Breech Babies

The majority of babies are lying head down by around 37 weeks towards the end of a pregnancy, ready for birth.  But for 3% of women, their babies are in a breech position, meaning that their babies are lying bottom or feet first in the uterus (RCOG 2008).  Breech presentations can sometimes lead to complications and your obstetrician will discuss with you whether to try to turn your baby, to offer you a Caesarean section or to allow you to have a vaginal breech birth.  

What can be done to turn my baby?

Your obstetrician or midwife may recommend an external cephalic version (ECV) which involves a skilled obstetrician firmly pushing on your abdomen to turn the baby around.  Postural exercises such as involving knee to chest positions on a daily basis may also be recommended.  However, an increasing number of patients are recommended acupuncture and moxibustion as more research evidence is coming to light for its effectiveness in correcting breech presentations.  

A Dutch review of clinical studies was carried out to assess the relative effectiveness of acupuncture and moxibustion treatments on the acupuncture point BL67 (Zhiyin), versus ‘expectant management’ which included ECV (van der Berg 2010).  It also took into account treatment compliance and costs for stimulated breech presentations.

The results were that:

  • 53% of women treated with expectant management for breech presentation were still breech, versus 32% of women treated with moxibustion;
  • 50% of women treated with expectant management for breech presentation still required a caesarean section, versus 37% of women treated with moxibustion;
  • Moxibustion was more effective and less costly than expectant management. 

The authors of the study concluded that 'offering BVA-T (moxibustion therapy) to women with a breech foetus at 33 weeks gestation reduces the number of breech presentations at term, thus reducing the number of caesarean sections, and is cost-effective compared to expectant management, including external cephalic version’.

These findings are similar to those in a Spanish review published in the American Journal of Obstetrics and Gynaecology which found moxibustion at the point BL67 to be 30% more effective than no treatment or postural management (Vas 2009).  This review found that moxibustion may also reduce the need for oxytocin during labour, a hormone prescribed to start or strengthen contractions, and that it presented no additional safety risks such as Caesarian section, pre-term delivery or premature rupture or membranes.

When do I need to get in touch?

Most breech babies will have turned by themselves by 35 weeks.  If your baby is still breech at 35 weeks, get in touch with us for more information.  

We recommend undergoing moxibustion treatment as close to 35 weeks as possible for optimal effect as the baby has more room to manoeuvre.  You will usually only require one treatment, although in some circumstances two treatments may be necessary.  

For further information about moxibustion, please get in touch and we'd be happy to advise you further, or to speak to your midwife.  


REFERENCES

Royal College of Obstricians and Gynaecologists. A breech baby at the end of pregnancy: Information for you. 2008. LINK

van der Berg I, Kaandorp GC, Bosch JL, Duvekot JJ, Arends LR, Hunink MG. Cost effectiveness of breech version by acupuncture-type interventions on BL67, including moxibustion, for women with a breech foetus at 33 weeks gestation: a modelling approach. Complement Ther Med. 2010 Apr;18(2). LINK

Vas J, Aranda J, Nishishinya B, Mendez C, Martin M, Pons J, Liu J, Wang C, Perea-Milla E. Correction of nonvertex presentation with moxibustion: a systematic review and meta-analysis. Am J Obstet Gynecol. 2009 Sep;201(3):241-59. LINK

Posted by Lily Lai.