At 30 weeks...I wouldn't worry. But just in case she stays that way, here is how to turn them- my favorite is the slant board. Also, one not listed here, is to just get on all fours on the floor, with your head touching the ground and your hips high in the air. Stay like this as long as you can (at least 10 mintues), and then roll onto your side. Stay on your side for at least 10 mintues. (sorry, this is a REALLY long post!):
Breech Turning Techniques
Mobility
Walking is an excellent way to help baby turn and stay vertex. Walking creates movement in the pelvis which helps baby to turn as the mother’s upright stance provides more room making it easier to turn effectively. Regardless of which technique is used to turn baby, Mom needs to get upright, and stay in upright, active positions for at least 30 minutes a day to encourage baby to stay head down.
Relaxation and Visualization
Relaxation is a very important component in allowing baby to turn. When you are upset or tensed up, so is your baby. Your baby can sense when something is wrong and will even turn to a breech position until you are ready, at which time the baby will often also turn to a vertex position. As mentioned above, it may be Mom’s fear of birth or an aspect of giving birth. Positive visualization combined with a relaxed mind and body can often be the first and only step needed.
Some visualizations that have worked are:
• Imagine a helium balloon attached to the baby's foot, imagine the baby turning somersaults.
• Combined with deep-water immersion and handstands in the water, Mom can visualize the baby doing a forward somersault.
• Visualize baby not only un-engaging, but turning to the vertex, and re-engaging in a favorable position (be specific in your visualizations). The key to this is RELAXATION.
• Visualize the baby turning while practicing deep relaxation. Imagine the baby doing a front dive heading for the mom's backbone and then "splashing down" into the pelvis.
• Have dad tell the baby where to be and visualize this as he explains "talks" baby through the turn. It may be helpful to have a picture or pictures to help with knowing how and in what position is best.
Sound/Light Therapy
An extension of visualizations is talking to your baby and sound therapy. In Childbirth Without Fear by Grantly Dick-Read, he "encourages the mother to talk to her baby, encouraging it to turn around...the baby may not understand the words, but the soothing tone of voice will ease any anxiety about shifting out of a disadvantageous position."
An alternative is to "place earphones just above your pubic bone and play music for the baby. The theory is that babies can hear well and may move toward the music in order to hear better." Excerpt from Pregnancy, Childbirth and the Newborn by Simkin, Whalley & Keppler. You can also put a radio or cassette/CD player in your pants, near your pubic bone or you can also try between your knees when you are on the ironing board (see slant board techniques below). Nice sounds such as soothing music, your recorded voice or whale sounds are the best. Talk to the baby about turning. Partner can even speak close to mom, low down on her belly, to encourage baby to move towards the sound.
In contrast, place headphones on Mom’s abdomen in the fundal area and played "headbanger" music. The baby went vertex very soon after. Presumably the baby didn't appreciate the music and turned to get away from it.
A variation is to use a flashlight so the baby may move toward the light. You can start by shining the light at the top of your belly and then slowly moving it down to where you want the baby's head to be.
Hypnosis
"Hypnotherapy may help pregnant women turn their breech baby around to the normal head-first, or vertex, position. A researcher at the University of Vermont, Burlington, used hypnosis with one hundred pregnant women whose fetuses were in the breech (feet-first) position between the thirty-seventh and fortieth week of gestation.
The intervention group received hypnosis with suggestions for general relaxation and release of fear and anxiety. While under hypnosis, the women were also asked why their baby was in the breech position.
The study, which appeared in the Archives of Family Medicine, reported that 81 percent of the fetuses in the hypnosis group moved to the vertex position, compared with 48 percent of the control group. Not surprisingly, hypnosis was most effective for the women motivated to use the technique."
Natural Health magazine, November-December 1995
Hot and Cold Therapy
In colder climates it’s believed that heat around the pregnant belly can encourage baby to turn. This can be done with a hot water bottle or warm compress, or a tub full of warm water. This helps to relax the stomach muscles, allowing baby the extra room to move. An excellent start to other breech turning techniques as this relaxes the stomach muscles, which makes other techniques more effective (See also deep water immersion, below).
