I can’t believe we’re in the home stretch. Now as I’m entering my third trimester, time is moving quickly and before we know it, baby girl will be here! Baby girl and I are doing really well, and the waddling phase has really set in as my belly continues to grow. We recently found out that she is in complete breech presentation, meaning that her head is sitting underneath my ribs as her bum is sitting in the pelvis. So I feel like this is a perfect time to delve into what breech presentation is and the impacts that it can have on delivery. 

Breech presentation occurs in 3-4% of pregnancies and is when the baby’s buttocks, feet, or both are in the pelvis and come out first during delivery. Usually your OB will not be too worried that the baby is breech until around 36 weeks. Your OB may be able to tell which way the baby is laying by doing an abdominal exam and feeling for the fetal head, back, and buttocks. If breech presentation is suspected, this can be confirmed by ultrasound. 

When a baby is breech beyond 36 weeks, your OB may offer you an External Cephalic Version, or ECV, if you’re an appropriate candidate. An ECV is a procedure during which your OB will place firm pressure to the abdomen in an attempt to roll the baby so that he or she is head down. Many practitioners perform ECV with two people and use ultrasound guidance. The baby’s heart rate will be monitored during the ECV, as it can lead to placental abruption, preterm labor, rupture of membranes, or a decrease in heart rate which could require immediate delivery. The success rate of ECV is quoted at around 50% and depends on a variety of factors unique to each pregnancy, but if done successfully, an ECV can improve your chances of having a vaginal birth.

If you choose not to proceed with ECV, your OB will offer you a planned cesarean delivery. Some practitioners may feel comfortable offering you a vaginal breech delivery, however this is only considered in some situations, as the risk of complications can be higher. 

Currently, I’m 32 weeks so we’re keeping our fingers crossed that she decides to flip and move head down on her own! But as I have encouraged all of my patients in the past, it’s more important to me to focus on the fact that she is healthy and growing, instead of focusing on a birth plan and my delivery. My birth plan is to have a good outcome, simple as that! At the end of the day, I want the best and healthiest outcome for her and myself, no matter how that happens!

Please comment below if you have any questions about breech presentation or if you have delivered a breech baby!

With love,

Dr. Shweta Desai

*Follow my pregnancy journey here!