The position of breech babies before birth can add to the worry before delivery, because the location of the baby's head that should have been near the birth canal, is still above. The following is a further explanation of the risk of complications of breech babies, both for normal childbirth or cesarean section.
Breech baby position is common when pregnancy enters the third trimester. Generally pregnant women will feel uncomfortable under the rib cage, often shortness of breath and feel pain right in the bladder due to the baby's kick.
If this is the first pregnancy, then at 36 weeks, the baby in the womb is likely to return to normal position. Only about 3% of breech babies survive until delivery.
Although it is not known with certainty the reasons for breech babies until delivery, there are several factors that increase the risk of the condition. These include a history of preterm labor, twins or more pregnancies, too little or too much amniotic fluid, abnormal uterine shape or abnormal growth of tissue such as myoma, and the placenta covering part or all of the uterine path (placenta previa). In addition, some babies with congenital abnormalities are also likely in a breech before birth.
One of the ways to change the position of breech babies before birth is to use the external cephalic version (ECV) method. Generally done at the age of 36 weeks of pregnancy for the first pregnancy, while for the second pregnancy and so on, usually done at 37 weeks gestation. For women who contain twins, or have experienced vaginal bleeding during pregnancy, this method is not permitted.
If the condition of a breech baby does not change until before delivery, there are some risks of complications that need attention.
Normal delivery
Babies born with a normal process in breech conditions will be preceded by the birth of legs, buttocks, body, hands, then head.
Risks that can arise when giving birth to a breech baby, are:
- The mouth of the uterus does not open and stretch maximally, so that the baby's shoulder or head may be held in the mother's pelvis. This condition can occur because the baby's head is the most recently born when the baby is in breech position.
- The umbilical cord falls into the vagina before the baby is born. This condition can cause the umbilical cord to be compressed or pinched, resulting in a decrease in blood flow and oxygen to the baby. If a pregnant woman wants to give birth to breech babies normally, you should ask your doctor for detailed advice about the benefits and risks.
- If breech babies are born normally, there is an increased risk for babies experiencing lower Apgar values at birth.
- Injury to the neck and cervical spinal cord at birth. This can occur when the baby's head is flexed excessively in the birth canal when it will be born.
Normal delivery for breech babies is most likely to be done if the part of the baby's body closest to the birth canal is the buttocks, not the first normal delivery, the condition of the baby before delivery is monitored stable and normal, there is an experienced team of doctors, and the availability of caesarean section facilities if at any time needed.
Caesarean delivery
Experts will generally suggest a method of caesarean delivery to deliver breech babies. Giving birth to a breech baby by caesarean will give a longer planning time, thus allowing pregnant women to be better prepared. The process of cesarean section for breech babies is actually not much different from Caesarean section in general. Only, the doctor will remove the legs or buttocks of the baby first before the head.
Even though caesarean delivery also has various risks, such as:
- Infection, bleeding, or injury to internal organs. As with any major surgery, both the caesarean procedure itself and the anesthetics used, are likely to cause side effects in some people.
- Caesarean section can also affect subsequent pregnancies, such as disorders of attachment (implantation) of the placenta in the uterine wall, or tear of the uterine wall. This risk increases, if caesarean section is done more often.
- The risk of a baby's head being pinched can still occur even though labor is done by cesarean section. This can occur if when the baby's head is about to be born, the mother's uterus contracts and clips the baby's head. This condition is more at risk for breech babies born prematurely.
Some conditions of breech babies that are most likely recommended for caesarean delivery are if the baby's feet are at the bottom of the buttocks, as well as twins with one of the babies in the breech position.
In addition, cesarean delivery will also be performed if the baby is estimated to be more than 4 kg or less than 2 kg, the mother has had a cesarean delivery with a narrow pelvis, the placenta is too low, or the mother has a dangerous condition such as preeclampsia. According to research, some pregnant women containing breech babies are more at risk of premature rupture of membranes. This causes the fetus in the womb must be born prematurely.
For premature breech deliveries, some research evidence concludes that safer births are performed by cesarean section. However, if there are no other complications in pregnancy, it is still possible for a normal delivery. The doctor will give the best advice based on various considerations.
The condition of a breech baby before delivery must receive special attention. The choice of delivery must be well considered between parents and doctors, to avoid complications of breech babies. Therefore, it is important to routinely consult an obstetrician to conduct a pregnancy check up, in order to monitor the health condition of the mother and baby, including monitoring the position of the baby in the womb, especially before delivery.
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