Having a baby can be one of the most joyous experiences for any mother. While many women hope for a vaginal delivery, pregnancies can sometimes come with complications that may require other forms of delivery. One of these complications, breech presentation, occurs in almost 4% of full-term pregnancies (Cruikshank, 1986). A breech pregnancy can occur for a number of reasons, some of which we will discuss below.
What is Breech Presentation?
Breech presentation is when the baby’s buttocks and/or feet, instead of its head, are closest to the mother’s cervix. The baby can be in either of the following three breech positions:
- Complete: The baby is in a fetal position with the knees bent
- Frank: The baby has both legs extended
- Incomplete: The baby has one knee bent and one leg extended
All babies are technically in a breech position during their first weeks of development. When the head of the baby becomes more developed and is heavy enough to weigh itself down, the baby will naturally turn to the cephalic position. Unfortunately, there are some uterine issues that prevent the baby from turning that may cause serious neonatal complications if delivered vaginally, such as restricted fetal growth (Macharey et al., 2017).
Sometimes, the placenta is blocking the cervix or is too big that it occupies too much of the space in the uterus. This keeps the baby from having room to turn on its own. At Naturna, we have even seen an umbilical cord wrapped around the baby’s neck, preventing it from turning head-down. The shape of the mother’s pelvis can also affect the baby’s mobility. An abnormally shaped pelvis can alter the shape of the uterus, creating more difficulty for the baby to move around (Cruikshank, 1986; Macharey et al., 2017).
Conventional Practices for a Breech Birth
The most common courses of action taken by doctors is to perform an External Cephalic Version (ECV) and/or a Cesarean section (C-section). First, an ECV is performed by an obstetrician when the mother is around 37 weeks pregnant to potentially rotate the baby head-down. This is done through a process of massaging the belly of the mother to attempt to move the baby. Before the procedure has begun, the obstetrician may give you an injection of tocolytic medicine to relax the uterus. While this procedure is considered beneficial, there have been some reported complications such as fetal heart-rate abnormalities. Just in case anything goes wrong, an ECV is performed in the labor and delivery unit with an operating room always available. Some cases, though very few, lead to an emergency C-section delivery (Grootscholten et al., 2008).
The C-section is the recommended alternative delivery approach when a baby is still in a breech position at full-term. A C-section is a surgical procedure in which the obstetrician delivers the baby by making incisions into the mother’s abdomen and the uterus, and removing the baby from the uterus. While this is the recommended procedure to prevent and/or reduce neonatal complications, there are some risks for the mother. It is possible for the mother to experience heavy blood loss, nausea, infection, and, very rarely, mortality.
Being pregnant can naturally be a stressful life event. To lower stress levels and reduce the need to take the route of an ECV or a C-section, we provided some great preliminary options to rotate the baby naturally.
Acupuncture/Moxibustion for Breech
In Chinese medicine, it is believed that the BL 67 point, zhiyin, located on the outer side of the pinky toe has a connection to the uterus, and is used to treat uterine complications such as breech presentation. The practice to turn a baby using the zhiyin point is by applying smoke of moxa sticks to the point for 20 minutes, which then triggers movement of the baby. Current research has shown that when moxibustion accompanied with acupuncture is applied consistently starting when the mother is 33-35 weeks pregnant, breech presentation at term is reduced, eliminating the need for an ECV or a C-section for many women (García-Mochón et al., 2015; van den Berg et al., 2010; Vas et al., 2012). Not only has there been plenty of research conducted showing significant results using acupuncture with moxibustion to turn breech babies, we’ve also had success at Naturna! Patients have written us explaining how shocked they were when they felt their baby start to move every time moxibustion was applied to the zhiyin points on both feet.
Another intervention that can be done while getting acupuncture is doing prenatal yoga. Many prenatal yoga centers recommend doing the child’s pose, the supported bridge pose, or the prolonged inversion which is similar to the downward dog. It is important to avoid squatting while the baby is in breech presentation, as this allows the baby to sink further down when the pelvis widens. We highly recommend checking out your local prenatal yoga center, so that a professional can help you with the different poses and to make sure your posture is correct.
We recently interviewed Dr. Isabel Blumberg about her integrative approach at her obstetrics and gynecology practice. Watch our interview to hear Dr. Blumberg discuss complementary modalities, and why she recommends acupuncture!
If you would like to learn more about breech presentation and the research behind it, or would like to look at the research studies used in this article, please contact us at [email protected] or at 646-609-4250. We look forward to hearing from you!
Cruikshank, D. P. (1986). Breech presentation. Clinical obstetrics and gynecology, 29(2), 255-263.
García-Mochón, L., Martín, J. J., Aranda-Regules, J. M., Rivas-Ruiz, F., & Vas, J. (2015). Cost effectiveness of using moxibustion to correct non-vertex presentation. Acupuncture in Medicine, acupmed-2014.
Grootscholten, K., Kok, M., Oei, S. G., Mol, B. W., & van der Post, J. A. (2008). External Cephalic Version–related risks: a meta-analysis. Obstetrics & Gynecology, 112(5), 1143-1151.
Macharey, G., Gissler, M., Rahkonen, L., Ulander, V. M., Väisänen-Tommiska, M., Nuutila, M., & Heinonen, S. (2017). Breech presentation at term and associated obstetric risks factors—a nationwide population based cohort study. Archives of gynecology and obstetrics, 295(4), 833-838.
van den Berg, I., Kaandorp, G. C., Bosch, J. L., Duvekot, J. J., Arends, L. R., & Hunink, M. M. (2010). Cost-effectiveness of breech version by acupuncture-type interventions on BL 67, including moxibustion, for women with a breech foetus at 33 weeks gestation: a modelling approach. Complementary therapies in medicine, 18(2), 67-77.
Vas, J., Aranda-Regules, J. M., Modesto, M., Ramos-Monserrat, M., Barón, M., Aguilar, I., Benítez-Parejo, N., et al. (2013). Using moxibustion in primary healthcare to correct non-vertex presentation: a multicentre randomised controlled trial. Acupuncture in medicine, 31(1), 31-38.