With just a few weeks left before the due date, Sarah Bedingfield Shutt noticed clear signs that her first baby was in the breech position. Instead of the head facing down towards the pelvis, the baby’s feet or bottom were positioned there. Sarah described her experience, saying her bump was smaller and the baby’s hiccups could be felt higher up, like a joey tucked up in its mother’s pouch.
Other indications of a breech position could include the presence of a hard bulge near the rib cage (the baby’s head), the baby not engaging into the pelvis as the pregnancy progresses, and discomfort or soreness in the upper body for the mother due to the baby’s head pressing on the lungs and ribs. However, at the time, Sarah had no idea that her daughter, Beatrix, was breech. This made a normal delivery difficult and raised the risk of complications for both mother and child.
Around 4% of babies in England and Wales, totaling to about 25,000 a year, are in the breech position in the final stages of pregnancy. While chance plays a role in this, certain factors like a low-lying placenta, abnormal fluid levels, and carrying more than one baby can prevent the baby from assuming the head-down position.
When a breech presentation is identified after 36 weeks, doctors can attempt an external cephalic version, where external pressure is applied to manually turn the baby in the womb. This procedure is successful in about half of cases. If a vaginal birth is attempted without trained midwives specializing in breech births, the baby may be at risk of dislocated arms or legs during birth. There is also a possibility of the baby getting stuck in the birth canal or experiencing brain injury due to oxygen deprivation. In 0.5% of breech deliveries, the baby may even die, compared to 0.1% in normal vaginal deliveries. 40% of cases require emergency caesarean sections, according to the Royal College of Obstetricians and Gynaecologists.
A planned caesarean section is usually the safest option when the baby is known to be breech. However, between 15% and 33% of women discover their baby is breech only when they go into labor, as routine ultrasound scans are typically conducted at 12 and 20 weeks, which is too early to detect the problem. This leads to many emergency caesarean sections, which can be risky.
To address this issue, researchers in the UK have proposed a solution that could reduce unexpected breech births by 70%. They suggest adding a routine third scan at 36 or 37 weeks of pregnancy to identify those at risk. This would enable mothers to have a planned caesarean or a natural delivery supported by midwives trained in breech births. The study conducted by researchers at St George’s University Hospital NHS Foundation Trust and Norfolk and Norwich University Hospital NHS Foundation Trust showed that the third scan significantly reduced the rate of unexpected breech births. Additionally, babies of women who underwent the third scan and were breech were less likely to be admitted to the neonatal unit, and less likely to have a poor Apgar score after birth.
Sarah herself discovered that her baby girl was breech after having the extra scan at 36 weeks. She made the decision to have a planned caesarean for the safety of herself and her baby. Currently, extra scans are only offered for complicated pregnancies, and standard pregnancies rely on midwives examining the abdomen by touch to determine the baby’s position, which is only 60 to 70% accurate.
The addition of a third scan at 36-37 weeks could greatly improve care and reduce the risks associated with unexpected breech births.
Denial of responsibility! VigourTimes is an automatic aggregator of Global media. In each content, the hyperlink to the primary source is specified. All trademarks belong to their rightful owners, and all materials to their authors. For any complaint, please reach us at – [email protected]. We will take necessary action within 24 hours.
