Breech Birth Health Article

Definition

Breech birth is the delivery of a fetus (unborn baby) in a bottom- or foot-first position. Between 3 to 4 percent of fetuses start labor in the breech position, which is a potentially dangerous situation.

Description

Throughout most of pregnancy the developing fetus is completely free to move around within the uterus. Between 32 and 36 weeks, however, the fetus becomes so large that movement is restricted. It is much harder for the fetus to turn over, so whatever position it has assumed by this point is likely to be the same position that he or she will be in when labor begins.

For reasons that are not fully understood, almost all unborn babies settle into a head down, or vertex, position. The fetus is upside down in the uterus, and the head will dilate the cervix (or vaginal opening) and lead the way during the birth process.

Some fetuses, however, present in a breech position. There are three breech positions: frank, complete, and incomplete. In a complete breech, the buttocks lead the way out of the uterus, and the legs are folded in front of the body. A frank breech baby also has his buttocks down, but his legs will stretch straight up with his feet by his head. An incomplete breech, also known as a footling breech, presents with one or both legs down so that the feet drop into the birth canal at delivery.

Of course, many babies are safely delivered from the breech position. There are certain factors that make a breech delivery more likely to be Successful; if ultrasound (a technique that uses sound waves to visualize the fetus) shows that the fetus is in the frank breech position, the fetus's chin is tucked on its chest, and the fetus is not big, it is more likely that an uncomplicated breech delivery is possible.

The biggest part of the fetus's body is usually its head. If the head fits through the mother's pelvis, then the rest of the fetus's body should slip out fairly easily. In addition, when the baby's head comes first, the soft bones of the skull "mold" to the shape of the birth canal during labor (which is what gives newborns that cone-headed appearance). If the fetus is born bottom first, it is possible that the body will fit through the mother's pelvis, but the baby's head will get stuck at the level of the chin. This condition, known as a entrapment, has the potential to cause serious injury to the fetus, and surgical intervention may be required to complete the birth.

There is also a possibility of umbilical cord prolapse with a breech birth. The baby continues to get its oxygen supply from its mother exclusively from the blood in the umbilical cord until the head is delivered and baby breathes on her own. In some cases of breech birth, part of the umbilical cord enters the birth canal before or with the baby's feet or buttocks and pressure on the cord cuts off the blood and oxygen supply. This situation is known as cord prolapse.