Ways to Turn a Baby in Breech Position
What is breech?
Breech position during pregnancy is when the baby is in an upright position, meaning bum down and head up. For a vaginal delivery, the goal is to have the baby to be head down, bum up. By the end of the second trimester, around 25% (1) of babies are in a breeched position. However, there is still plenty of time for the baby to turn during the remainder of the pregnancy, and as the end draws near, that number declines to 3-4% (1). The baby tends to flip naturally due to the shape of the uterus which when unhindered, resembles that of an upside-down pear. Because of this, as the baby’s head gets heavier while they develop, gravity aids the baby in turning. When he/she doesn’t turn, this is due to the lack of space available for them to do so.
Causes of space insufficiency:
This lack of space is caused by ligaments, muscles, and bones around and attached to the uterus that are too tight and deform or limit the uterus. Usually, a round ligament is tighter on one side and it pulls on the uterus which can cause it to tip or twist. Additionally, when a woman’s abdominal muscles are tight, which is more common in the first pregnancy, it limits the mobility of the baby and makes it difficult to find the space to turn. The opposite is also true - if the abdominal muscles are too loose as they more commonly are after multiple pregnancies, and the womb cannot be supported as well, it can lead to a more rounded uterine shape and doesn’t encourage the baby to turn. Another cause of space insufficiency is having tight muscles in between the ribs as there is no room to expand when those muscles won’t allow it. Also, if the piriformis and/or other butt muscles are tight, there again is a lack of room for expansion and for the baby to turn.
The Webster Maneuver:
Chiropractors can help make space for the baby through pelvic bone manipulations focusing on the sacrum. The Webster Maneuver is a method used by chiropractors to release tight round ligaments through massaging and stretching the sacral area and the round ligaments. This maneuver uses pelvic biomechanics and sacral analysis and is fairly successful (82%) (2) in giving the baby more space to move head down into the desired position.
What do PT’s do?
The role a PT plays to help turn a breeched baby is with the soft tissue. A PT will help you by working on your round ligament mobility, encouraging pelvic alignment through sacral exercises such as gluteal foam rolling, and encouraging pelvic floor muscle release. There are a few embedded videos to the left that show exercises you could try at home.
Utilize the dynamic duo of a Chiropractor and PT!
It would be beneficial to take advantage of both a chiropractor and a women’s health PT to help turn your breeched baby. The links below will take you to sites where you can find a Chiropractor and/or PT near you.
What else can you do at home to turn your baby?
A few ideas are listed below that you can try at home to help your baby turn.
tight abdominals- 1st time mamas (Triangle stretch in yoga)
Check your posture with the baby –
Standing: Ribs above hips and decrease the arch in the lower back through out the day by doing pelvic clocks
Sitting: keep knees lower than hips to make room for your baby
Sleeping: sleep by keeping your knees together, flex knees closer to your chest while also keeping your spine in a neutral position
Avoid wearing a bra if your ribs are tight (you don’t want any added constriction) and take deep breaths to allow your ribs to expand
Loose abdominal muscles – wear a pregnancy band
There are also some old wives’ tales that women try… keep in mind that there isn’t much evidence to support these methods, but they could be worth a try!
Put a cold compress at the top of your bump and a warm compress at the bottom.
Walking barefoot in grass to ground yourself and telling baby you are ready to meet he or she
Play music at the bottom of your bump to encourage the baby to want to move its head there.
Drink juice (often orange juice is recommended); the spike in sugar is supposed to get the baby moving.
Spinning babies also has a TON of of resources. It was created by a doula that has helped many babies head south.
Exercises to try at home to turn your baby!
Pelvic Tilt: Go into a quadruped position and flatten your back by tucking your bum underneath you.
Side Lying: Lie on your side on an elevated surface and drop your top leg off to stretch that round ligament.
Standing Pelvic Tilt: Lean forward on a chair/counter and flatten your back by tucking your tailbone under then relax.
Knees side to side with towel for sacrum: Place a towel under your butt and move your knees side to side.
Glute Foam Rolling: Grab a roller and start rolling. Change your angle to find those spots that really need it.
Pelvic Floor Stretch: Lie on your side and insert your hands between your sitz bones, pull up.
Sacrotuberous Ligament Massage: Take some lotion and massage from your sacrum down towards the sitz bones.
Inversion on Couch or Chair: Put your knees onto an elevated couch or chair and walk your hands out, putting your weight onto your elbows. Hold this position for a few minutes.
NOTE*** Do not do inversions if you have high blood pressure.
Ironing Board Inversion: Using an ironing board or a 2-by-4, lay flat on your back and stay there for a few minutes.
References
Spinning Babies. “Helping Your Breech Baby Turn - EBook.” Accessed May 20, 2021. https://www.spinningbabies.com/product/helping-your-breech-baby-turn-ebook/.
Pistolese R. A. (2002). The Webster Technique: a chiropractic technique with obstetric implications. Journal of manipulative and physiological therapeutics, 25(6), E1–E9. https://doi-org.ezproxy.library.wisc.edu/10.1067/mmt.2002.126127