How to Turn a Breech Baby: 3 Options for Moms Who Want a Vaginal Birth
- Sabrina Thorpe
- 8 minutes ago
- 6 min read
“My baby is breech. How do I get them to turn?” is a frequently asked question in a lot of mom groups on social media. Everything could be going beautifully in a pregnancy, and then a mom is told that her baby is breech, with buttocks or feet down, rather than head down and all chaos breaks loose. For most moms, a breech baby means they will need to have a c-section because they don’t have a provider who is skilled enough to attend a vaginal breech birth. Reasonably, most women would prefer to avoid major abdominal surgery if they can. While finding a provider who does have the skills to support you through a breech birth would solve the problem, this can be challenging as most obstetricians no longer receive this training and many midwives are heavily regulated and unable to attend breech births. So at that point the question for moms wishing to avoid a c-section is, can you turn a breech baby, and if so how? Yes, you can help a breech baby to turn, and here are 3 options to help your baby turn head down:
Inversions
Inversions are the process of tipping your hips up higher than your head during pregnancy. There are a number of ways to do inversions, but the most common are:
Puppy pose
Off the edge of a couch
Inversion table (or equivalent set up at home)
When you are doing an inversion, you are using gravity to help baby disengage from the pelvis so they have more room to turn. It also encourages baby’s buttocks to turn toward your rib cage in coordination with gravity. Doing inversions also helps to gently stretch any uterine ligaments that may be holding tension and restricting the baby's ability turn to head down, Inversions also take pressure off of the pelvic floor, allowing it to relax.
When completing an inversion, you want to make sure that the hips are up higher than your head so your upper body is sloping downward. Once in this position, you want to check in and feel where you may be holding tension. I often find that moms will be holding tension in their pelvic floors, hips, and through the abdomen. When you fully relax these areas, you will feel your belly shift up towards your ribs and many women report feeling baby disengage, or even a vacuum-like sensation in their vaginal area. You may also experience some pulling in the fascia of the abdomen. I encourage my moms to hold the inversion to their tolerance, breathing deeply throughout the process. When coming out of an inversion, it is important to go slowly to allow your blood pressure to accommodate and to come up tall into the knees, not sitting back straight to the heels. Staying in this tall posture allows baby the space to wiggle and find a new, hopefully better, position within your abdomen and pelvis. A few deep breaths in this tall kneeling position is usually adequate. You may or may not feel baby flip right away, but being inverted usually encourages a lot of movement from baby.
In my practice, inversions are usually my first recommendation for babies who are breech or poorly positioned in general. It’s something that can be done at home, and you can do them however much you want. There really are no contraindications to doing inversions, with the exception of potential blood pressure issues or rare medical complications. If you have any concerns about inverting yourself, make sure you speak with your health care provider.
External Cephalic Version (ECV)
An external cephalic version is a procedure that is performed in a hospital setting with a full medical team available and at the ready. It involves an obstetrician manually attempting to turn the baby to a head down position, which can be quite painful for the mother and often requires a mom to be medicated in some way to get through it. The success rate with this procedure is somewhere around 50-60%.
An ECV is also not something that can be performed outside of a highly medicalized setting. The pressure required to manually turn the baby from the outside can cause complications with both mom and baby. I would argue that this should be a last case scenario and not any woman’s first line of defense for flipping a breech baby.
Pelvic Floor Physical Therapy and Fascial Release
Saving the best for last: pelvic floor physical therapy can help breech babies turn! There is a caveat to this- your pelvic floor therapist must provide the following interventions in order to have the highest rate of success in helping your breech baby to turn:
Pelvic and sacral bone mobilization
Round ligament release
Broad ligament release
Uterosacral ligament release
Abdominal fascia release
Diaphragm release
Pelvic floor muscle release
All of these interventions are gentle in nature and a physical therapist who is skilled in these interventions does not physically turn your baby. Instead, we remove any mechanical blocks within your body that may be preventing baby from having the space to turn. Moms can hold tension and restrictions throughout their body for any number of reasons, so having these areas addressed is crucial to giving baby ample opportunity to turn on their own. Babies tend to be repelled away from tension (or kick at it incessantly to try and make room for themselves), so releasing these tissues gives them the space they need to find a more optimal position. At our Waukesha clinic, we have had good success with helping babies find optimal positions for birth. When moms see us prenatally starting in the second trimester, the rate of breech babies at term is currently 0%. For those moms who are 36+ weeks pregnant with breech babies, we have a good success rate with babies turning in the days following their first positioning session. Moms with ECVs scheduled can often cancel them.
It should also be noted that if you are choosing to try an ECV, seeing a physical therapist who specializes in fetal positioning can increase the chances of the ECV being successful. By preparing the body and releasing these tissues just prior to the ECV procedure, the obstetrician may have an easier time getting the baby to flip without having to force baby past restricted areas in your body. Unfortunately, most obstetricians don’t recommend moms do pelvic floor physical therapy ahead of their ECV procedures, and it is likely because a) there aren’t enough physical therapists who are providing this specialized service, and b) they don’t realize that it is even possible to support the ECV procedure in this way as they are not musculoskeletal experts.
Honorable Mention: Acupuncture
I am not an acupuncture expert, however, this deserves an honorable mention as a way to help breech babies to turn. Acupuncture works to help the body find balance, just like a physical therapist does. However, acupuncture goes about this in a different way by using needles and pressure at specialized points to help the body find balance. It is typically a very relaxing experience (even for people with needle-phobia like me), and it is worth adding to your list of things to consider if you have a breech baby you would like to encourage to turn.
There is a lot you can do to help your breech baby turn. However, it is important to recognize that there isn’t a guarantee that a baby will turn, even if you did everything listed here. Honoring the fact that baby has insider information (literally) and recognizing that they are going to choose the best way to be born based on the individual circumstances is important for all moms with breech babies. But you can be empowered in your pregnancy and birth by doing what you can to help baby along and knowing you truly tried everything.
Work with us
Do you have a breech baby and want to try physical therapy to help them turn? Or maybe you are earlier in your pregnancy and you want to give your baby the best chance to be optimally positioned going into labor? Foundation Physical Therapy in Waukesha, WI is currently accepting new clients. We would love to work with you and your baby.
You can click the link here to be taken to our site for more information about prenatal physical therapy and online scheduling.
Dr. Sabrina Thorpe is a Doctor of Physical Therapy with a decade of clinic experience. She specializes in treating pregnant and postpartum women and their infants at Foundation Physical Therapy in Waukesha, WI.