Cold therapy is also beneficial. Using the "Frozen peas" trick, have mom place a bag of frozen peas on her fundus, which is where the back of the baby’s head is, and the baby will move away from the cold. This can be done in conjunction with a warm bath, positioning, light therapy and other techniques.
Deep Water Immersion
The most successful do it yourself technique for turning a breech fetus is headstand done while totally immersed in water, according to Susun Weed in Wise Woman’s Herbal for the Childbearing Year. It's important to find a pool that's warm enough that you are *really* relaxed. Ideally, finding a therapeutic pool that is kept at a temperature higher than a regular pool where people heat themselves up swimming laps would be best.
Get into the pool and spend at least 15 minutes just paddling around and having fun. Now go to where you can stand with your head just above water, then do 5 handstands in a row. Just plain swimming can also help the baby turn because of the stretching and crouching involved. This will help you to relax those abdominal muscles to give the baby more room to turn. This may have to be repeated several times before baby will turn. It's best if she can judge vertex from breech because then she'll know when to quit. She may also want someone there to help her into this position.
Don’t forget the benefits of deep-water immersion on increasing your amniotic fluid, also helpful to the baby's turning. Being in deep water will squeeze the fluids in your tissues into your bloodstream and increase the volume of amniotic fluid.
In contrast, if you are an avid swimmer and swim everyday, stopping swimming and try alternate techniques.
Aromatherapy
When in the (breech tilt) position, use a little sweet almond oil to massage your belly over the area of your baby's back using a firm but gentle pressure. Excerpt from Aromatherapy for Pregnancy and Childbirth by Fawcett. This would help relax the stomach muscles and encourage baby with the massaging strokes of your hand. Massage in the direction you want baby to turn.
Homeopathy
As with all diagnosis, it is preferable to consult with a professional to ensure the correct remedy and dosage for each situation. First, check for underlying concerns.
Is fear causing tightness of the lower uterine segment and keeping the baby high? Ignatia Amara 30C, one tablet every two hours has proven effective for anxiety, depression from suppressed grief, anger or shock.
If Mom has excess or not enough amniotic fluid, try homeopathic Natrum Muriaticum. Excess water may cause baby to float to a breech position. Mom can also eat lots of watermelon or cucumber with the seeds to reduce fluid as they are natural diuretics. Too little fluid will also be problematic as baby will not have enough buoyancy to turn. Recommended doses:
• Pulsatilla 1M, one tablet. Repeat one more day if baby doesn’t turn,
• Pulsatilla 30C, one tablet every two hours for up to six doses (during the course of one day). Don't take it for more than one day, or
• Pulsatilla 200C, once a day for three days, or
• Pulsatilla 6X, one tablet under the tongue four times a day, up to 10 days.
Pulsatilla, a well known homeopathic remedy that is used for breech and other mal-presentations as well as prolonged labour. Pulsatilla acts on the muscular walls of the uterus and stimulates their growth. Start as soon as you find out about the breech presentation, but no longer than four weeks prior to your due date as baby will have ample room to turn on his or her own prior to that, and likely will. Take in whatever dosage you have available and lower dosages simply repeat more often each day.
Combine this with the breech tilt exercise at least twice a day for 10 minutes each time. Have Mom take one Pulsatilla tab before beginning the breech tilt.
And finally, Bach Bougainvillea flower essence has been found to work really well for turning breeches. Although not technically a homeopathic remedy, I will include it in this category.
This information from Guide to Homeopathic Remedies for the Birth Bag by Patty Brennan and Homeopathy for Pregnancy, Birth and Your Baby’s First Year by Miranda Castro
Acupuncture and Acupressure
Acupressure or acupuncture (preferably with a professional) using the Bladder 67 point has been proven to turn breech babies. The Bladder 67 point is on the outside of the little toe on both feet, right next to the nail. To apply acupressure, rub and push your fingernail into this point.
