Wednesday, June 24, 2009

Turn the Other Cheek

I love knowing that one little thing I did for sheer personal satisfaction effected so many people. I originally put Heads Up! on the web because I wanted a website that people came to. I knew there were hundreds of thousands of websites that wanted to tell you how to have a great birth. I wanted one that was popular (only way to get that 15 minutes of fame over and over again!)
So back by popular demand....
This is a compilation of links I collected for breech turning techniques from the Heads Up! All About Breech Babies Website. I am sending this information to the owner of the Breech Birth Coalition website and hope she will post them. As it is. I have tagged this blog with my old website name in hopes that those looking for this information will find their way back to me.

Breech Turning Techniques
Prenatal Breech Issues - discusses numerous ways to turn a breech baby.
AOCG Report on External Cephalic Version - report discusses which patients are candidates for external cephalic version, risks and benefits of the procedure, predictive factors of its success or failure, use of tocolysis, and cost implications of the procedure.
Guidelines for External Cephalic Version (EVC) of a Breech Presentation- a nice concise article about EVC and a brief explanation of how to conduct a vaginal breech birth.
External Breech Versions - this link has a description of an external cephalic version, plus it is on a nice web site. Follow the link for external breech version.
One Midwife's Collection of Breech Turning Technique
Hypnosis may help turn baby in a breech birth -
Mothercare Website - looking at the choices needed to be made, then at what can be done. An excellent resource for breech information.
CAN (International Cesarean Awareness Network)- this is the main link to their website. Click here for their breech breech turning info. If you are in a VBAC situation, this is the site for you.
Webster Technique Links - here are some links to information regarding this chiropractic technique that is stated to help a breech baby to turn.
This website has an opinion against the Webster Technique

Jane O'Hare- Lists the numerous ways to turn a breech baby

Self-help methods
Not all of these methods are supported by quantifiable data, but there is a great deal of anecdotal evidence, mainly from midwives, that they can help to turn a breech. Although these methods are low risk, pregnant women are advised to discuss any self-help methods they are considering with a midwife.

Visualize your baby in the head-down (vertex) position. You could imagine a helium balloon attached to your baby's foot, or imagine the baby turning somersaults.

Swimming may help to turn a breech baby. This is probably due to a combination of relaxed abdominal muscles and deep water immersion, which increases the amniotic fluid, helpful to the baby's turning. However, there is some evidence that regular aqua aerobic exercise may actually prevent breech babies from turning.

Headstand in the shallow end of a pool
Get into the pool and spend at least 15 minutes just paddling around, helping to relax your abdominal muscles. Then try a couple of headstands, with a helper to support you.

Knee-chest exercise
Get on your elbows and knees, so your hips are higher than your head, and stay in this position for 15-20 minutes a couple of times a day. You can also try crawling around in this position. A study in 1977 by Dr. Juliet DeSa Souza, retired professor of obstetrics and gynaecology at Grant Medical College, Bombay, found this method successful for 89% of 744 women studied.

Postural inversion or *breech tilt*
Lie with the hips propped up 12-18 inches higher than the head, two to three times per day, for between 10-20 minutes at a time. This helps to disengage the baby from the pelvis, and when the baby's head comes up against the inside of the fundus, it is inclined to tuck its head in and do a somersault into the vertex position. It is sometimes recommended to try this with an empty stomach. Small studies have reported success rates of between 89% - 96%.

Stimulate your baby's senses
You can try to attract your baby to turn using light, sound and cold. Try shining a torch close to the vagina, so the baby heads towards the light, or to place a radio or headphones near the pubic bone. You can also try placing a bag of frozen peas on the back side of the baby's head, as babies tend to move away from the cold.

Ask yourself: "why your baby is breech"?
Some birth practitioners believe that a mother who has anxieties about pregnancy and birth or who is stressed for other reasons (such as working late in the pregnancy) may be more likely to have a breech baby. Some suggest that that babies often turn to the breech position in order to come up to comfort the mother. Try to relax and spend some time talking to the baby. Explain that you would feel better if your baby turned, and that you and your baby could enjoy a more positive birth experience.

