Breech Delivery
Breech Delivery Breech presentation is baby lying bottom first in the womb. It occurs in 3-4% of pregnancies. At term, after 37 weeks, if the baby lies in this position it may either be a matter of chance or there may be factors which prevent the baby from turning into head down position (vertex). Rarely, babies with certain defects are unable to turn into head down position before birth. Having said that, most breech babies are absolutely normal babies, just in a different presentation.
Factors associated with a breech presentation
- Too little or too much liquor / amniotic fluid
- More than one fetus in the womb (Twins/ Triplets / Quadruplets)
- Fibroids in the womb
- Preterm babies
- Low lying placenta
- Birth defects that prevent turning of the fetus
Options
- External cephalic Version (ECV)
An attempt made at changing the baby’s position from buttocks down to head down. This is usually offered between 36 to 38 weeks of pregnancy and is done by manipulation abdominally. The procedure is done in a set up where the facilities for an emergency cesarean delivery are available. Ultrasound guidance may be used for ECV. No anesthesia is required for this procedure. Fetal heart beat is monitored before, during and after the procedure. Should there be a problem, an immediate emergency cesarean delivery can be performed. - Cesarean Delivery:
Most breech babies are delivered by a planned Cesarean section, as the risk of complications to the baby occurring during a vaginal breech delivery is higher. - Vaginal Breech Delivery:
For some women, vaginal breech delivery is an option after a detailed discussion and thorough evaluation. It is important that your obstetrician is well versed with vaginal breech delivery and there are facilities for an emergency, cesarean section, if need be. Your baby’s exact position, birth weight, history of previous womb surgeries, adequacy of pelvis and a location of placenta will determine whether vaginal breech delivery is an option for you.
The various risks with vaginal breech delivery are as follows
- Baby’s head may get stuck. Since in breech delivery, baby’s breech and body are delivered prior to head, there’s a chance that the neck of the womb (cervix) is not stretched enough to deliver a baby’s head.
- Umbilical cord may come out before the delivery of head and any pressure on the same may compromise the blood flow to the baby.
- While handling the baby & trying to deliver the head in time, there may be fractures or damage to internal organs, more so, if the obstetrician is not experienced enough and the head is taking longer to deliver.
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