Moxibustion
Doctors in Italy and China use moxibustion, the application of heat from burning herbs to acupuncture points. Moxibustion is applied to the Bladder 67 and is an alternative to acupuncture or acupressure techniques.
For a great article on how to do moxibustion for breech baby:
http://www.birthinternational.com/ar.../andrea13.html Webster’s Technique
The contemporary chiropractic technique used for turning breech or other adverse fetal presentation is called the "Webster In-Utero Constraint Turning Technique" or Webster’s technique after Dr. Larry Webster. Dr. Webster reports effecting successful version in 97% of breech presentations, documented successful versions by other chiropractors is 82%.
The first step is to confirm presentation of baby and acquiring a maternal history of the pregnancy and other relevant factors is mandatory. When the baby is found to be in a breech presentation, the Mother is assessed clinically to determine, and correct, sacral alignment. The Mom then turns on her back and the baby’s location is determined in relation to her belly button. The trigger point for the rectus abdominus muscle is then found on the Mom’s left side and the chiropractors thumb is placed on this point. Pressure is exerted gradually and evenly straight down until the trigger point is found and pressure is maintained, but shifted slightly inward to isolate the broad ligament. As little as 3 to 6 ounces of pressure is often sufficient to induce relaxation of the trigger point. Pressure is maintained for a minimum of one to two minutes, more as necessary on evaluation of the trigger release, even up to 35 minutes. If little or no fetal movement is felt, some counter pressure with the opposite hand can be applied on the uterine wall opposite the side of the trigger point.
Following the adjustment, Mom is again assessed for sacral alignment and in most cases the alignment is achieved. If not, another sacral adjustment is needed. Additional adjustments should not be performed on the same day as the Webster technique. As little as one procedure may work, but typically it can take from three to ten adjustments performed over a two to three week period. Thus it is important to initiate this technique as soon as possible and know that it is harder for the baby to move close to term.
Pelvic Tilt and Slant-board Exercise
This is probably the most well known alternative breech turning technique. The position of your baby will dictate which position works best. If baby has his/her back to your front, the slant-board exercise is most effective. If baby has his/her back to your back, the beanbag or pelvic tilt exercise will be most effective. The baby’s back and head are the heaviest parts and these techniques use gravity to push the baby’s head into the fundus, tuck it and then do a somersault into the vertex position.
Do this exercise on an empty stomach and discontinue for lightheadedness or shortness of breath. Realize that there will be some pressure exerted on the thorax (chest cavity) by the abdominal contents being pushed upward toward the mom's head. One question often asked about these techniques is, "wouldn't the heavier head keep the baby in that position?" These techniques do two very useful things.
1. It helps to disengage the baby from the pelvis and
2. When the baby's head comes up against the inside of the fundus, s/he is inclined to tuck his/her head and do a somersault into the vertex position.
Slant-board Exercise:
Lie on your back with your hips raised high on pillows or lie on an ironing board slanted at a 45-degree angle against a sofa. For lightheadedness you can us a small pillow under the right hip (if the "plank" is stable) to elevate some uterine pressure from the inferior vena cava (large vessel bringing blood back to the heart from the legs). This maneuver should not be tried if you have high blood pressure, heart problems or lung problems. Relax, breathe deeply, avoid tenseness.
An alternative is for Mom to also use pillows on a flat surface to raise hips 12-18" above shoulders.
Beanbag Chair or Pelvic Tilt Exercise:
Made an indention for your tummy and lie down on your front, again with your head lower than your hips. An alternative to this is to adopt an all fours position and slowly lower your chest to the floor (knee chest position), again so your hips are higher than your head. (This looks like the position recommended for prolapsed cord).
If done 10 minutes twice a day for 2-3 weeks after the 30th week the pelvic tilt had an 88.7-96% success rate in 744 patients. It is recommended that the pelvis be raised 9-12 inches above the head and be done on an empty stomach.
You need to do this several times a day for 10-15 minutes and you have to be persistent, as they do not usually turn on the first try. If the baby does turn, stand up slowly and talk a long walk or do some squats to try to help the baby settle into the vertex position
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