What do I do with a breech baby?

If your baby is breech, you know how emotionally intense it can be hoping they’ll turn before it’s time for their birth. 3% to 4% of babies are still breech at 36 weeks. As a doula, this is something that I have seen time and time again and I’m here to share with you some things that can help.
 
Before we get into all the good tips, I want to share some do nots.

1. We do not ever want to try to manually move a baby. There is a procedure called an ECV that obstetricians can do (while monitoring baby’s heart rate). We don’t ever want to try to scoot them around. Sometimes there’s a reason they stay breech.
2. We don’t ever want to sift rigorously. Everything I do I do it gently. Even though in the womb, we are handling a baby. Be gentle with momma too.
3. We don’t want to ignore the cautions for individual techniques such as avoiding going upside down if momma has high blood pressure.

 
I personally have not created any of these techniques. So, throughout this blog I will be linking to the sources that I have learned from. I want to give honor to these women who have chosen to freely share their wisdom to help women around the world. If you’ve got time, explore their websites and social media. There are some wonderful resources here.
 
One more thing before we get into the techniques. I do want to mention that in recent years I am seeing more and more social media posts about this topic. Some of them are just looking to get views and are not sharing accurate information. Look for relevant credentials. If you are able to work with a midwife or doula who is familiar with the position of your baby and can assess for imbalances or tightness that could be hindering baby from getting into a better position, that’s really ideal.

Spinning Babies

Alright. Let’s get into it. As a doula, the very first resource I share with the parents of breech babies is a wonderful resource called Spinning Babies®. Gail Tully is a midwife who is a matriarch in teaching birth-workers in this century how to help babies find the best position. I’m very thankful for her work, and I recommend you take time to explore her website.
 
The Three Balances are

1. The jiggle
2. Forward-leaning inversion
3. Side-lying release
   

 
Here is her page explaining these techniques. https://www.spinningbabies.com/pregnancy-birth/techniques/three-ways-to-body-balance/
 
The jiggle can be done with the mother in a side-lying position, using a peanut ball, or you can shake the apples in open-knee chest.
 
Forward-leaning inversion can be done for 30 seconds one to three times a day. Hips being forward from the knees (not hips and knees aligned straight) will give more space for baby to rotate.
 
Side-lying release needs to be done on each side so it is balanced. Do 3 minutes each side. This is a good exercise to do daily.
 
Check out her website linked above and click on the further explanations about how to do these techniques. Pictures and video are on her site. Please do read the safety information before trying these methods.
 
There is also something called the Breech Tilt. You can use an ironing board to lay head down feet up and let the baby “roll” out of the pelvis to settle back down better. Do this up to 20 minutes. Here is her page for that. https://www.spinningbabies.com/pregnancy-birth/techniques/other-techniques/breech-tilt/

Additionally 

I also recommend trying open-knee chest followed by exaggerated runners.  

Open knee chest is when you get on all fours and then lower your chest to the ground with the pelvis up in the air. Try to do this for 30 minutes a day. If forward-leaning inversion is too hard for an individual, this is my go-to. If mom is having a hard time holding the position, dad or a support person can wrap a rebozo around the upper thighs (not the belly) to help hold her up. Using a rebozo for support can make it easier to lean at a deeper angle and get the pelvis even more upward than the upper body.
Image: https://www.instagram.com/p/B4SP6xug3sG/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA==
 
Exaggerated runners is when you lay in bed on your side and toss your top leg over a peanut ball or toss a leg over pillows. Keep your bottom leg straight like you do with side-lying release. Let your top leg come up as much as you can. If you’re able, pull your bottom arm behind you to really angle that pelvis. Do both sides. Strive for 15-30 minutes each side.
Demonstration with pillows: https://www.instagram.com/reel/Cv705mSgvOd/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA==
If you’re doing this with a peanut ball, you can add in some rocking to encourage baby to rotate.
 
 
Personally, I recommend these two methods as secondary to the Three Balances and Breech Tilt above.

If the above doesn't work

If those techniques don’t work, I start assessing for imbalances or tightness that could be hindering baby from having a balanced space in the womb to settle down in an ideal position. Babies will lay where it is the most comfortable. If momma has tension on one side that’s affecting the pelvic floor muscles, baby may favor the other side without tightness.
 
So, let’s talk about bodywork.
 

• Everything is connected.
• The uterus is “suspended” by ligaments and held up by a “hammock” of pelvic floor muscles.
• The inversions above work on stretching the ligaments.
• There is a group of muscles that make up the pelvic floor.
• The psoas muscle goes from your lower back to your femur.
• The QL muscle attaches from your bottom rib to the top of your pelvis.  
• The erector spinae muscles run from the cranium to the sacrum.
• When we have imbalances such as from the way we sit and stand or hold a baby/toddler on our hip, this can affect more than where we feel tightness or discomfort.

 
If you feel any tightness in your hips or lower back, I want you to work on stretching that out. I’m going to show you a couple different stretches.
 
The first is called the psoas release. There are a few different ways we can do this.
 
