If your baby is in a breech presentation at 32 weeks, will he or she stay that way? What can be done, and will a cesarean be performed? Obstetrical Nurse Wanda Steele offers some insight.
Wanda Steele, RNC

The question: My due date is 8 weeks away and the doctor has told me that the baby is breech. What are the chances at this point that the baby will turn around? Are there ways to make the baby turn around? - Cortney, Chicago IL

The expert answers:

Hi, Cortney -

First, let's define what is meant by breech. When a baby is born, usually the first part that we see emerging from the birth canal is the head. In a breech birth, the first thing we would see would be the buttocks or the feet. In others words, this baby would be coming out the "wrong" way.

ask your question! At your gestation of 32 weeks, it is very probable that your baby may turn itself. If it has not turned by 37-38 weeks, it probably will not, BUT we have all heard stories of how the baby turned around on the way to the delivery room. Maybe... maybe not!

If your baby has not turned by about 38 weeks, there is a procedure called breech version [or external version] which can be tried. This is done in the hospital with every precaution taken to assure the health of the mother and the baby.

You would have an IV started and be given a medication either in the muscle or in the IV to relax the muscles of the uterus. Under ultrasound observation, the baby is moved around by the doctor's hands on the outside of your abdomen. This can be uncomfortable but should not be painful. If the baby is going to be amenable to turning, it usually does so without a lot of difficulty. Occasionally, the baby is already wedged into the pelvis and the doctor will be unable to get the baby to turn at all.

Chances of getting the baby to turn and to stay there are about 50/50. The main risk in this procedure is cord entanglement, and that is the reason that everything is watched so carefully by ultrasound during the procedure. Should an emergency develop while the version is being attempted, an immediate cesarean delivery would be done.

Remember, even after a successful version, the baby can turn around again. There are no guarantees that once it has turned, that it will stay.

Vaginal deliveries of a breech presentation are not done too often these days. The main reason is that you have the largest part of the baby coming through the pelvis last. This can be a problem if the head or shoulders become entrapped. Because of the unique presentation, there is also an increased chance that the cord could be involved and the baby's blood and oxygen supply be diminished for a longer period of time than usual at delivery. For these reasons, it is generally felt that the safest way to deliver a breech baby is by cesarean delivery. While cesarean delivery does pose the same risks as any surgery, the risks to the baby are minimal and do not involve the unique problems that I mentioned that are very specific to breech births.

Good luck to you, Cortney -- I wish you and your baby a really good turn!PregnancyAndBaby.com

Tags: breech turning

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