Turning a breech baby
You’re getting close now! Things are becoming more real each day, and those flutters of movement felt in earlier months now feel more like little kicks and punches, as things get cosy inside the womb and there is less room for baby to move. In your antenatal appointments, your midwife will be checking to see if baby is in optimal position for labour. With the space restriction increasing each week, it is optimal for baby to be head down by week 34. There is still plenty of time to turn, and this can happen right up until labour, however sometimes baby needs a helping hand, in order to avoid more invasive labour interventions. Chinese Medicine has been shown to be an effective, safe approach.
What is a breech baby?
For birth, the optimal position for baby and mum is head down. In a breech presentation, the baby is head up, bottom (or feet) down. Most of the time it is only a matter of chance that a baby does not turn and remains in the breech (bottom down) position. In few situations certain factors make it difficult for a baby to turn during pregnancy. These might include the amount of fluid in the womb (either too much or too little), the position of the placenta or the presence of more than one baby. The majority of breech babies are born healthy but, for a small minority of babies, breech may be a sign of a problem with the baby and therefore all breech babies will have a newborn examination.
There are a number of approaches your midwife and obstetrician can take to try to encourage the baby to turn. These include the Webster technique (a chiropractic procedure that is believed to relieve the musculoskeletal cause of intrauterine constraint) and External cephalic version (ECV). There are also daily exercises and positions that mum can try at home to try to encourage baby to turn. If the baby is still in a breech position after 39 weeks, your antenatal team will discuss your choices for birth (vaginal breech delivery or Caesarean section).
Another option discussed with you will be the traditional Chinese medicine technique of Moxibustion.
Moxibustion to turn a breech baby
Moxibustion involves the burning of a herb (Mugwort) close to the skin to induce a warming sensation. Moxibustion close to the acupuncture point Bladder 67 (BL67—Chinese name Zhiyin), located at the tip of your fifth toe, has been shown to be effective to correct breech presentation.
A landmark study published in the Journal of the American Medical Association in 1998 found that up to 75% of women with breech presentations before childbirth had fetuses that rotated to the normal position after receiving moxibustion at BL67. Published evidence also suggests that moxibustion is effective in reducing the need for an external cephalic version (ECV).
How does it work?
This technique involves holding moxa sticks (1.5cm in diameter and 20cm in length) or burning moxa cones on or over BL67 on both toes. The heat felt should be warm but not uncomfortable. Treatment regimens vary and there is no consensus on the best regimen, but moxibustion may be administered for 15–20 minutes daily for up to 10 days.
Administering Moxa opens up the uterus to make more room for the breech baby to turn. Combined with an acupuncture treatment, moxibustion helps to increase fetal movement, and the effect of gravity will encourage the heaviest part of the baby, the head, to enter the pelvis as it shifts its position.
Your acupuncturist can demonstrate the procedure, in order for you to safely repeat it at home (with the help of your partner if necessary).
Is it safe?
There have been no reported side-effects for mothers or babies. The burning moxa’s heat touches the acupoint indirectly at a point above the skin. Since the moxa’s heat does not reach the skin directly, the threshold for discomfort is easily monitored. The acupoint given attention is located on the toes, so no actual heat approaches the uterus, making moxibustion safe for mother and baby.