Typically, children are born head-first. In the breech presentation, the baby is turned around so that the feet or buttocks enter the birth canal first. When this happens, the baby is at risk for complications such as head trauma, brain bleeds, umbilical cord problems, hypoxic-ischemic encephalopathy, cerebral palsy, seizures and birth asphyxia.
Fetal descent is impacted by the maternal pelvis. The maternal pelvis is a bony structure, and it forces the baby to make several movements in order for it to fit through and to delivery vaginally safely.
Typically, the baby is going to be head down and entering the canal at this angle. Sometimes, the baby—for multiple reasons—cannot make that flip. So that’s when we have a breech presentation.
Breech presentation can happen in a couple different ways. There’s when the bottom is presenting first. Sometimes the legs are all the way up, and that’s a frank breech. You can also have a footling breech where their feet are coming out first. Typically, the most often cause of breech presentation is early gestation. The amount of amniotic fluid can influence it. Definitely the placental structures, and if the mom has had multiple pregnancies (if she’s a grand multipara—more than five or six pregnancies); that can also impact it.
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