If you are one of the 3-4% of people carrying their baby in a breech position towards the end of pregnancy, it’s good to know there are techniques that can help turn baby head down. Sometimes babies lie this way because it’s best for your uniquely shaped pelvis. Sometimes its due to a pelvic restriction or imbalance,  perhaps caused by a sedentary lifestyle or an injury like a fall or accident, the position of the placenta or too much or too little water around the baby. 

Whatever the reason, there are a number of biomechanical techniques and positions that can help turn baby round. Before using them check in with your care provider and do take note of any contraindications. It is advisable to find a doula, midwife, physio or birth preparation teacher who has been trained in using these techniques to take you through them safely.

These can be used from 34-36 weeks gestation. They are used in sequence for a full day at least twice a day and can be repeated for 3 days if necessary. Please use them in the order they are displayed on the page. They may also help with a transverse or oblique positioned baby.

Start the sequence with a simple Psoas Release technique. Use the Constructive Rest Position for 10 minutes. This is an Alexander Technique and advocated by Liz Koch as an effective technique to relax the psoas muscle. It's described as: "one of the simplest ways to help yourself improve posture, reduce excess tension and manage the effects of stress". Remember - this is conscious form of rest, not just a lie down and a snooze!

Improvise a diagonal support and sit with bottom directly in front of the bolster and lie back. Do not prop the head up with a pillow - the chin should be "neutral". Keep knees bent and feet flat on the floor a hip width apart. Focus on breath, inhaling into the side of the chest to stretch diaphragm. With each exhale imagine the thigh bones becoming heavier and sinking deeply into the hip sockets. Repeat for 15 breaths or 10 minutes

Follow this with a Leg Swing - stand upright on a stair or a block high enough to allow your leg to swing freely. Be Safe - support and balance yourself with your hand on the wall or a piece of furniture

Allow the right leg to hang freely and gently swing it back and forth like a pendulum. Take care not to let the trunk bend or twist as the leg swings. Repeat the same movements with the left leg. Swing each leg for one to two minutes. 

Sidelying release —  twice a day. 5-10 minutes each side.

 This is one of the most effective biomechanical techniques - it helps stretch connective tissue that cover muscles and ligaments attached to the pelvic floor and sacrum and cross over or through the hip to the leg. It's use gives the baby a more space to get into an optimal position. Picture one demonstrates the position partners take to make sure you are safe. Picture two shows a modified position for use with epidurals and demonstrates the correct position of shoulders - square to the bed, with back and hips, aligned.

Safety first - this position leaves you very close to the edge of the bed - always make sure there is either furniture to support you or a partner present to prevent you from rolling forward and slipping off the bed

Contraindications - avoid if you are hypermobile.

When using SLR be aware that:

• You may feel the stretch in one buttock or both while practising the position - don’t worry if you don’t feel a stretch - it is still effective.
• If there's pain or discomfort under the bump or down the side or back of the legs it means the stretch is not happening in the right place - a little tweak in the way you are lying will often correct this. 
• It’s advisable to mobilise for several minutes following Sidelying Release, Always work both sides. 

 

Finish the sequence with the  Open knee chest position.

Hold the position for 20-30 mins.  Make sure you have a small cushion to rest your head. Your shoulders rest on your partner or supporter's feet. Chest is on the floor and knees are angled away from your hips. 

Contraindications; Do not use it if you have high blood pressure, polyhydramnios, glaucoma or any condition that increases your risk of a stroke.  

Other useful techniques: 

• Some midwives advocate rocking on the gym or birth ball : back and forward, side to side and figure of 8. Do each movement 4 times.  Do this twice daily from 30 weeks for 3 weeks.
• see an osteopath who may offer the Webster technique to balance the pelvis 
• hold an ice pack near the babies head while using the positions above. 
• The obstetrician may offer a technique called ECV-External Cephalic version, usually offered around 36 weeks gestation.  It is a technique that aims to turn the baby manually. This technique has a 50% success rate  
• moxibustion and reflexology can also be useful. Moxibustion has a slightly higher success rate 60% compared to ECV.
• Remember that if your baby stays in a breech position you may choose to give birth vaginally or by caesarean section. If you choose to give birth to your baby vaginally please seek out a confident and experienced vaginal breech birth practitioner. 

Useful Links

• For more detail about breach birth visit the Breech Babies Club.
• Dr Shawn Walker's  Optibreech Project has info about the latest developments and research about breech birth
• Obstetrician Florence Wilcock discusses ‘bottom down’ babies in her podcast "The Obs Pod".