Getting Specialist Help
A researcher at the University of Vermont, Burlington, USA, used hypnosis with one hundred pregnant women whose babies were in the breech position between the 37th and 40th week of gestation. The women received hypnosis with suggestions for general relaxation and release of fear and anxiety. While under hypnosis, the women were also asked why their baby was in the breech position. 81% of the babies in the hypnosis group moved to the vertex position, compared with 48% of the control group. Hypnosis was most effective for the women motivated to use the technique. Aside from the visualization involved, the deep relaxation of hypnosis can help your abdomen to relax enough to allow the baby to turn if it wants to.
(Lewis E. Mehl, MD, PhD (1994) Archives of Family Medicine, Vol. 3, Oct. 1994)

A professional acupuncturist or shiatsu therapist will apply pressure on acupoint BL 67, which is on the outside of the little toe, right next to the nail. Although you can do this yourself, there is a small risk that it could bring on labour, and the technique is likely to be more effective if done by a professional.

Traditional Chinese medicine uses moxibustion (burning herbs, usually in a cigar shape) to stimulate acupoint BL 67, to help breech babies turn. Its effect may be through increasing fetal activity. No randomized controlled trial has evaluated the efficacy of this therapy, but studies have reported success rates of between 75% and 80%. It is possible to buy moxi sticks and try this yourself, but, as with acupressure, it is recommended to use a professional.

Yoga exercises
The classical yoga shoulder stand posture can help to give the baby room to turn and stimulation to allow the baby to turn itself. However, it is an advanced posture, and will need to be done in a modified position if the woman is not accomplished in the posture already.
To obtain maximum effectiveness, the posture should be done when the baby is most active. Other yoga exercises can also help - approach an experienced yoga practitioner who is experienced in antenatal exercise for advice and support.

The Webster Technique
This must be carried out by a chiropractor. It is a simple technique, which involves the chiropractor working gently on the woman*s legs and vertebra, usually requiring a series of appointments every two or three days for two weeks. Clinical case studies show a 80-100% success rate with this technique and a widespread trial is planned.

Homeopathic Pulsatilla causes the muscle fibers in the uterus to even out and may help to turn a breech baby. Homeopathic natrum muriaticum can help reduce swelling (odema) if this is a contributing factor. Consult an experienced homeopath for advice. (my midwife used 1M before my version p.b.)

External Cephalic Version (ECV)
ECV involves the external manipulation of the baby by an obstetrician. Ultrasound is usually used to find out exactly how the baby is lying and to locate the placenta and the baby is monitored throughout. The Royal College of Obstetricians and Gynaecologists recommend that ECV is offered to all women with an uncomplicated breech pregnancy at term (37-42 weeks). Performed prior to 37 weeks there is a risk of preterm labour and many babies will turn on their own around this time anyway. The biggest risk associated with ECV is separation of the placenta which rarely occurs, mostly due to the guidance of the ultrasound. Large scale trials report success rates for ECV of 46% in the UK, 65% in the US and 80% in Africa. Recent studies show that epidural anesthesia during ECV may actually increase its success rate.

Keeping the baby in the vertex position
Being aware of your posture, and sitting upright, cab help to keep your baby in the vertex position. Upright exercise, such as walking, can also help. So can simple yoga exercises, such as sitting in the classic *tailor* position and leaning forward.

After all that...if your baby is still breech...
If your baby remains breech, there may be a good reason why. It may be because of the position of the placenta or a short, knotted or twisted cord. Breech can also result if a physiological condition is present in either mother of child. These things are not necessarily anything to worry about, and breech may simply be the best presentation for your baby.
Consider your options for birth and discuss these with your midwife or obstetrician.

(Hi Heather! hope this helps your lady!)

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