Doula Digest - Turning a Breech Baby

Posted by Kim:

I have a doula couple who are very excited about the arrival of their little one, but as of week 37 the baby is still breech (head up and feet down). My clients are being very realistic about the whole situation, but until the day they HAVE to have a cesarean birth, they are going to try everything to turn the baby. However, they are not interested or at this point willing to try an external aversion. So I have been doing some research trying to help them with suggestions about what they can do to try and get the little one get into position.

In order to gather information I searched on the internet, requested information from my Twitter following and most importantly consulted with two of my doula mentors. I am so blessed to be surrounded by so many wonderful, giving, experienced doulas! It sure makes being a new doula easier and makes me feel a lot more confident knowing that I have so many people I can turn to.

Anyway, when I searched the internet I found the Natural Pregnancy Project website and their 15 suggestions and was referred to the Spinning Babies website by my twitter friends and most informational a good doula friend sent me the information below that she has acquired through research and experience.

POSSIBLE REASONS FOR BABY BEING IN BREECH PRESENTATION

§ Low-lying placenta
§ Short or tangled cord or around the neck
§ Fibroids
§ Small baby with lots of room to move around
§ Polyhydramnios
§ Emotional reasons

STRATEGIES FOR HELPING BABY TURN IN UTERO

The following are some “tricks of the trade” used to help mothers encourage their babies to turn to a head-down presentation in preparation for delivery.

As you can see from the list above, at times the baby cannot turn due a medical complication. The methods described below are considered harmless ways of getting baby to turn, but there may be good reasons why your baby can’t. So please do not be discouraged if baby doesn’t turn, it may be the best possible outcome.

INCREASE FLUID INTAKE
Drink lots of fluids (water, milk, juice) because if the amniotic fluid is low and baby is less likely to turn.

SWIMMING FREQUENTLY, HANDSTANDS IN POOL
It has been proven that submersion in water for 10 days in a row can greatly increase amniotic fluid. Swimming frequently, for at least 45 minutes at a time, fully submerging the body, and turning in the water, and especially doing handstands in deep water have been especially helpful in helping stubborn babies to turn.

USE GELATIN RECIPE TO INCREASE ANIOTIC FLUID
Take a package of Knox gelatin, mix it with warm apple juice or water per directions, and drink the fluid after it cools down, but before it starts to gel (somehow, the gelatin helps the amniotic fluid increase). She can also substitute the knox brand for more natural type gelatins. If this doesn’t work for the baby, you will have beautiful hair and nails anyway!

SENSORY ATTRACTIONS/ REPELLENTS
Sensory attractions for the baby have also worked to help babies turn in utero.

This works by directing music (perhaps headphones or a small speaker) or light to where you want the baby’s head to be. Play soothing music such as lullabies or classical music on the very low belly near the pubic bone to entice the baby towards it. Some women have put a source of light between their legs in a dark room to attract the baby lower down.

Putting a bag of frozen veggies such as peas or corn several times a day on the fundus (top of the uterus) the current location of the baby’s head is may make the baby try to scoot away from it. A warm blanket over the lower belly and pubic bone are helpful. This can also be done in a warm bathtub – the baby may turn away from the cold toward the warmth

Perhaps a noise or vibration near the baby’s head can get it to turn away and down. Annoy that baby!

USING GRAVITY TO HELP BABY CORRECT ITS POSITION
Set up your ironing board against a bed or sofa, and use it to support your lower body, while you have your hips elevated above your chest (head on floor, butt in air on board). Lying tilted upside-down this way several times per day can relieve the pressure on your cervix, and help baby to flip. This is known as Dr. Souza's method or exhagerrated trendelenburg). You can also try it with 3 pillows under your bottom for 10 minutes twice a day with an empty stomach. Also kneeling and getting into a “floor-kissing” position, with your butt in the air is an alternative pose. Yoga exercises (such as sitting in the tailor position) can also prove helpful.

VISUALIZATION
Search for emotional reasons, such as fear of delivering vaginally or fears of imagined dangers, and do not hesitate to discuss these with your doula.

