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Third Trimester Pregnancy: Breech

October 30, 2020


“What if your baby decides to be feet down or bum down and not in the normal sephalic or head down position? Well, most babies will spend some of their time in the breech position with their bum or their feet down, but usually by 32 to 36 weeks, babies will have made that transition to head down and they’ll usually start to grow big enough that they won’t switch around or somersault any longer after about the 36 week mark. So you’ll notice when you go to the doctor in the third trimester, which is that latter third of pregnancy, that the doctor will start to record whether your baby is head down or maybe transverse, which means sideways or maybe breech, which means bum down or feet down and head up. And when the baby is in the position with the head up, then we need to start to think about delivery.

And is the baby going to deliver in that breech position? Or are you going to need a C-section to deliver that baby? So we don’t worry too much until 36 or 37 weeks as we get closer to delivery, but at full term, which is around the 37 week Mark, if the baby’s still in a breech position, your Dr. May talk to you about what’s called an external cephalic version. And that’s where they gently attempt to move the baby from head up to head down, to get that baby back in position so that it can have a head down. So phallic vaginal delivery, often and external cephalic version won’t work, and the baby will stay in a breech position all the way till your due date. And some of the things you need to be thinking about in that situation is for example, if the water breaks and the feet or bum are down, sometimes the umbilical cord can come down and that would be an emergency because if that umbilical cord comes out before the baby, it can be compressed in the birth canal and it can cut off the oxygen supply to the baby.

That’s why being in a breech position makes it a little bit higher risk and more important to be monitoring for things like your water breaking or going into preterm labor or having contractions, because you’d want to get to the hospital sooner. If you were in a breach, if your baby was in a breach presentation. Now, the other thing to think about is, although some doctors will do breech vaginal deliveries, there is a lot of indication that sometimes that can be more dangerous for the baby. Um, sometimes it’s more dangerous because the head is the biggest part and if the bum and the legs and the, the abdomen and the thorax all come out, but the head is still left behind. It can sometimes lead to a reduction in oxygen for the baby because of the umbilical cord, which is already out the birth canal is getting compressed.

So there are only certain indications and certain, very experienced healthcare providers who are trained in vaginal breech deliveries, who would be willing to do a vaginal breech delivery. And if you’re interested in a vaginal breech delivery, it’s really important to have that lengthy and very cautious conversation with your healthcare provider about the pros and the cons of a vaginal breech delivery versus a cesarean section for a breech delivery. And those are the kinds of conversations that you will want to have well before you’re in the labor and delivery room, but all in all, having a baby in a breech position does not necessarily mean that there’s anything wrong with the baby or that anything is going to go wrong with your labor and delivery. It just means that we need to be a little more cautious about how that baby is going to be delivered and what you and your healthcare provider decide is best.”

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