When to do it
When, in Pregnancy, is breech an issue?
Many home birth midwives suggest interacting with a baby at 30-34 weeks to encourage a head down position (vertex). After 32-34 weeks, chiropractic adjustments are suggested. The later in pregnancy a baby is breech, the more difficult it is for the baby to flip head down. The baby’s size grows in relation to the uterus and there is a smaller percentage of amniotic fluid for the baby to move freely in. Read More by clicking the link here.
When should I start maternal positions or body work to help my breech baby flip head down?
Before 30 weeks
Routine good posture with walking and exercise will help most babies be head down as the third trimester gets under way.
A 30-second inversion is good practice for everyone. Unless you have a medical reason not to, please consider the forward leaning inversion shown in the video clips under Inversion in the Techniques section of this website.
If you have a history of a car accident, falls, an uncomfortable pregnancy, hormonal imbalance or a previous breech or posterior baby, then begin the Inversion and body work before pregnancy or in early pregnancy.
Between 30-35 weeks
Use of maternal positions that put the mother up-side down can help a baby use gravity to flip. The breech tilt, other inversions or use of an inversion table are all possible options. The Open-Knee chest extends the mother's chin and I've changed my mind about that position. I like inversion positions that allow the mother to tuck her own chin. Myofascial workers tell me this relaxes her pelvis whereas extending the chin tightens the pelvis. This matches what we know about open-throated vowels sounds in labor (sounding or moaning in labor).
There is often enough amniotic fluid for an easy flip before 35 weeks. Gentle methods used in alternative maternity care will not force the baby. A few midwives recommend version (manually turning the breech baby to head down) at 30 –31 weeks. They find that there is less resistance from the uterus because there is more fluid and the baby is yet small. See my notes on version safety in this section. Bodywork is suggested for first time moms or women who had a difficult time with their first birth. If a previous baby remained either breech or posterior until birth, I suggest Bodywork throughout this pregnancy. Diligent use of maternal position is also more effective now then later in pregnancy, in my opinion.
Wed, Feb 11, 2009
"...I'm 30 weeks and the baby is what I'd describe as oblique breech - his head is on my right side next to my belly button, his hips/butt are in my pelvis on the lower left side (my left) and his feet are in front of his face. I think he's facing forward - towards my belly button. I've known this for weeks just because his big head is so hard I always bump that spot on accident.
.... my first son was 9 lbs and born posterior, so I'm really hoping this baby is in the ideal position for delivery... so both of these things make me nervous that he won't move. He has been in this position for a few weeks now. ...
Anyway, just wondering if I should worry and what, if anything, I can do to help him move now. My Midwife suggested a Chiropractor that can do some adjustments. I'd like to do the couch inversion too. Would it help for me to walk more? Also, should I sleep more on one side than the other?
Thanks for your help! Great site!"
It is common for babies to be breech at 30 weeks. However, now is a good time to take action, not so much that your baby is breech, but because your first baby was OP. You see, a pelvic misalignment and/or round ligament spasms (they often go together) can result in either a breech or a posterior fetal position. So, a breech will often flip to a posterior position and may stay that way unless you resolve the underlying issue.Maternal positioning is often not enough by itself to correct a posterior fetal position when there is a history of previous posterior or breech babies. While certainly, most breech babies flip head down, its beneficial to help correct the symmetry of your uterine ligaments now, while the baby is still small enough to have plenty of room to flip head down once the reason for the previous posterior position is remedied.
See some things a Chiropractor can do for breech and posterior by clicking on the title of Profession Help, under Techniques.
A uterine septum
An unusual exception to the “don’t worry” stance is when a woman has a uterine septum. (Remember, a septum is a vertical wall of tissue separating the womb into two parts. It can make the uterus into more of a heart shape.)
The baby will have to get head down while very small. We don't know what size that is because all each septum is a little different. It may be at 5 or 6 months along. A doctor may not succeed in manipulating the baby in to a head down position at 36 weeks if there is a septum. The baby may not be able to flip down after he/she gets to a certain size. Most women don't know they have a septum until after their first cesarean. It isn't that common, but it isn't really rare either. Alternative practitioners have some non-manipulating ways of helping, view “Professional Helpers" among the In Pregnancy articles.
Between 35 and 36 weeks
If you baby is breech during this time your doctor or midwife will begin to talk about how to help baby flip head down and possibly about scheduling a manual version for 36-37 weeks.
Getting bodywork and having acupuncture or homeopathy will help soften the ligaments and a tense uterus to either help the baby flip spontaneously or to allow more success in an attempt at a version.
During this time, you can continue with the suggestions in the "Professional Helpers for Fetal Positioning" article. Also, an obstetrician may suggest manually flipping the baby to a head down position at this time. (A few midwives will also offer this, perhaps earlier, at 30-34 weeks. But don't let someone manually flip your baby without using careful monitoring of the baby's heart beat. Accidents can occur even when their is good intention. The baby must be listened to and the version stopped immediately if the heart rate drops.)
You may also agree to go through with a cephalic version (the doctor manually turns the baby head down through your abdominal wall). I suggest getting Chiropractic, myofascial and acupuncture, homeopathy or moxibustion (or all) before the version. Financially this may not be possible, I realize. But see what you can do. The Forward-leaning inversion when done repeatedly and correctly over time may possibly help align the pelvis by correcting the utero-sacral ligament and its pull on the sacrum (one of several benefits of the Forward-leaning Inversion).
