Flip a Breech

How can I help my breech baby flip head down?

Here are self-care exercises and explainations of how a professional might help if baby is still breech after 30 or 32 weeks gestation. Combine this list with those on the Daily Activities page for the most comprehensive approach.

 

Your midwife or doctor may also have advice

Please work with an experienced midwife or doctor whose hands know your belly and your situation. Together you can find a way that empowers you for a safe resolution.  You may print this page and give a copy to your doctor, midwife and Chiropractor for discussion. Ask  your doctor if there is a medical reason you couldn’t try some of these suggestions.

Is one of your twins breech? Also, check out Spinning Babies and... Twins.

 

In General

• Put your self in the position you want your baby to be in! Head down!
• Share your plan with your caregiver before you begin. 
• When your womb is in balance, the baby is likely to flip head down by themself
• If the baby is still breech at 37 weeks or later, it may be worth it to have a external cephalic version
• When breech runs in the family, or the mother's thyroid is low-functioning, or the womb has a septum or unusual shape, these exercises may or may not work.
• Talk to your baby, heart to heart, and tell your baby what you want - and ask your baby what she/he needs in this situation, too.

 

  Forward-Leaning Inversion

 We want to let the lower uterine segment (the lower, narrower part of the pear shaped uterus) expand to make room for baby's head.

Do the Forward-leaning Inversion (right) for 30 seconds first and follow up with the Breech Tilt.

 

Doing an Inversion on the stairs, or off the couch, as in the video, allows you to tuck your chin, which will prevent a tension in your fascia that could keep the baby from going head down.

Inversions for 30 seconds can be done by all pregnant women (who don't have polyhydramnios or high blood pressure). Repeating the forward-leaning frequently is better than doing the Inversion for longer periods of time.  (Start out with fewer seconds if its hard.) You will find this position more comfortable with repeated use.

Two of the benefits of either the forward-leaning inversion (from the couch or stairs as shown on the video) or the breech tilt are

    1.) Helping the baby stay out of the pelvis, and
    2.) Helping the baby to tuck his or her chin so that baby is able to make the flip.

 

In a steep forward-leaning inversion, the mother's neck is free to move, helping the fascia over the pelvis be more free to move.

This position is used for 30 seconds for the posterior baby. While it may be held longer for flipping a breech, it's the frequency that seems to matter, not the length of time with this type of inversion. 

 

After the baby flips...

If your baby was breech (head up) and is now head down you can stop the inversions for a few days. Now walk briskly for a mile, or more, every day for three days.

What if I think my breech baby has flipped head down but I'm not sure?

If you think the baby may have flipped head down, but you aren't sure, you can either cease doing inversions until you know for sure, or simply hold the forward-leaning inversion position for only 30 seconds, or 3 long breaths.

If baby is head down, will baby flip breech (head up) if I do a forward-leaning inversion? 

Whether the baby flips on their own, or with the help of an experienced midwife or doctor, the newly head down baby is often in the right occiput posterior position. A daily Forward-leaning Inversion can continue to help the baby get into an even better position for the start of labor. Remember, head down is only half the story.

 

I just wanted to thank you for all the wonderful information on your website.

I am 31 weeks with baby #2 and discovered she was in the frank breech position.  I did just three 30-second inversions and have been playing a lullaby CD for 30 minutes once daily for 3 days, so far.  Today's sonogram revealed she is now head down.  I was concerned because I also have 3 fibroids, so far they did not hinder her change of position.

~Amanda K. from Lake Mary, Florida  

 

The Breech Tilt is well known

 We want to let the baby's head flex so the baby can put his/her chin on his/her chest. This is called flexion. Flexion is the first step before flipping. Just like the gymnast, the baby tuck's his/her chin before rolling.

 

 

Get a broad plank of wood, like an ironing board. Prop it at an angle against the couch or a chair. A few pillows stuffed around the base will help prevent tipping. Another pillow goes under your neck. The funny thing is next. Lie on the board with your head down and feet resting on either side of the board on the couch. Try it a couple times to get it right.

Remain on the board for up to 20 minutes, 3 times a day.

After you've got this down and you can relax inverted like this, put a bag of frozen veggies, wrapped in a thin towel, behind baby's head, and a very warm “hot pac” in front of the baby near your pubic bone. Put the warm pac on the same side of your belly as the baby's hands and feet are on, but close to your pubic bone.
Other times, place a paper towel tube in the same spot and have family members speak through it or play Beethoven. When you think or know your baby is head down, walk a good long walk each day for a couple days.

Integrate your Breech Tilt and other activities with the  Balancing Activities  for an Optimal Fetal Position.

