Breech Birth Health Article

Causes and symptoms

The cause of breech birth is not known. There are generally no identifiable symptoms. However, some women can tell the position of the fetus by where they feel the fetus kicking. Most women cannot tell what position the fetus is in at any given moment.

Diagnosis

A health care provider can often tell the position of the fetus by feeling it through the wall of the mother's

abdomen. Another clue to the position is the location where the heartbeat is heard best. If the fetus's heartbeat is best heard below the level of the mother's navel, it is likely to be positioned head first. On the other hand, if the heartbeat is best heard above the level of the navel, it is likely to be breech.

The only way to really be sure, however, is to do an ultrasound exam. Using this technique it is very easy to tell the position of the fetus.

Treatment

If a fetus is in the breech position in the last weeks of pregnancy, there are three possible courses of action: Cesare-an section, attempted version, or vaginal breech delivery.

Cesarean section is the most common way to deliver a breech baby. This surgical procedure carries more risk for the mother, but many women prefer to take the risk of surgery on themselves rather than let the baby face the risks of breech delivery.

Version is gaining in popularity. Version is a medical procedure in which the obstetrician tries to turn the breech fetus to the head first position. Version is successful more than 50% of the time. However, some babies who are successfully turned will turn back to the breech position after the procedure is done.

Some women choose breech vaginal delivery. This should only be attempted if ultrasound shows that the fetus is in a favorable breech position. Most babies will do very well during a breech delivery, but it is always possible that the fetus will be injured, perhaps seriously.

Prevention

There is no way to prevent a fetus from settling into the breech position at the end of pregnancy. A woman who has had one breech fetus is more likely than average to have another.

Amy B. Tuteur, MD

BOOKS

"Techniques for Breech Delivery." In Williams Obstetrics. 20th ed. Ed. F. Gary Cunningham, et al. Stamford: Appleton & Lange, 1997.