Sometimes a woman and her caregivers don’t know the baby is breech until this late. Rarely a baby flips breech this late in pregnancy. It may be the bio-physical ultrasound exam that discovers the baby is breech.
A External Cephalic Version may yet be tried and depending on the fluid level and the flexibility of the uterus, baby’s head position and location, a uterine septum, where the placenta is, etc. the version may yet succeed.
After the birth
While the concern about breech position is during the birthing, when the baby is breech for most of the third trimester, their skull bones become shaped by the inside of the upper womb (the fundus). Craniosacral therapy can gently reshape baby’s head, ideally during the month or two after birth, without using force.
Here is a note from a pregnant mother to her yoga teacher who referred her to use the Forward-Leaning inversion. Doing the inversion helped bring the baby's bottom out of the pelvis and the doctor was able to flip the baby manually:
Just wanted to thank you again for all of your support and insight -
And to let you know that we had the version yesterday at the hospital and it worked!!! We are so excited - and the procedure was really not that bad at all…
Just wanted to share the good news.
If the doctor can't get the baby head down by doing a cephalic version, a cesarean may be scheduled.
Some women will seek help for a vaginal birth. One of the factors in assessing the safety of breech vaginal birth is a baby that is born between 32 and 40 weeks. Of course, before 36 weeks the baby is too premature to be born other than at a hospital with a special care nursery.
Postdates with a breech (after your due date)
By 41 weeks the baby’s skull bones are setting up more firmly and a vaginal birth is less favorable. Besides, I would wonder why a mom with a breech wasn’t going into labor if she had been getting regular bodywork for weeks now.
After 41 weeks
For a head down baby, 41 weeks and 1 day is a common time for labor to begin on its own. With a breech, going all the way to 42 weeks may or may not be more of an issue. In a mother whose birthed before in a straight forward manner, a vaginal breech birth may still be safe. For a mother with a "sloshy" metabolism, I am inclined to transfer care to a kind hospital provider about 41 1/2 weeks. This is the mom who is a little overweight, slow metabolism, with little get up and go. This might be a classic low thyroid body type. On the other hand, many of the women who birth spontaneously have a classic lean look, does this indicate good or even hyper thyroid function? It would be interesting to know.
Here is a breech baby born gently, vaginally, in an American hospital at 42 weeks gestation.
Spinning Babies Parent Class
Soon pregnant parents around the world can take a Spinning Babies class from their own monitor! Join six couples and find out how Spinning Babies might enhance your labor and birth.
Real consultations with two couples right at our class location, one with a breech baby (head up) and one with a baby in a transverse lie (lying sideways).
A companion to Daily Essentials (below), Spinning Babies Parent Class goes beyond the basics. Simple props show complex concepts. Little-known anatomy is linked fetal positioning.
The section on labor discusses two labor patterns- the one "promised" in other books and the unexpected labor pattern associated with the posterior labor.
Learn techniques to help baby through the pelvis.
Empowering birth with practical know-how.
Filmed in Minneapolis at Everday-Miracles Pregnancy Center. This video is all Spinning Babies.
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Spinning Babies; Daily Essentials Video
Together Sarah Longacre, international prenatal yoga instructor and birth doula, and Gail Tully, yours truly, created a unique instructional video for flexibility and comfort in pregnancy and to support better fetal positioning in time for birth.
Here are daily activities for stretching and balancing a pregnant body. Start early in pregnancy to prepare to make the most space for baby's best birth position and the most ease for mother's opening during the birth process.
We begin the program for women of average flexibility (or just plain stiff to start with) and beginner tips. But soon, you'll be ready to move freely! That's when Sarah brings the stretches all together into her easy to follow, playful, sensual, and flowing "Blooma Style" daily routine.
Sarah's "dance of opening," moves joints and ligaments to come alive under the delightful melody and percussions of Carin Vagle. This isn't about core strength; its about freedom of movement and creating space in the body.
Sarah plays along with Gail's little game of "Flashlight" to show pregnant women how to evaluate their own posture and positions. Smart Maternal Positioning helps baby snuggle their backs into the front of the womb for Optimal Fetal Positioning.
Daily Essentials includes tips for using Maternal Positioning around the house. Actual scenes in the bedroom, living room and even the bathroom. Practical instruction like no other video. You will be sleeping more comfortably immediately when using these tips. Within a week or two many pregnancy discomforts of the pelvis and lower back may be reduced when all these nurturing techniques are integrated into your daily lifestyle.
Spinning Babies and Blooma Yoga-- a natural collaborative!
Blooma Yoga Prenatal Yoga for AM and PM
Warm up in the morning and cool down in the evening in two 30-minute sequences. Sarah Longacre shares her own blossoming pregnancy to the exquisite music of Carin Vagle. Sarah's affirmations will carry you through labor with emotional strength and encouragement. Bring your hormones into harmony with the day. Cool down at night with a sleep enhancing stretch before bed. This video is all Blooma! Blooma's AM/PM Yoga
All three videos are professionally produced by Melissa Koch of Grey Duck Productions, with stills by Tanya Villano Photography, each of these three videos are dynamic on their own. Together they will enhance your pregnancy and labor experience with fun and empowerment in the most practical manner. Feel hope for your birth abilities, this is support for your journey. Gain the confidence and flexibility to fully bloom. I believe these videos carry the potential to bring your best birth dreams into the gentle reality.
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