 

 

Can you get in a deep, warm pool and stand on your head?

Repeat a few times in the pool.

 

 

Loose ligaments are supported by wearing a pregnancy belt. Baby can get angled in a way that gives baby a better advantage to improve fetal positioning.

 

 

Open-Knee Chest may be / may be not effective for flipping the breech

 

Moxibustion

 

At 34-35 weeks, Moxibustion has been shown to be very helpful for flipping a breech. You can do moxibustion at other weeks gestation also, but the studies that showed the most success were done were done during the 34th week. Moxibustion is also helpful for rotating a posterior baby towards the anterior. The mugwort herb in the sticks makes a lot of smoke. You can do this outside or buy "smokeless" moxa.

 

  That was from Dr. Lorne Brown in California.
Now, watch a beautiful, home video of a woman, her midwife and her friends doing moxibustion after a party. See the happy results on her next ultrasound...

 

 

Let's do some gentle things to help baby be head down before labor! Maternal positioning, journaling, emotional exploration and using professionals to help with pelvic adjustments, abdominal and sacral releases, homeopathy, acupressure and acupuncture, hypnosis and moxibustion have been show to be effective.

- Inversions are effective as long as there is enough amniotic fluid and uterine ligaments are not super tight. If the ligaments are that tight, professional bodywork can release them and give the baby a more flexible home to move around in. If the ligaments are too loose, wearing a pregnancy belt can give your lower belly the slope baby needs to correct their position. When the baby flips You may or may not notice the baby flipping. This mom's baby was breech on Sunday and head down on Monday.

Here are the pictures Gail drew from her palpating from Sunday, on the left, and Monday on the right.

 

Standing Sacral Release

This "releases" the sacrum, the triangle bone between your spine and your tailbone (considered part of the spine).

The pressure of the helpers hands is almost anti-pressure! The weight of a nickel (shilling?). Go get a medium sized coin and feel the weight of it and don't press any more than the weight of the coin in your hand.  

Carol Phillips, DC, developer of Dynamic Body Balancing and MaBaby Workshops, shows us an in depth standing sacral release (excerpts) in her video proposal to HayHouse Publishers. Watch the pregnant woman get an standing sacral release.

If your ligaments are loose it may be wild to see and funny to feel. If your ligaments are tight it may be uncomfortable and may cause a few contractions (check contractions out with your midwife/doctor if you get 6 in one hour, especially if you are less than 37 weeks). If you are asleep the movements may wake you, but usually they don’t wake you. Work closely with your doctor and midwife to monitor the baby.

You may notice a difference in where you feel kicking after baby flips. USUALLY, the strongest kicks are from the legs not the arms, and will be high in the womb when the head is low. An anterior placenta (one that is in the front of the womb) can block the baby’s limb movement and confuse people who are trying to tell the baby’s position. More often, a mother will notice a difference in how she is carrying the baby.

Notice where your baby is kicking. If that is quite different, and is now strong at the top of your womb, you may want to stop measures to flip baby. If the same, you may want to continue your breech tilt or inversion until you can get the midwife or doctor to verify the position. Once head down, take a mile long, brisk walk each day to get the head into your pelvis.

This technique might be done by a professional or by a friend who has been shown what to do.

 

 

Professional Help for Flipping a Breech Baby

Professional help may include

• Chiropractic Webster Maneuver
• Chiropractic Adjustment
• Homeopathy
• Acupuncture
• Myofascial
• Craniosacral
• Maya Massage
• Hypnosis

 

Chiropractic and the Webster Technique or Webster Maneuver

Many chiropractors can loosen the ligaments by doing the Webster Technique. 

Adjusting the sacrum, for both a vertical twist or a buckled (horizontal wrinkle) sacrum will let the baby put their head down more readily because the bones won't be in the way.

Here is a YouTube video showing the Chiropractic Webster Maneuver for resolving a breech position

 

 

 

 

Chiropractor Adjustment

        * The sacral ala is corrected vertically (SI joints) from any twist,
        * The sacrum is checked for a buckle (wrinkle) that a sacral release will undo (below)
        * The pubis symphysis is adjusted

        * Any other alignment necessary, such as the neck and jaw, to help the pelvis and SI joints stabilize. 

 

Homeopathy

Seek a homeopath to select the right remedy and the right dose for you and to monitor for side effects, if any. I don't want to prescribe here, so please search this effective option out on your own.

 

Acupuncture

Look for experience, look for high level education. There are simple points that might work for some, given by the certified. Other women will need someone with advanced skills. Another way towards balance. The thyroid can be helped through this modality, too. 

