Breech Birth | Michigan Birth Injury Attorneys

Typically, children are born head-first. However, in 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, birth asphyxia, hypoxic-ischemic encephalopathy (HIE), cerebral palsy (CP), and seizures. It is the physician’s responsibility to identify a breech baby, make appropriate attempts at turning the child, and safely deliver the baby by C-section when necessary. In fact, research shows that a C-section delivery is often the safest way to deliver a baby who is in breech position (1, 2).

What Is Breech Presentation?


Video: breech birth demonstration

In this video, nurse Andrea Shea discusses the types of breech presentations and explains the risks involved in the delivery of a breech baby.


Types of breech presentations

There are three types of breech presentations (1):

  • Frank breech: In this position, the baby’s buttocks are pointed toward the birth canal and the knees are extended. Frank breech occurs in about 50-70% of breech cases.
  • Complete breech: This position is similar to a cannon-ball position in which the baby’s buttocks are pointed down toward the birth canal and the legs are folded at the knees. A complete breech occurs in about 5-10% of the breech cases.
  • Incomplete or footling breech: As the name implies, in this position a  foot presents first and one or both of the baby’s hips are extended. It occurs in about 10- 40% of breech births.

Causes of breech presentation

Although the causes of breech presentations are not fully understood, there are predisposing factors that appear to make breech presentation more likely. These include (1):

  • Premature births or a history of premature delivery
  • Previous breech presentation
  • Multiples pregnancy (twins, triplets, etc.)
  • Amniotic fluid levels: Too much amniotic fluid (polyhydramnios) or too little amniotic fluid (oligohydramnios)
  • Uterine anomalies such as an unusual shape or fibroids
  • Placenta previa (the placenta grows in the lowest part of the uterus and covers all or part of the opening to the cervix)
  • Small pelvis or uterus
  • Fetal abnormalities

Diagnosing and managing a breech birth

When a breech position is diagnosed, the physician may try to turn the baby into the proper head-first position. Physicians use manual techniques to push the baby into place from outside the mother’s abdomen. If the baby cannot be turned, then the physician must assess whether the conditions exist that will allow a vaginal birth (eg: baby is full-term and in the frank position; baby does not show signs of distress while heart rate is closely monitored; x-rays and ultrasound show the size of the mother’s pelvis would allow a safe vaginal birth; a stat C-section is possible on short notice).

However, most healthcare providers and the current medical literature recommend a C-section for babies in breech presentation, as they are the safest method of breech delivery to avoid potential birth injuries (1, 2).

Birth injuries from mismanaged breech presentation

If vaginal delivery of a baby in breech presentation is attempted, serious complications can arise. Common complications associated with vaginal delivery of breech babies include:

  • Umbilical cord prolapse: This is an obstetrical emergency that occurs when the umbilical cord becomes compressed by the baby’s body as the infant moves through the birth canal. The baby must be delivered immediately to avoid brain damage or death.
  • Nuchal cord (cord wrapped around baby’s neck): This can also be an obstetrical emergency. If not corrected, oxygen to the baby may be diminished.
  • Fetal distress: Sometimes the stress and pressure of a breech delivery cause heart rate changes in the infant that can be extremely dangerous for the infant.

If the above complications arise and are not properly managed, serious and permanent birth injuries may result. Birth injuries often associated with breech presentation include (1):


Birth injury attorneys helping children with  injuries from breech birth

The attorneys at Reiter & Walsh, P.C. focus exclusively on birth injury cases. Our attorneys and in-house medical staff determine the causes of our clients’ injuries, the prognoses of birth-injured children and areas of medical negligence. Our specific focus on birth injury allows our attorneys to provide unparalleled legal service to our clients, who hail from many different states. If you believe your loved one’s birth injury resulted from an instance of medical malpractice, you may be entitled to compensation from a medical malpractice or personal injury case. During your free legal consultation, our birth injury attorneys will discuss your case with you, determine if negligence caused your loved one’s injuries, identify the negligent party, and discuss your legal options with you.

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Sources:

  1. Hofmeyr, G.J. (2018). Overview of issues related to breech presentation. Retrieved from https://www.uptodate.com/contents/overview-of-issues-related-to-breech-presentation.
  2. Hofmeyr, G.J. (2017). Delivery of the fetus in breech presentation. Retrieved from https://www.uptodate.com/contents/delivery-of-the-fetus-in-breech-presentation.

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The information presented above is intended only to be a general educational resource. It is not intended to be (and should not be interpreted as) medical advice.