What A Breech Baby Means For Your Pregnancy

Photographed by Ashley Armitage.
Yesterday, Brooklyn Decker posted a selfie with a heating pad "on the poon," and an ice pack "on the belly," with the caption: "File this under breech baby urban myths." Last month she shared a similar photo laying on the couch while her husband Andy Roddick burned Chinese herbs by her feet, to try to flip her upside-down baby around. Kim Kardashian West has some experience with this, too. During her last pregnancy, she said she "lay practically upside-down three times a day for 15 minutes," because Saint was breech.
If you're not hip to this trend in celebrity parenting, "breech" is a fancy word for "butt," and it just means that a baby is positioned to come out butt, feet, or both butt and feet, first, according to Lynn L. Simpson, MD, FACOG, professor of women's health in the department of obstetrics and gynecology at Columbia University Medical Center. "Rather than getting into the head-down position — which is what you need for a vaginal birth — the fetus gets its butt down," Dr. Simpson says. This is fairly common, and about 3 to 4% of all babies at term are breech, according to the American Congress of Obstetricians and Gynecologists (ACOG).
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Most practitioners and clinicians won't offer a vaginal delivery of a breech baby, because delivering a baby's head last can be risky, Dr. Simpson says. So, a breech baby usually is delivered via C-section, she says. (Some studies have found that 86% of breech babies are delivered via C-section, so it's not impossible to deliver vaginally.) "Or you can try to do things that might facilitate the baby becoming head-down," she says. And that's where the Chinese herbs and urban myths come in. But often times babies will just turn on their own — even ones that are breech at 34 weeks — so everyone is different, Dr. Simpson says.
Ahead, Dr. Simpson and Fahimeh Sasan, DO, assistant professor of obstetrics, gynecology, and reproductive science at the Icahn School of Medicine at Mount Science, tackle the FAQs of these in-utero acrobatics.
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How does a baby get breech?

We don't know 100% why, Dr. Simpson says. "Some babies with certain neuromuscular issues are more apt to present as breech babies," she says. But there are many potential causes that have no bearing on the baby's health post-birth. In some cases, a pregnant person's pelvis and uterus can be structured in a way that "prevents the baby from getting into the head-down position," she says, which is expected to happen around 30 weeks.

Dr. Sasan adds that a baby can end up breech because the umbilical cord is short, or there's low amniotic fluid. A low-lying placenta can also get in the way of a baby pushing its head downward into the pelvis, but that most of the time, there's no real cause, she says.
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What does this mean for the rest of your pregnancy?

Breech is typically identified when you're around 30 weeks, and your doctor will do so by feeling around for the baby's head and buttocks, and they may use an ultrasound to confirm it, according to the ACOG.

Having a breech baby really doesn't change much for the rest of your pregnancy, besides potentially altering your birth plan if you were planning on delivering vaginally, Dr. Sasan says. The reason why a C-section is generally preferred when a baby is breech is because some studies have shown that babies born breech may have more difficulty or trauma during birth, Dr. Simpson explains. Think about it: If a baby comes out butt- or feet-first, then their head would be the last thing to exit the vagina, meaning it's exposed to a lot of squeezing and not a lot of air for longer than it would if it were to pop out first. Sometimes, the baby's body won't stretch the cervix enough to allow the head to pass through it, which can be dangerous, according to the ACOG.

Should you devote yourself to encouraging a flip-flop, that will also change your pregnancy: You may spend more time upside-down or with strategically placed ice packs, like Brooklyn Decker.
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Are there any legit ways to turn a breech baby?

Actually, yes. "From a medical point of view, most of us would offer an external cephalic version (aka ECV)," Dr. Simpson says. ECV is a procedure that's done by a doctor between 36 weeks and 38 weeks, and involves putting their hands on the pregnant person's abdomen, gently feeling the head and butt, and helping the baby do a somersault, she says. But this is not something you should try at home. Dr. Simpson cautions it's usually done with an IV in place and the operating room available in case there's an emergency, like changes in the fetus's heart rate, or premature water breaking, that requires the baby to be delivered by C-section ASAP.

Usually this works quite well, and there's around a 60 to 70% likelihood that it'll be successful, but it depends on the person, according to Dr. Simpson. A person who's had a baby before might have more luck with ECV, because their abdominal wall is not as taut, she says. "Babies in complete breech presentation, where they have both hips and knee joints bent, are a little harder to make do a somersault," she says. A big baby is generally harder to turn than an average-sized one, and when a person has twins, ECV isn't recommended. If you're not eligible for this method, your doctor might suggest some safe at-home techniques.
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What about those home remedies?

Dr. Simpson cautions anyone who's attempting to manipulate their baby at home. "You just never know what's going on with that baby," she says, adding that, in general, we don't want to interfere with a pregnancy without our doctor's say-so.

One safe thing you can do at home is hydrate, Dr. Simpson says. If you're well hydrated, then your baby will be, too. "They'll have more fluid around them in order to give them a chance to make the turn," she says. They need that amniotic fluid to have space to wiggle around.

And then, a couple times a day when you have nothing else to do, it can be helpful to get on all fours and chill out for five minutes or so, Dr. Simpson says. "Just allow the baby to fall forward into the uterus and into the abdomen," she says. "That may help the baby's butt get dislodged from the pelvis and allow it to make a turn." Again, this isn't manipulating the baby in any way, it's just allowing the baby to do its own somersault if it's able to.
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And what about those kooky urban myths?

There are myriad techniques that people claim will flip a breech baby (some parents claim that simply playing music for their baby was enough to make them flip), including Decker's ice-and-heat combination and the Chinese-herb burning, which is actually called moxibustion. In traditional Chinese medicine, it's believed that burning mugwort by a specific point on the body can turn a breech baby. "There's no harm in trying acupuncture or moxibustion, I just don't know if the scientific strength of the studies suggest it's a good investment of your time and money," Dr. Simpson says. Again, just talk to your doctor before you do anything DIY, and try not to flip out if your baby doesn't want to turn.
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