 

Myofascial Release

Muscles and fascia are released. Depending on the background and style of the practitioner, this may be subtle, gentle or vigorous and rough. I like gentle. :)

The Standing Sacral Release (above) is an example.

 

Craniosacral Therapy

A very gentle and subtle "release" of the fascia supporting the skull and pelvis. Again, when the mother is in balance the baby will move into the most ideal position possible.

 

Maya Massage

Traditionally, the Central American Maya Midwives give pregnant women a massage and do sifting with the Rebozo (Manteado y Sabada) every 15 days in pregnancy. The abdomen is wrapped with a long, thin strip of linen to support the lower abdominal wall when walking and traveling about. Breech was extremely rare when Anthropologist Brigitte Jordan was interviewing midwives there in the last century.

 

Hypnosis

Hypnosis has been useful for many women to help flip their breech baby to head down. 

Phyllis Klaus, one of the founders of DONA International doula organization has used hypnosis to help women figure out why, or at least, what happened that their babies went breech. This starts the release that often leads to the baby flipping. 

A Hypnobabies member shares the benefits of Hypnobabies hypnosis for fetal positioning at InexplicableWays.com.

 

These techniques work for most babies. Even for a baby who doesn't flip, these techniques could help a vaginal breech birth go more smoothly. Always use physiologic breech birth practices (Knee-elbow or hands and knees maternal position, hands-off the breech, natural childbirth). Otherwise, a cesarean after labor begins gives the baby a bit of labor hormones to help transition into life outside the womb. Discuss these options with your midwife or doctor. There is currently better data in obstetrics to support physiological breech vaginal birth.

Read these Emails on Breech

"I just found out my baby is breech."

I recently found out my baby is breech.  This is a 2nd baby.  My first was a very calm baby and was always head down.  This one is QUITE active and apparently flipped in the 4 days between my midwife appointment and an ultrasound (they thought my placenta was low... it's ok).

I exercise 3-5 times a week.  I eat well and am in good shape.  I am seeing a chiropractor ...   Initially, saw her for "shifty hips" that would pop out of joint... hasn't happened since.

My only pregnancy problem (with both) is uterine irritability... I've tried cramp bark tea for this but usually the only solution is to sit down.  If I don't nip it in the bud, it progresses to quite strong contractions where I vomit.  My uterus is often quite tight for hours on end when I am walking around or at work (I'm a nurse).  I was much worse with my son (they kept thinking it was preterm labor but my cervix never opened).  Of note, he was a very quick and easy labor/ birth (less than 4 hours)-- maybe from all the uterine toning?

Here's my questions:
1.  The Chiropractor did a Webster Maneuver once; usually she is cracking my back and neck and hips and such.  Should she be doingWebster every week?  What should I be expecting from her?  I've never seen a Chiro before.  I haven't seen her yet since the baby flipped.

2.  How does my uterine irritability play into all this?  My midwife said I had very good abdominal tone also.  Is this hurting things?

3.  I'm being more diligent about my posture now and I'll start some tilts/ inversions (already doing pelvic rocks).  I'll see if my husband can try the Rebozo sifting on me-- would a Mayawrap sling work OK for a scarf?

4.  I plan a homebirth/ waterbirth with a CNM.  I know she won't do breech births at home.  I'd be willing to give it a go if there was a practitioner.  My mom and grandma were both easy birthers and I'm shaped like my grandma who popped 10 kids out on the farm :)

5.  Any other thoughts/ suggestions?  Thank you so much for your time!  I better go do my pelvic rocks-- the baby is dancing around in there!

 Gail's reply:

Your contraction symptoms and baby's breech position seem to match the picture of asymmetrical ligaments.

        * The Webster Maneuver would help the round ligaments.
        * The Inversion will help the cervical ligaments first and then help the broad and round somewhat.
        * Pelvic adjustment releases any possible pulls on the ligaments supporting the womb from even a slight misalignment of the pelvic joints.
        * Get the abdomen ligaments relaxed and then supported. A pregnancy belt may help the looseness that makes it hard for the baby to have a toned slope to settle head down on.
    When a baby is breech the first action is to relax a twist in the womb using the above methods.


    

 

Question 1. )  The Chiropractor may have to adjust the pelvis in three ways.

I don't know what your individual needs are among these three or beyond them. Emails just don't relay that kind of detail !

 

 

     Suggest your chiropractor check:

        * The sacrum vertically (SI joints) for a twist at the ala,
        * The sacrum horizontally for a buckle (wrinkle) that a sacral release will undo
        * The pubis symphysis.

