Sometimes you get the news that baby is not yet in a head-down (vertex) position but rather that baby is breech. For many, this news makes them fear that baby cannot be born outside of a hospital or that baby’s presentation is an automatic reason for a cesarean. It doesn’t need to be this way.
There are many ways to try to encourage a breech baby to turn. Remember, a baby can turn at any time, right until the very last minute. Stay positive! Trust your body and your baby! Only 3-4% of babies are still breech by the time they reach full term.
The following list of non-invasive exercises, therapies and suggestions is designed to help you take an active role in encouraging your baby to turn. I believe that if you have made every pro-active effort to turn your baby, then you can feel satisfied knowing you have done your best and your ultimate experience of the birth journey will be much more positive, however it plays out. Discuss these options with your care provider. It is likely that your baby may not turn immediately and that it may take repeated efforts and a combination of these efforts for the baby to turn successfully.
As always in pregnancy, make sure you stay hydrated! Drink plenty of fluids to help ensure there’s plenty of amniotic fluid so baby can move freely enough to turn.
To do pelvic rocks, position yourself on hands and knees and gently tilt your pelvis as you arch your back, then return your back to a flat position and relax your pelvis. Do 20 to 30 of these twice each day, with one of those times just before bed. Relax while you do this, inhaling and exhaling slowly and deeply. It’s not a race!
You will basically be using gravity to encourage your baby to turn. Ideally, you will position yourself with your knees on a chair or couch and lean forward and down with elbows on the floor to achieve the desired angle for this inversion. But if that’s not feasible, start with any two stable surfaces and lean down to the lower one. Have a support person nearby to help you get into – and out of! – this position.
Open Knee Chest Position
To do this, kneel with your hips flexed at slightly more than 90 degrees (but do not let your thigh press against your abdomen) and try to keep your head, shoulders, and upper chest flat on your mattress. Maintain this position for 15 minutes every few waking hours for five consecutive days. By positioning your body so your head is lower, gravity encourages the baby’s head to turn toward your fundus. She should flex her chin onto her chest and start to turn, then as pressure builds on the back of her head, she gradually rotates into a transverse position, then all the way to the vertex position we want to see. It may be easier to do this with a support person offering leg support with a rebozo.
Lie on your back with your hips elevated (use a cushion or several pillows) and your hips and knees bent. Gently roll 180 degrees from side to side for 15 minutes and repeat this maneuver three times a day. It may be best to do this when you have an empty stomach and when the baby is active. Focus on the baby, avoid tensing your body (especially your abdomen), relax as much as you can and visualize your baby turning.
Acupuncture & Moxibustion
Acupuncture and moxibustion (the burning of Chinese herbs next to your little toe) is said to help turn breech babies. Some acupuncturists claim a success rate as high as 80%. It is definitely worth a try – it is one of the easiest and most relaxing ways to encourage your baby to turn. Locals, I recommend Sarasota Community Acupuncture. You will get a lovely relaxing treatment and suggestions on how and how often to do the moxibustion at home.
Chiropractic & Webster’s Technique
Chiropractic care throughout pregnancy and specifically the Webster’s technique as performed by specially trained and certified chiropractors can help to release tight ligaments and open up and align the pelvis to allow the baby enough space to turn. Locals, I recommend Dr Amy Tafeen of Family Chiropractic. Another chiropractic technique that may be useful in turning breech babies is the Logan Basic Technique.
The Leg Hang
Assume the side-lying position: position yourself at the very edge of a bed or couch, on your side, making sure you have a support person standing right before you, leg up against the bed or couch, to help you balance and ensure you don’t roll off. Hang your top leg down, keeping your hips aligned, while your support person applies slight downward pressure to your top hip. Relax the leg. Feel the stretch! Be sure to do both legs, not just one! Remember, balanced joints are needed now – bodywork such as massage therapy or cranio-sacral therapy can also help compensate for tightness on one side.
