Breech Presentation
When Your Baby is “Upside Down”
Discovering the wonderful news that you are pregnant is both a time of joy and anxiety. Within the next 40 weeks, your body will begin to undergo many profound changes ranging from hormonal, biomechanical, and increased nutritional demands to physical and psychological changes. Unfortunately, as wonderful as it is to be pregnant, there are often some unpleasant and often uncomfortable changes in your body that go along with it.
Perhaps you were not anticipating the morning sickness, fatigue, low back pain, sciatica, headaches, and carpal tunnel syndrome. Perhaps you have reached 30 weeks or more and you have just found out that your baby is in a breech presentation and your obstetrician is already scheduling a C-section which completely foils your plans for a natural delivery. So, now what can you do?
Fortunately, there is a powerful and safe solution to many of these pregnancy-related conditions—chiropractic care! In order to understand the tremendous role that chiropractic care plays in the health of a pregnant woman, we need to first understand the relationship of the spine and pelvis to the nervous system. Since our brain and nervous system control the function of every cell, tissue and organ of our bodies (and our unborn baby’s body) it is vitally important for our nervous system to operate at 100% for optimal health. Our spine protects our spinal cord and when a spinal bone shifts out of normal alignment it may produce abnormal motion and damaging pressure on spinal nerves. This condition is known as vertebral subluxation and if present, it may interrupt the vital nerve flow within our bodies and to our baby.
Chiropractic care corrects subluxations which interfere with normal body function. Subluxations are an inherent part of pregnancy because during pregnancy, the dynamics of the spine and pelvis change dramatically and the potential for damage to the musculoskeletal system is great. When a woman is pregnant, her growing uterus produces a shift in her center of gravity. Along with the hormonal changes that occur, her posture becomes unstable and as a result stresses her joints, nerves, muscles and connective tissue. As pregnancy progresses, the abnormal stresses produce symptoms such as pain and numbness, most commonly felt in her spine and pelvis. At other times, there may be little or no symptoms, but there can still be spinal and pelvic dysfunction. This is what often occurs when a baby is in the breech presentation.
By the beginning of your third trimester of pregnancy, your doctor or midwife should be able to determine by feeling your abdomen (or more specifically by ultrasound) exactly what position your baby is in. Obviously, with the continued growth of your baby, there is less and less room in your uterus and this begins to cause what is known as in-uterine constraint. Most babies maximize their cramped quarters by settling in head down, in what’s known as a cephalic presentation. But if your baby is breech, it means he’s poised to come out buttocks or feet first. There are several types of breech presentations, including frank breech (bottom first with feet up near the head), complete breech (bottom first with legs crossed Indian-style), or footling breech (one or both feet are poised to come out first).
When labor begins at term, nearly 97 percent of babies are set to come out head first. Most of the rest are breech and in rare cases, a baby will be sideways in the uterus with his shoulder or arm presenting first— his is called a transverse lie. Currently in the United States, obstetricians and midwives are quite reluctant to deliver a baby in the breech presentation because of the possibility of complications to both the baby and the mother. So, if you are hoping to avoid a c-section, what are your options if your baby is not head down?
The medical procedure that may be mentioned by your obstetrician is called an external cephalic version (ECV). This procedure is done in the hospital by applying pressure to your abdomen and manually manipulating the baby into a head down position. This procedure is not entirely risk free and some women find it extremely uncomfortable. It is approximately 50% successful as long as you are a good candidate but severe complications, although rare, can occur. The procedure is performed in a hospital in case an emergency c-section needs to be performed. Not all women can attempt to have an ECV such as those that are carrying multiples, have had placenta previa or have had a prior c- section.
What many women prefer is a completely natural, non-invasive, highly successful technique (literature shows as high as 92%) to help a breech baby get into a better presentation for a successful vaginal delivery known as The Webster Breech Turning Technique. This gentle chiropractic technique has been featured on The Learning Channel’s “A Baby Story”, Midwifery Magazine, and Midwifery Today. The way it works is the following: The uterus is attached to the bones of the pelvis by ligaments. As long as the bones are in the right position and are moving properly, the ligaments should provide equal and balanced support for the uterus. If the pelvis is misaligned or subluxated, the ligaments become torqued and can cause a condition known as “in-utero constraint”. If the uterus is constrained as birth approaches, the baby is prevented from getting into the best possible position for birth and may end up breech. Specially trained Chiropractic Physicians diagnose the subluxations and then gently correct the subluxations of the pelvis as well as decrease tension in specific pelvic ligaments ( perhaps you have heard of the Round Ligament which often causes a cramping type of pain in the lower abdominal region in the third trimester) to help the baby turn.
Another specific chiropractic technique to help babies in the breech presentation obtain a better position for a vaginal delivery is The Bagnell Technique, which in one recent research study was shown to be 95% successful. This technique again focuses on the proper alignment of the pelvic bones, specifically the sacrum (the triangular bone that sits above your tailbone) and the bones in front of your pelvis which come together to form the pubic symphysis joint (sometimes misalignment or even separation of this joint during pregnancy causes significant pain which can also be helped by proper chiropractic care).
It is important to stress at this time that neither The Webster Technique nor The Bagnell Technique are to be misconstrued as the practice of obstetrics. These techniques are specific chiropractic techniques intended to relieve a specific musculoskeletal condition, and they are well within the trained chiropractor’s scope of practice. At no time does the chiropractor attempt to change the position of the fetus as is done in external cephalic version (ECV).
By this time you are probably wondering “How do Chiropractors correct these subluxations?” Chiropractors correct subluxations by performing chiropractic adjustments. The adjustment is a gentle procedure in which the Chiropractor applies light pressure to the joints of the spine to restore normal motion and alignment, decrease stress on the nervous system, and decrease pain and muscle spasm. Chiropractors who specialize in maternity care will often have special adjusting tables for the pregnant mother so that she can lie on her stomach without any pressure (they love these tables!) so that her spine can be examined.
So, while a pregnant woman adjusts to her new body during her pregnancy, it is important for her to learn and understand the benefits that chiropractic adjustments may offer in terms of improving her overall health as an expectant mother. First of all, Chiropractors are the only doctors who are licensed to diagnose and correct subluxations. This degree is known as a Diplomate of the International Council on Chiropractic Pediatrics (D.I.C.C.P.) and additional certification in the Webster and Bagnell Techniques is also important when caring for pregnant women.
Second, chiropractic offers a drug-free approach to pain reduction. Obviously, it is not ideal for pregnant women to take unnecessary medication and avoiding potentially risky procedures is important. Studies show that expectant mothers who receive chiropractic care are less likely to suffer from the dreaded “back labor”, they have a decreased incidence of C-section and they have reduced labor time.
Remember, pregnancy should be a time full of health and happiness! Don’t waste another minute suffering from pain or discomfort during your pregnancy! And, if you have been told your baby is presenting breech and you would like to avoid a C-section (or want to do something natural to hopefully prevent a breech presentation in the first place) please find a local Chiropractic Physician who has specialized training in maternity care so that you can experience the quality of life you and your unborn child deserve!
