According to the Federation of Midwifery Associations of Spain, in almost a four percent of full-term pregnancies the baby is breech. This news, which falls like a jug of cold water to the future mother, usually communicates in the last ultrasound that is performed in pregnancy, and sometimes begins to talk about a scheduled C-section if the baby does not turn on time.
But according to the latest published studies, the vaginal delivery when the baby comes from buttocks should be the first option to shuffle before the scheduled caesarean section, as long as a series of requirements are met.
Requirements to try a vaginal delivery with the baby's buttocks
In 2011, the Spanish Society of Gynecology and Obstetrics (SEGO) published a Assistance Protocol for term breech delivery, where we can read the following conditions that must exist for a safe delivery:
Vaginal delivery can be attempted in cases of a fetus with adequate fetal intrauterine growth and an estimated weight of less than 4 kg.
He childbirth must progress adequately.
The attitude of the fetal head should be flexed or indifferent, (in no case can the baby be looking up). This is determined by ultrasound or radiography once the delivery has been triggered.
The baby must be in pure buttocks position (with the legs up, the ass embedded in the birth canal) or full buttocks (both feet in the birth canal).
If we assess the recommendations of the American Obstetrics Association to opt for vaginal delivery in case of breech presentation, we find the following indications:
The baby must be full term and in presentation of pure buttocks.
The baby do not show signs of fetal distress and your heart rate should be monitored closely.
Childbirth should progress properly.
The baby shouldn't be too big For the mother's pelvis.
It is important that the anesthesia be available to be able to opt for an emergency C-section if it becomes necessary.
The respected labor association, "Childbirth is ours," also published a detailed article on term pregnancies in which there is poor fetal position, and the recommendations to follow to opt for a natural birth when the baby comes from buttocks.
In a fragment of this article we can read the following conditions that according to Dr. Emilio Santos must be met for opt for a safe buttock delivery:
He beginning of labor should be spontaneous and not provoked;
Hamilton maneuver (or rupture of membranes) must not be done to cause it;
If the woman does not dilate properly when there are still no birth criteria, it should be expected (as should be done in any birth);
If the woman is clearly in labor but does not progress properly, a cesarean section should be performed;
Restrict vaginal exams to a minimum to minimize the risk of membrane rupture before the buttocks are supported, and consequently decrease the risk of cord prolapse;
Perform a vaginal examination or proper monitoring of the baby as soon as the bag is broken to rule out a cord prolapse;
Encourage women to adopt a free posture, suggest squatting or four-legged postures, which favor the correct position of the baby's back;
Do not perform episiotomy while everything is going well, with the philosophy of favoring the pressure of the bottom of the uterus that helps to avoid malpositions of the head and arms and that the baby is born by propulsion and never by traction "
For its part, in this article published by the American Obstetrics Association we can read the following:
"Most doctors recommend a cesarean delivery for all babies in breech position, especially babies who are premature. Since premature babies are small and more fragile, and because the head of a premature baby is relatively large in proportion to its body, it is unlikely for the baby to stretch the cervix as much as a full-term baby. This means that there may be less space for the head to come out. "
What can I do to help my baby turn around?
If you see that your pregnancy is progressing and your baby is not well placed there are several exercises, techniques and positions that you can try to help you turn.
Swim breaststroke regularly It is an excellent exercise so that your baby can be placed in a cephalic position since it helps the relaxation of the pelvis and muscles of the abdomen so that the baby can turn more easily.
Control our posture throughout the day. For an optimal position of the baby, the ideal is to sit upright with your back slightly tilted forward. It is also better to sleep on your side than on your back.
Others recommended exercises They are all those who disengage the baby from the pelvis so that he has more freedom to turn around like kneeling on the floor and resting his head on the forearms on the floor, or doing the pine with help in the pool.
If your doctor recommends it, you can also go to an acupuncture professional to test the moxibustion, an ancient Chinese technique in which heat is applied to the little finger of the foot to relax the uterus and intensify the movements of the baby.
"Moxibustion is presented as an economic alternative, safe, simple, practical, non-invasive, painless and generally well tolerated by pregnant women and the fetus, since it does not alter fetal well-being" - Moxibustion in fetal malposition, Federation of Associations of Midwives of Spain.
- Finally, you can look for a gynecologist with experience in performing an external cephalic version, a manual procedure by which the doctor tries to turn the baby with a massage on your abdomen.
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