Hip opening exercises
You want to create enough space in your pelvis to encourage baby to turn. You may want to visit a local prenatal yoga class and ask the teacher specifically about which exercises might be most appropriate for you. For example, as you lie on your back, bend both knees so your feet rest comfortably on the floor. Hold one thigh as you lift the ankle to rest it against the other leg just above the knee and gently push the thigh away from you to stretch your ligaments. Alternate sides.
A rebozo is basically a long piece of cloth – you may use a scarf, sheet, or babywearing wrap in this exercise. You will need a partner for this technique. Get into the hands and knees position and position the cloth over your belly, so your support person holds both ends of the rebozo. While you relax as fully as you can, your support person stands right behind you and gently sifts, or jiggles, your belly by pulling in short gentle bursts on each side of the rebozo. This should be gentle and comfortable for mom! You can see a video here.
Elevate the pelvis by lying down head-down on a board or ironing board that has been propped up onto the edge of a couch. Make sure the board is stable before you hop on! This position can be assumed for 8 to 10 minutes a day.
Get a full body massage! This relaxes the whole body and is essential for you to feel the space for the baby to turn. Remember, for any pregnant woman, we want to achieve the highest levels of emotional, physical and mental relaxation that we can. In the case of breech babies, this is even more critical. After your massage, place pillows under your knees, tilt slightly with a rolled up towel under your right side for support, and touch your belly, talk to the baby and rotate your hands in the direction that you want baby to go. Have total faith that your baby will turn. Visualize it happening and talk your baby through the process!
Use the power of your mind and intention to help turn your baby. Combine visualization with the other exercises and techniques you’re doing. You can simply picture in your mind what you want to happen, whether you’re driving along or having a bath. Envision the baby turning, imagine what it will feel like, put yourself in your baby’s position, will her the strength to reposition herself for an easier birth.
Talk to your baby!
Have your partner talk to the baby! Let your baby know you want him to turn, you are inviting, encouraging and welcoming him to turn. Your baby is listening. Say whatever comes from your heart. Some people beg the baby to turn, scold the baby for causing them stress, or pray that the baby will turn. You might say something along the lines of:
“Hi there, baby! We love you and we can’t wait to meet you and hold you in our arms! We want you to choose your own birthday and we want your journey from my womb to my arms to be as comfortable for us both as possible. But you’ve got to help me here and get in a better position! It’s OK for you to turn now. We want you to move around so that your head is down, against my cervix, so we can both be ready for whenever you decide labor should start. Turn, baby, turn! OK, I’m going to take some deep breaths now and just really relax my body for you so it’s easier for you to move. Just tuck your little chin to your chest and rotate. Can you feel my hands gently massaging my belly? I want you to turn in that direction too. Come on, baby! We love you! You’re strong and healthy and you can do this! We’re doing our best to help you as we all get ready for your birth. We’re doing this together!”
Proper Leg Support
Remember to support both your knees AND ankles with pillows, cushions, pool noodles or whatever works for you when side-lying during SLEEP so that your hips and pelvis are nice and open all night long. This will help give baby the space needed to turn to a head-down position and it will help you maintain better alignment.
In these modern times, we simply don’t use our bodies like we used to. We likely have an imbalance of tension on one side. Think about what you do each day and where there is tension in your body, and where there is movement and fluidity. Do you drive a lot, using your right leg for the pedals? Do you sit at a computer and use your right hand and arm for the mouse, leaning in toward that side? Do you check your smart phone and use your right hand to text and scroll from app to app? Do you carry your purse on one shoulder when you’re out and about? Do you carry groceries or toddlers on one side? Do you perform repetitive movements or carry unbalanced loads at work? Think about it! That all adds up!
