appointment my midwife suggested I have an ultrasound to ascertain baby’s exact position before formulating a plan to help baby flip. I got an ultrasound scheduled for the following day. Starting in the second trimester I regularly wore a support belt to help me manage my growing belly and loose ligaments. I suspected that the support belt was hindering baby’s movement head down so I took off the belt, did some of my favorite prenatal yoga poses, tried some of the exercises suggested on Spinning Babies, and started praying baby girl would settle head down by the next morning…

Foot at the top, a head pointing down!

Foot at the top, a head pointing down!

We were happy to find baby girl in the cephalic presentation at my ultrasound. Hallelujah! Once baby was confirmed to be head down my midwife suggested that during the day I wear the support belt to help keep her in position. Baby girl was still head down at my 37 week appointment, but the jury is still out as to whether or not she’ll stay put until for the rest of my pregnancy. Stay tuned!

Did you have a baby successfully flip late in pregnancy? What worked for you?

 

Resources

“Slide Show: Fetal Positions Before Birth” mayoclinic.org

“Fetal Positions for Birth” clevelandclinic.org

“How to: Daily Activities” spinningbabies.com

Cephalic version by moxibustion for breech presentation” Coyle ME1Smith CAPeat B

What is the Evidence for using an External Cephalic Version to turn a Breech Baby?”  evidencebasedbirth.com

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