Some 3 to 5 percent of pregnancies end in breech birth. That means that, in utero, babies shift from the typical head-first position to one of three breech positions. Those breech positions include complete breech, where the baby’s bottom is pointed towards the cervix with the legs folded in; frank breech, in which the baby is bent at the waist with legs straight; and footling breech, with legs pointed toward the cervix as if preparing to exit the womb feet-first. If labor were to progress with the baby in any of these positions the result would risk the mother’s wellbeing, which is why doctors generally try to turn breech babies or have mothers undergo a cesarean section.
Why are breech birth’s dangerous? Because serious complications, notably head entrapment, are highly probable if not inevitable. Breech births were likely the cause of high infant mortality rates before the advent of modern medicine. That said, breech babies are can be planned for and accommodated thanks to modern medical technology. There is, to put it succinctly, no reason to panic, but plenty of reason to be proactive.
A baby in a breech position is usually detected at around halfway through the third trimester. At that point, if a doctor deems mother and child to be candidates for the procedure, they can attempt what’s called “external cephalic version.” Basically, that’s a fancy way of saying they manually attempt to turn the breech baby to a normal birthing position. Oftentimes, the baby will actually turn to the position on its own. But if that doesn’t happen, a cesarean section is necessary, and parents need to prepare. That starts with awareness, and an informed father or partner can absolutely help ease the concerns.
“The best thing to do is start talking about why it’s not safe to do a vaginal delivery of a breech. We want to have, at the end of the day, a healthy baby and a healthy mom,” says Dr. Mary Rosser, a fellow at the American College of Obstetricians and Gynecologists and an OB-GYN at Columbia University Irving Medical Center. “It’s about planning and talking to the patient and the couple to discuss this early if the baby doesn’t look like he or she is turning.”
Rosser points out that a cesarean section is one of the most common surgeries performed, but stresses that it’s still a major surgery. That’s compounded by the fact that expectant mothers are often young and healthy, so the fears and concerns snowball: they’re going under the knife possibly for the first time, they’ve heard the terrifying term “breech,” and they’re entering motherhood. To prepare, she recommends asking as many questions as possible from an OB-GYN and the maternity ward nurses.
When the time comes, things get chaotic. And while a father or partner will be compelled to provide comfort and see the baby as it emerges, it’s also important to stay out of the way and let the hospital staff do their thing. Which is to say, put the camera down.
How to Prepare for a Breech Baby
- Breech babies can be recognized halfway through the third trimester.
- Some babies may turn themselves to the correct position on their own before birth.
- Some doctors may opt to perform an external cephalic version in order to turn babies while they are still in the womb.
- If the baby doesn’t turn, parents should prepare for a cesarean birth.
- Partners can help best by offering calm support both in and out of the operating room.
“Not only is the setting different for the average person, but you have an anesthesiologist and an anesthesiologist tech, an obstetrician and their OR assistant, then you have the circulating nurse and the scrub nurse, and then you have the pediatricians… and then the partner. Before you know it it’s a very very full room,” says Rosser. “What you want to do is support your partner. That’s what you’re there for.”
After the baby is born, pain management becomes an issue, much as it will with vaginal birth, but with the added stresses of surgical wounds healing. Rosser emphasizes that, especially amid the opioid epidemic, parents should talk to doctors about what medications to take in order to remain alert and functional.
“You want to be comfortable, but you don’t want to be gorked up on all these medications,” she says. “You’ve got the woman recovering from major surgery. Motrin and acetaminophen go a long way in post-op pain control.”
Generally, the baby will be fine, though pediatricians often conduct ultrasounds to ensure healthy hips when a baby has been in the frank position. At this point, dad becomes something of a caretaker, as generally planned, but with the added complication of taking care of a new baby and helping the mother recover from surgery.
“Readying the home is all about having resources for your new little family, whether it’s having meals brought in or frozen, or having family or friends who will come in for a period of time,” Rosser says, suggesting that family visitors be limited in the first few days.
Mostly, though, preparing for a breech birth is just a matter of preparing for a cesarean birth. A partner should be doing research to help ease a frightened mind and remembering the Boy Scout Motto: Be prepared.