If your baby is in a frank breech position, their bottom is positioned down towards the birth canal instead of their head. In a typical vaginal delivery, the presenting part—the part of the baby that emerges first—is usually the head. However, in some cases, the baby’s bottom or feet may be the presenting part, leading to a breech presentation. The frank breech is one of the most common types of breech presentations.
In this guide, we’ll explore various types of breech positions, their causes, treatment options, and what to expect during a breech delivery.
Types of Breech Positions
Babies can assume different positions in the womb, but most will naturally turn head down as delivery approaches. Despite this, breech presentations can occur. The frank breech position is where the baby’s bottom is down and their legs are extended upwards with the feet near their head. This position is the most prevalent among breech births, occurring in 50% to 70% of breech cases at full term.
Complete breech is another type where the baby’s bottom is down, but their knees are bent and feet are near their buttocks. About 10% of breech births fall into this category.
Incomplete breech, also known as footling breech, involves one or both of the baby’s feet presenting first. This position makes up approximately 25% of breech deliveries.
Identifying a Breech Baby
As your pregnancy progresses, your healthcare provider will monitor your baby’s position closely. Several methods are used to determine if your baby is breech. One way is by assessing where you feel the baby’s kicks. If you notice kicks in your lower pelvis, this may indicate a breech position, while kicks higher up suggest the baby’s head is positioned downward.
Another method is palpation. During your prenatal visits, your doctor or midwife will feel your abdomen to locate the baby’s head, back, and bottom. The position of the baby’s heartbeat can also provide valuable clues about their orientation.
For the most accurate information, an ultrasound is the most effective tool. It offers a clear picture of the baby’s position and can confirm if they are in a frank breech position or another type of breech presentation. Finally, during labor, a pelvic exam can help verify the baby’s position by feeling if their head or bottom is in the birth canal.
Causes of Frank Breech Presentations
Several factors can contribute to a baby being in a breech position. Prematurity is a common cause, as premature babies have more space to move around in the uterus, increasing the likelihood of a breech presentation.
Multiple gestations also play a role. Twins or other multiples may not have enough space to turn into the head-down position as delivery approaches. Uterine abnormalities, such as fibroids or a heart-shaped uterus, can obstruct the baby’s ability to turn.
A short umbilical cord can limit the baby’s movement, while amniotic fluid levels—whether too high or too low—can affect the baby’s ability to turn. Additionally, placenta previa, where the placenta covers the cervix, can hinder the baby’s turning. Lastly, congenital abnormalities may prevent the baby from assuming the head-down position.
Treatment Options for Breech Presentation
If your baby is breech, there are several potential approaches. Natural turning is possible early in pregnancy, with a chance that the baby will turn to a head-down position on their own.
If the baby remains breech by the 36th or 37th week, your doctor might attempt External Cephalic Version (ECV) to manually turn the baby. ECV has a success rate of about 60%.
If the baby remains breech close to delivery, a Cesarean section is often recommended. However, some doctors may consider a vaginal delivery for a frank breech baby if specific conditions are met, such as having emergency resources available and continuous monitoring throughout the delivery.
Potential Complications of Breech Birth
While many breech babies are born healthy, breech deliveries come with some risks. Umbilical cord prolapse is a potential issue where the cord might slip ahead of the baby during a vaginal breech delivery, potentially compromising the baby’s oxygen supply.
Head entrapment can occur if the baby’s head gets stuck when the cervix hasn’t fully dilated, posing significant risks. Breech deliveries can also increase the risk of physical injuries to the baby, including bruising, fractures, and developmental dysplasia of the hip (DDH).
Furthermore, vaginal breech deliveries might require interventions like an episiotomy, leading to possible injury to the birthing person. It’s essential to consider these factors when planning for a breech delivery and to consult with your healthcare provider to ensure the safest approach for both you and your baby.
Conclusion
If your baby is in a breech position, it’s important to work closely with your healthcare provider to determine the best course of action for delivery. While a frank breech presentation might allow for a vaginal birth in some cases, a C-section is often the preferred method to ensure the safety of both mother and baby.
Therefore, understanding the various breech positions and their implications helps us in preparing for a smoother delivery. It always consult with your healthcare team to make informed decisions about your birth plan.