What we often need to turn a breech baby is proper alignment. The 3 principles of alignment are:
If your daily activities create imbalance or tightness on one side, thereby restricting fluid movement, take the time and effort to add daily stretches and exercises to counteract that and help your body loosen up. This can make all the difference for you and your baby. Again, bodywork, massage, cranio-sacral therapy, chiropractic care, and yoga can be key elements to rectifying any imbalances or misalignments. It’s never too early to start with these as they will benefit you in pregnancy (even if baby is not breech) and help prepare your body for labor.
Light & Music Stimulation
Here, we appeal to the baby’s senses. Turn on a flashlight, and place the light directly against the skin of your lower abdomen – the lower, the better. At the same time, position portable speakers against the lowest part of your belly, with music on but not blasting – we want the baby to move toward the sound, not flinch away! Your baby will hear the music and see the light. Hopefully, both will encourage him to turn toward it, thereby moving head-down in your pelvis. Try this for 30-45 minutes. Your partner can help you and talk to baby. You can further encourage baby by doing this while in the open knee chest position described above. You can use pillows to cushion your knees and support your head. If you feel baby moving, take deep breaths and focus on relaxing all your tummy muscles. Some people stroke the light and sound from the top of the belly toward the bottom, asking baby to follow the light/sound down, toward the cervix.
Cold & Heat Stimulation
Babies are in a wonderfully cozy warm womb. They don’t like to feel cold. So this technique encourages them to move away from the cold sensation they dislike and towards the warmth they love. Simply place something cold, such as a bag of frozen peas, at the top of your uterus (the fundus) and at the same time, place something warm, such as a warm pack, at the lower part of your belly bump. Be sure to do this with a thin layer of fabric between you and the cold/heat source. As you do this, get comfortable and relax. Visualize your baby moving.
Swim downward underwater
Only do what is comfortable, but apparently the equalized pressure of being in the water and swimming downward and using gravity to help has helped turn some babies.
Stand with your knees relaxed, not locked, and your hands on the wall in front of you as though you’re being frisked. Have your support person stand beside you and apply light nickel-weight pressure on both your belly and fascia (lower back). Practice visualization, breathing and any relaxation techniques that work for you while in this position.
External Cephalic Version (ECV)
This procedure must be done by a doctor or midwife and involves manually turning baby through strong externally-applied guided pressure, which may be uncomfortable or even painful for some women. Success rates are about 65% in studies but these vary by provider so make sure you find someone who does these regularly, is comfortable doing them and offers a better than 50-50 chance of success.
An ECV is contraindicated for women who are rhesus negative, have experienced bleeding, or whose placenta is situated low in the uterus. Risks associated with ECV including the possibility of causing distress to the baby and a chance of bleeding or premature rupture of the membranes. Discuss this option with your provider. In my own limited experience, it seems women who have actively done many of the other techniques have a better chance of success and less discomfort with an ECV.
Change Care Provider
Another potential option for some women is to search for a doctor or midwife who has experience delivering vaginal breech babies. The care provider would assess your personal situation, discuss your options and then together with you make a decision about the best course of action. Some women have no interest in vaginal breech birth and would prefer a cesarean. That is perfectly OK! The important thing is that you do have options! Only you can choose the best one for you and your baby!
One local mom travelled to North Carolina to have the birth she wanted: a beautiful home water birth of her breech twin girls! Wow! See photos of her story here and hear her talk about her birth story on Maternally Yours during their annual fundraiser night.
A final word:
Remember that some babies keep their parents in suspense and wait to turn until the last minute. Once your baby is head-down, you should no longer do some of these exercises, such as the inversions, open knee chest and breech tilts, while others, like visualization, acupuncture, talking to baby and body awareness will still be encouraged. Do communicate openly with your care provider about what you’re interested in doing to turn your baby as some of these techniques may not be advised depending on your personal medical and physical situation. Finally, for a few babies, a breech position may be best for them for whatever reason. If vaginal breech birth is not desired or believed not to be possible, then you can still have a positive and empowered caesarean birth experience!
For more information, check out these sites:
- www.spinningbabies.com - The site for turning babies!
- Birth without fear: Breech does not equal c-section