Visualizing the baby turning can relax the necessary muscles and ligaments to do so.

ACUPUNCTURE/ MOXIBUSTION
Here is some information kindly provided by local doulas, regarding accupuncture methods for assisting breech mothers:

“My best understanding of what moxibustion is: The Acupuncturist inserts a fine needle into any spot they feel it is necessary (depending on the condition they are treating). To enhance the effect of the acupuncture, they put a substance that looks like bits of sticky sponge on the end
of that same fine needle. Then they light it on fire. It sort of burns like a cigarette. The burning substance heats up the needle and causes an increased effect of the acupuncture. Another way they can do it (and our acupuncturist did it) is to remove the needle and do "direct moxibustion".
In this, she put a tiny chunk of the moxi (the spongy substance) directly on the client's skin (again on those same spots on her toes). Then, she lit it on fire. It sort of burned like a cigarette butt would and when the client said, "It's hot" the acupuncturist IMMEDIATELY pinched it off with her fingers. Then, did it on the other toe and repeated this process for a total of about 10 minutes. It usually only took about 4-5 seconds before it was "hot" to the client.

To turn breech baby: The spot is lower outer quadrant of your baby toe toenails on the skin.”

HOMEOPATHY
Homeopathic pulsatilla has been known to assist babies in flipping. For doses, or to discuss the ins and outs, talk to herbalists.

EXTERNAL VERSION
An MD can do external version, using ultrasound to physically turn the baby. They do this by palpating your abdomen with their hands. They will not do it, if they feel it is unsafe. Some midwives are also very skilled in external version.

CHIROPRACTOR: WEBSTER TECHNIQUE
Here is a description from the industry of the Webster In-Utero Constraint Technique:

Chiropractic care benefits all aspects of your body’s ability to be healthy.

This is accomplished by working with the nervous system—the conduit of intelligence between your brain and body. Doctors of Chiropractic work to correct subluxations (misalignments) of the individual spinal bones. When subluxated, these bones put pressure on the spinal cord and the spinal nerves causing malfunction in any part of the body.

One such malfunction may be the tightening of pelvic muscles and ligaments producing uterine constraint. It is these tense muscles and ligaments and their constraining effect on the uterus which prevent the baby from comfortably assuming the vertex (head first) position. The Webster In-Utero Constraint Technique is a specific chiropractic analysis and adjustment used to correct subluxations in the pregnant mother’s sacrum and pelvis. This relaxes the mother’s muscles and ligaments, providing the physiological environment necessary for normal baby positioning.

Dr. Larry Webster, Founder of the International Chiropractic Pediatric Association developed this technique as a safe means to restore proper pelvic structure and function for pregnant mothers. In expectant mothers presenting breech, there has been a 75-95% success rate of the baby turning to the normal vertex position. Most commonly known for its success in turning
breech babies, any position of the baby other than vertex may indicate the presence of subluxation and in-utero constraint. It has been strongly recommended by Doctors trained in this technique, that the specific analysis portion of this technique be used throughout pregnancy, to detect subluxations and prevent in-utero constraint.

Because of the effect the chiropractic adjustment has on all body functions,

all pregnant mothers should have their spines checked regularly throughout pregnancy, optimizing health potential for themselves and their developing baby. Yes, chiropractic care from conception and continued after birth for both mother and child has given many families an opportunity for greater health.

WAITING
Finally, by simply waiting, some babies turn on their own. It can not be over emphasised that some babies have too short a cord to turn, or can not turn for a variety of reasons that make the breech position safer.

ON DELIVERING A BREECH BABY VAGINALLY

For a beautiful example of a vaginal breech delivery with no interventions, check this website. The mother delivered a BIG baby over an intact perineum (no tearing or instrument delivery!)

Birth Diaries

ADDITIONAL RESOURCES

WEB SITES:

http://www.mother-care.ab.ca/rebozo.htm

www.epregnancy.com

http://www.birthdiaries.com/diary/47vbirth.htm

BOOKS:

Jean Sutton's book, Optimal Fetal Positioning

Breech Birth, Woman Wise, by Maggie Banks.