Monday, March 29, 2010
Usually babies are head down by 32 weeks and hopefully 36 weeks. But if they remain breech or head up, then we have to decide what the best option for delivery is. If you have a normal uterine anatomy and your baby does not have any anomilies and your placenta is in a place that makes it safe to attempt to turn your baby, then we can schedule you for a time in labor and delivery and I will assist my OB backup physician in attempting to manually turn your baby. This is call an external version. We/he places our hands on your abdomen and try to somersault your baby into the right position. There is about a 3% risk of doing harm which would necessitate an emergency c/section. If all goes well, we monitor your baby for about 30-60 mins after and then send you home. We usually do these around 36-37 weeks when your baby is small enough to hopefully have success at turning, but old enough that survival outside the womb would be fine if you have to be delivered immediately. Your other options are to wait and see if the baby turns on its own, or you can try leaning down in the decline position on your elbows and knees a couple times a day for 5-10 mins and see if that helps your baby spontaneously move. If your baby doesn't turn and remains breech at the time of labor, you will likely need a c/section. If you think you are a good candidate to deliver a breech baby and you wish to try this, we send you to Dr. Silver at the University of Utah. I think he is one of the only OB's in Utah that will still attempt breech deliveries, as these are fairly dangerous. Otherwise we schedule you for a c/section. I have also had some patients go to acupuncturists and do acupuncture and they have had success. These acupuncturists claim to have an 80% success rate-which is pretty dang good if you think about it! Of course you check with your provider to make sure this is appropriate. If your uterus has a septal defect, or your baby has some other defect, or your amniotic fluid is low, it is best to leave things alone and have the c/section. You risk more damage to yourself or the baby to try to intervene, and let's face it, we want you to have a live healthy baby even if this means a longer recovery for you!