Breech Pregnancy

A breech pregnancy when the baby is lying feet first with their bottom downwards.

A breech pregnancy when the baby is lying feet first with their bottom downwards, and a transverse pregnancy is when the baby is lying sideways. This would require close monitoring and you may be advised to give birth in hospital.

Is it normal?

Most babies twist and turn. This is perfectly normal and nothing to worry about. It is very common to have a breech or transverse positioned baby during early pregnancy and for the baby to have settled into a different position by the time labour begins. However, this doesn’t always happen.

How do you turn a breeched baby?

If your baby is breeched, your obstetrician may offer you an external cephalic version (ECV). This is when the obstetrician tries to maneuver the baby into a head down position by applying pressure on your abdomen. When performed by an experienced gynaecologist obstetrician, this procedure is completely safe and the woman will not experience any pain. ECV is successful in more than 50% of cases, allowing the woman to deliver by normal vaginal delivery. If the procedure becomes uncomfortable for the woman, it should stop immediately as further interference may lead to Placental Abruption.

If the ECV does not work, it is still possible for breeched babies to be delivered vaginally but cesarean section may be recommended.

In which situations will I need a cesarean section?

  • It is your first breeched baby
  • Your baby’s feet are below its bottom
  • Your baby is more than 3.8kg or 8.4lbs
  • Your baby is less than 2kg or 4.4lbs
  • Your baby is premature or you are having twins
  • Your baby is in a certain position (e.g. if their neck is tilting backwards)
  • You’ve had a cesarean section delivery before
  • You have a narrow pelvis
  • You have low-lying placenta
  • You have pre-eclampsia

Transverse Pregnancy

If your baby remains in the transverse position by the third trimester, there is a small risk that the umbilical cord will prolapse if your waters break. If this happens, it is a medical emergency- the umbilical cord will have exited the uterus before the baby, leaving it with no oxygen supply or source of nutrients, and the baby must be delivered very quickly by cesarean section.

To prevent this, your gynaecologist might attempt to maneuver the baby using ECV or admit you to hospital so that you will receive the fastest, safest care possible.

All babies in the transverse position at the time of labour should be delivered by cesarean section. However, some physicians use internal cephalic version, which must only be performed by highly experienced gynaecologist obstetricians when the woman is FULLY dilated.

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