The Webster Maneuver is a gentle press on the round ligaments in a specific direction to soften the ligament. It takes a just a few moments and will soften a cramp, spasm or even "good tone" to allow the baby to flip past the ligaments into a head down position. Releasing a kink or tightness in the round ligaments also helps the uterus become more symmetrical, which also helps baby into an ideal starting postion for labor.

The Webster can be done repeatedly, weekly or bi-weekly if in the last month or two. It is one step in helping a breech baby flip. Sometimes it is the only step needed, especially if repeated about 3-4 times. But sometimes you need more body work or self care to flip a breech baby.

 

Question 2.) Pelvic alignment and ligament release will help uterine irritability, especially getting the sacrum "unbuckled".

After a sacral release, you may wear a belt as much as possible to support a loose abdominal wall. There are other ways to help uterine "irritability", scroll down on this page. Good tone may be good tone or too tight a broad ligament. We use that phrase a little loosely in our desire to say positive things, and in ignorance of the myofascial clues among those of us untrained in this type of bodywork. It would take training to tell the difference, I think. A tight broad ligament often goes along with an asymmetry in the round ligaments. Releasing it helps the baby turn past it.

Carol Phillips, DC, my link to the myofascial world, says that premature contractions are often solved by a sacral release (standing sacral release). The moms that I have referred to have this type of bodywork done have found it to work. I also suggest a high protein, whole foods diet with plenty of leafy greens, yellow vegies, Omega 3s, liquids and salt-to-taste (Brewer Diet and then some).

 

Question 3.) Posture, Inversions, Rebozo.

Using the Rest Smart positions will be helpful, of course. But probably not enough to help baby flip on his or her own after 32-34 weeks. But you have a clear idea of several things you yourself can do, and the body work that will help.

Continue with the inversion. I suggest the method of getting upside down shown in the inversion video on my blog.

A sling for a Rebozo helps relax the broad ligament if you can relax your belly into it like a hammock and your partner can lift the weight of the baby off your spine without scrunching the baby into your spine. And then start slowly to do short jiggles until your involuntary muscles can relax. About 3 minutes. Repeat daily as possible. Using a sling, sheet or any long, broad woven material can be substituted for a Rebozo.

 

Comment 4.) Finding an attendant for a vaginal breech birth.

Your clarity on your ability to birth a breech baby is one of several aspects of safety for breech vaginal birth. Important physical assessment will help determine if a vaginal breech birth might be safe in your situation. Searching out an experienced midwife or physician in breech birth is a challenge, but a necessary one if you decide to have your baby naturally at home or in the hospital.

You will have to ask at midwifery circles, homebirth support groups, cesarean prevention groups, and teaching hospitals for referrals. Having an experienced person reduces the risk to breech birth but doesn't eliminate the risk, of course. Finding someone who can sit on their hands for the first half of the birth is a good start.

Click here to go to a YouTube video of a midwife attended, hands off breech birth in water. YouTube Breech birth. I don't know the midwife or the mother. The birth is inspiring. I don't know that I would have had the patience to let the head wait that long for birth, as the body is arching away from baby's chin. Later the baby's body floats back to a better position for chin flexing and the contraction brings the head out suddenly. 

 

Question 5.) Besides Chiropractic and Myofascial care for uterine "irritability" I suggest

        * 3-4 cups of bulk Red Raspberry Leaf Tea daily. If you don't have sensitivities to dried herbs, that is. The bags of RRL are too old and lack oil. The bulk herb is more effective, go to a coop, though, for "fresher" dried herbs. Use 2 TBSP in a wire mesh strainer and fill a quart jar with ALMOST boiling water to steep for 5-6 minutes only. Remove herb and drink hot or cold, straight or with a splash of apple juice, or other herbal teas. (There's no caffeine in bulk Red Raspberry Leaf.)
        * Eat plenty of protein, too, but watch the peanut butter, its hard for a pregnant liver to process.
        * Drinking a total of 3 quarts or more is almost always necessary for pregnant women's health.
        * Also, check for a calcium magnesium supplement that is easy to absorb.
        * Wear a snug pregnancy belt.

    

Your email was very detailed except for your weeks gestation.

If your baby isn't head down and you are later than 32 weeks, you may like to try the methods you can use at home, the Rebozo, the Inversion as well as the Rest Smart positions in Pregnancy Posture.

Some mothers wait to try these techniques until they are 34 weeks. They still may work that late if you have plenty of amniotic fluid. Talk to your midwife about these suggestions to help your baby flip.

 

Its just a matter of finding what your womb needs for your baby to flip, or to find what your baby is telling us if he/she can't flip.