Breech deliveries carry a risk of more complications than a vaginal delivery. So, due caution must be exercised during breech deliveries.
The breech pregnancies are not dangerous until it’s time for the baby to be born. In the breech presentation, the baby’s feet or bottom is located at the opening of the uterus instead of the baby’s head. The head is the largest part of the baby that must fit through the birth canal. During a normal head-first delivery, there is a time during labor for the baby's head to slowly shape itself so that it can pass through the birth canal more easily. When the baby is in a breech position, the baby's bottom is the first to go through the birth canal. Once the bottom has been delivered, the baby’s belly, chest, arms, and head follow quickly. This does not allow enough time for the baby's head to shape itself to fit through the cervix (opening to the birth canal) and then through the birth canal. The cervix may close around the baby's neck and the baby’s head gets stuck inside the uterus. This eventually leads to the injury or death of the baby. In most cases, a planned cesarean delivery is the safest option for the baby when the fetus is still in a breech position near the due date.
There are several risks associated with breech presentation in both vaginal and cesarean births:
- Cord prolapse: Umbilical cord is squeezed as the baby moves down the birth canal. The squeezing of the cord slows down the supply of oxygen and blood to the baby.
- Movement: Baby may not move as easily through the birth canal, which can require the use of forceps or other tools.
The different types of breech presentations include:
- Frank breech: The baby’s bottom is down, and the legs are pointing up and near the head. This is the most common type of breech presentation.
- Footling breech: The baby is head up and has one or both of their legs hanging down.
- Transverse breech: The baby is lying horizontally in the uterus.
- Complete breech: The head is up, the bottom is down, and the legs are crossed.
- Oblique breech: The baby’s head is down but is pointed towards one of the mother’s hips.
What are the causes of breech delivery?
The most common causes of breech delivery include:
- The mother may have an abnormally shaped uterus
- Pregnancy is less than 37 weeks along
- They are part of multiple births (two or more babies)
- Too much amniotic fluid
- Not enough amniotic fluid
- Multipara (the woman has been pregnant before)
- Presence of uterine abnormalities, such as fibroids
- The placenta is covering either a part of or all the uterine opening (placenta previa)
What is the external cephalic version (ECV)?
A doctor may try to turn the baby into a head-first position using a procedure called an external cephalic version (ECV). During this procedure, the doctor may put pressure on specific parts of the bump to encourage the baby to move around in the womb. An ECV can be done from 36 weeks onward until early labor if the water has not yet broken. It is successful for some women. If successful, the mother will be less likely to need a cesarean delivery or other medical assistance during labor.