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Feet First—Breech Presentation

You’ve just learned from your OB-GYN that your baby is situated in a breech position. What does this mean for you and your little one? Breech babies are situated in the uterus with their feet pointing down and their heads tucked under your rib cage. Not the optimal position for delivery. But most babies bounce back and forth from a feet-down to head-down position throughout pregnancy. Those who get stuck feet-first in the later stages of pregnancy are known as breech.

According to Dr. Andrew Jenis, chairman of the Department of Emergency Medicine at Cortland Memorial Hospital in Cortland, New York, at 28 weeks gestation about 30 percent of all babies present in the breech position, but by full term, many turn on their own (3 to 4 percent of babies arrive in the world feet first).

Types of Breech Presentation

  • Frank Breech: This is the most common breech position (65 to 70 percent of all breech babies are in this position). In this presentation, Baby’s bottom comes first, his legs flexed at the hip and his knees extended (with his feet near his ears).
  • Complete Breech: A complete breech baby looks like he is sitting cross-legged in the womb (with his hips and knees flexed).
  • Footling Breech: Footling breech babies have one foot stretched out and the other tucked underneath, much like a bird standing on one foot. This is a rare breech position for full-term babies, but is common with premature fetuses.
  • Kneeling Breech: This is a very rare position in which the baby is in a kneeling position, with one or both legs extended at the hips and flexed at the knees.

Breech Baby Delivery Risks

Most types of breech presentations can’t be delivered vaginally—the laws of physics will not allow it to go smoothly. A frank breech baby, on the other hand, can be delivered vaginally, the buttocks alone acting as an efficient dilating wedge (much like the head would).

But the statistics on delivering breech babies vaginally are a concern. Assuming of course the delivery was frank breech, the statistics say there is still an increase in the number of babies born who may suffer from “soft” neurological complications.

Besides an increased risk of obvious trauma, soft neurological complications often go unnoticed but haunt parents later in the form of hyperactivity, attention deficit disorder, dyslexia, and a host of other problems. Since studies on the legitimacy of this theory are still inconclusive, many doctors advise in favor of Cesarean delivery for frank breech presentations.

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