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Ask A Childbirth Educator
Questions and Answer

Q. At this very moment she is in the hospital where her OB is going to try and reposition the baby. How effective is this and can you give me some insight as to how that is going to affect the baby, her, and what her chances are of having a vaginal birth now. I'm in the dark and very worried.

A. The procedure is known as an external version, and the OB is performing it relatively early enough that it will likely be successful. External version usually will not affect her or the baby, though sometimes women have sore abdomens afterwards. During the procedure the baby's heart is monitored to make sure he is handling the version well. (when babies aren't happy, their heart rates react--this is why practitioners listen all the time) If the baby seems distressed during the version, the procedure will be abandoned. In essence, the OB monitors the baby's heart rate and the position of the placenta by ultrasound, as he applies pressure to the baby's head and butt to encourage him to turn.

There are some other ways to help turn a baby who is breech:

• Lying on a slant board with your hips higher than your head twice a day for 15 minutes.
• Lie on your back with your hips propped on three or four pillows and massage your belly gently, telling the baby to turn.
• In the breech tilt exercise, the mom takes an ironing board, pads it well, props one end up on the couch, and lays on it head down. She relaxes and gently starts trying to push the baby into proper position, by placing one hand on the baby's head, and one on it's breech. The key here is gentle encouragement---you do not force the baby to turn in any way. If the baby does flip, mom quickly gets up, squats and takes a walk, to try and settle the baby further into the pelvis. It has been reported that often by the fourth day of this exercise, baby will turn in anticipation of the exercise.

Having a breech baby vaginally is wholly dependent on the practitioner's experience. If your daughter wants to have her baby vaginally if it is breech and her OB does not do vaginal breech deliveries, she might need to call around to find a doctor or midwife skilled in delivering breeches. A term breech baby is less likely to have complications than a premature breech baby, but the very mechanics of the birth require an experienced practitioner who knows how to be patient. Mismanagement of a breech is often the cause of complications of the newborn, so trying to convince your practitioner to deliver a breech vaginally when they are not comfortable with it is foolhardy. Better to find a practitioner who is experienced and willing to assist a breech.

If the baby turns head down, there is no reason why she should not be able to have a vaginal birth.

Karen Klimsak-Ungar, CCE has been a certified childbirth educator for Birth Works® since 1996. She is currently Managing Editor for the Birth Works newsletter, sits on the Birth Works Board of Directors, and serves on their National Trainee Review Committee. A happily married mother of two, she also continues to teach Birth Works classes as well as private classes.

Karen will answer your questions on fertility, pregnancy, birth, breastfeeding and babies. Her advice does not take the place of your practitioner. Personal answers will not always be possible.