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33. Breech presentation
Introduction
While anything between a quarter and a third of all fetuses are "breech" (that is, positioned in the womb so that the bottom will emerge before the head) around 22 - 24 weeks of gestation, less than one in twenty will be in that position at term (after 37 weeks). Breech presentation is therefore not a normal feature in pregnancy and is regarded by doctors as a risk factor.
The structure and function of the body mean that a longitudinal lie with the baby's head coming first is the ideal and safest position for delivery.
The breech position does not confer any disadvantage to the fetus while it is still in the womb. Delivery is a different matter. This is why a considered decision has to be made before the onset of labour as to the best method of delivering such a baby. In general terms, the decision will be made on the basis of the absence of any contraindicating factors, parental wishes and the availability of the necessary expertise.
There is, of course, the option of manually turning the baby (a procedure known as external cephalic version or ECV before labour, to allow it to come head-first. All these issues are discussed and explained in detail in this chapter.
The breech position does not confer any disadvantage to the fetus while it is still in the womb. Delivery is a different matter. This is why a considered decision has to be made before the onset of labour as to the best method of delivering such a baby. In general terms, the decision will be made on the basis of the absence of any contraindicating factors, parental wishes and the availability of the necessary expertise.
There is, of course, the option of manually turning the baby (a procedure known as external cephalic version or ECV before labour, to allow it to come head-first. All these issues are discussed and explained in detail in this chapter.
An informed mother-to-be can significantly influence how her pregnancy is managed, a factor that is ultimately crucial in the overall experience of the pregnancy.