Baby Is Breech! Now What?

Why Does It Matter?

Why even try to turn a breech baby? Breech babies are more difficult to deliver safely with a vaginal birth. For this reason (and because the latest generation of doctors has very little experience with breech vaginal deliveries), most breech babies are delivered via C-section. C-sections are more expensive, have certain elevated risks, and usually involve a longer recovery, compared to vaginal births. If you don't want a C-section, you'll want to try to get your baby to turn.

Breech Presentation, Birth Defects, and Other Problems

Breech presentation is associated with many different types of birth defects. This means that studies have shown that many types of birth defects are more common in breech babies, compared to vertex (head-down) babies. Before you panic, please take a minute to think through the following two points:
  • By the time your doctor is concerned about breech presentation (the third trimester), you've probably already had one or more ultrasounds to check for most of the common birth defects. Chances are excellent that your baby is totally normal.
  • For many (probably most) of the birth defects, it is the birth defect causing the breech presentation, not the other way around. For instance, breech babies are more likely to have hydrocephalus, not because breech presentation causes hydrocephalus (it doesn't), but because the larger head in babies with the condition prevents the baby from settling into a head-down position.
Babies in the breech position have a higher risk for developmental dysplasia of the hip, a condition involving loose, easily dislocated hip joints. The risk is especially high for breech babies delivered vaginally (the risk is lower for C-sections). Although all babies should have their hips checked for developmental dysplasia, breech babies will be monitored especially closely for this problem. The good news is that this condition is treatable if caught early.
Similarly, breech babies may have a higher risk for torticollis -- a condition involving abnormally stiff neck muscles that can lead to an irregular head shape. Like developmental dysplasia of the hip, torticollis is quite treatable.
Sometimes, breech babies have very unusually shaped heads, although often, breech babies have beautifully rounded heads without the usual molding seen in head-down babies. Generally, this goes away with time. If the doctor is concerned, a quick ultrasound can be done to evaluate any unusual head shapes.
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