Here is one simple way to stretch the psoas. https://www.instagram.com/p/CVVrH3Grmay/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA==
 
The middle tip here is a standing psoas release. https://www.instagram.com/reel/CzuK_kKJJCW/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA==
As she mentioned here, heat can help. If you do feel tightness in your lower back or hips, consider putting heat on it (heating pad, corn/rice bag, heat pack, warm bath).
 
You can also do a forward lunge as shown here. https://youtu.be/1EVieaDobt0?si=m-gjPXnzyMKpIvOa

Body Ready Method

This is another great resource, Body Ready Method. The founder/owner is an exercise physiologist and doula who has brought great wisdom to the birth community about exercises that can help with pregnancy issues and labor bumps in the road.
 
One method she introduced is called The Glute Scoot. Here is the video explaining it. https://www.facebook.com/share/v/1FeB7vbq1M/
 
I do this method with anyone having lower back pain.

Other stretches

Here are a couple of other stretches.
 
For the QL muscles of the lower back, we can do dip the hip.
https://www.instagram.com/reel/CXCIcqhJItm/?utm_source=ig_web_copy_link&igsh=MzRlODBiNWFlZA==
 
You can also kneel in front of a birth ball and stretch your hips that way.
 
You can also lean on the ball or choose all fours for pelvic tilts in cat/cow.
 
Here is a hip opener stretch. https://youtu.be/GffXQl3zvUI?si=KKOZHn-H2RDJIGhT
 
Mamaste Fit is another good resource. Here is a video with multiple exercises for breech baby. https://youtu.be/yxisd5CvCgk?si=m8k8mvTb6Nwy6t_f
 
While not an exercise, one thing we do need to address in our culture is posture. The way we sit and stand affects the position of the pelvis. Sit up straight and have your knees lower than your hips. Try sitting on a pillow or a rolled-up towel. The birth ball is a great one for good posture!

Some other things we can try

If the above has not worked, there’s a couple more things we can try.
 
If you’re comfortable with going to the chiropractor, that can be helpful. Look for someone certified in the Webster technique.
 
There is a Traditional Chinese Medicine technique called Moxibustion that uses a warm moxa stick near (not on) a specific acupuncture point on the pinky toes.
 
For those that use homeopathy, pulsatilla is thought to relax the uterus. 200c once a day or 30c 3 to 5 pellets twice a day is commonly recommended.

Stress management is worth mentioning. Stress adds tension to the body. Let’s work on releasing tension and trying to relax our bodies and our minds.

If all the things don't flip the baby

If you do all of the stretches and all the exercises and all the things… but this baby just won’t flip head down, there is something else.
 
It’s called an external cephalic version or ECV for short. This is done in the hospital. Your OB will manually turn your baby while monitoring the heart rate. Typically, this is done in the OR. Some places may do it in the labor and delivery room. They usually give a medication to relax the uterine muscles and make it easier to turn baby. Pain management options include epidurals or spinals, IV pain meds, or opting for none if you prefer not to take meds. Talk to your doctor about how ECV is done at that hospital and what their recommendations are.

If baby doesn't turn

Some babies just stay breech despite our best efforts. Breech is a variation of normal. That said, American obstetrics almost always does a c-section for breech babies. They can usually be delivered vaginally, but there are additional risks. Most of the risks are to the baby more than additional risks for the mother. One of the most serious risks is head entrapment.
 
Resources to learn more about risks of vaginal breech delivery:

• https://pmc.ncbi.nlm.nih.gov/articles/PMC9284475/
  
• https://pmc.ncbi.nlm.nih.gov/articles/PMC11502450/
  
• https://pmc.ncbi.nlm.nih.gov/articles/PMC12500088/
  
• https://pmc.ncbi.nlm.nih.gov/articles/PMC12591833/
  
• https://pmc.ncbi.nlm.nih.gov/articles/PMC11262641/ This one is a study on breech birth at home or in birth centers  
  

 
 
It is your right to decide you want to attempt a vaginal delivery with a breech baby. That said, attending a breech delivery as a doctor or midwife is an advanced skill set. It’s important to have a care provider who has training in this. Breech Without Borders is a good resource to look into. There is also the Coalition for Breech Birth.
 
As hard as this reality is, we must always approach birth knowing that needing a c-section is a possibility. It’s a good idea to come up with a birth plan for a scheduled c-section if baby still does not turn before your due date. Talk to your doctor about what a scheduled c-section looks like. Something to consider is scheduling a birthday party surgically (c-section) and continuing to try the above until then. I know you wanted a vaginal delivery. I understand your heart may be set on natural birth. I understand you may be scared of surgery. It’s okay to feel however you feel about it. If you feel peace about it, that’s wonderful. If you feel upset about it, that’s completely understandable. It’s okay to grieve the loss of the birth you expected or wanted. You can adapt your birth plan with this different route than expected. And I hope that your baby will turn head down in a good position for you before then, but if they don’t I hope you are able to have a calm cesarean with skin to skin in the OR, a good experience with caring staff, and a quick recovery.

Share your wisdom

Best wishes to you in getting your breech baby to turn head down. If you have used any of these methods with success, comment below to tell your story. If you have anything to add, please do comment and share the wisdom.
 
I hope this blog is helpful to you! Congratulations on welcoming your little one here soon!!

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