This Medical Video: A breech birth is the birth of a baby from a breech presentation. In
the breech presentation the baby enters the birth canal with the
buttocks or feet first as opposed to the normal head first
presentation.
There are either three or four main categories of
breech births, depending upon the source
* Frank breech -
the babys bottom comes first, and his or her legs are flexed at the
hip and extended at the knees (with feet near the ears). 65-70% of
breech babies are in the frank breech position.
* Complete
breech - the babys hips and knees are flexed so that the baby is
sitting crosslegged, with feet beside the bottom.
*
Footling breech - one or both feet come first, with the bottom at a
higher position. This is rare at term but relatively common with
premature fetuses.
* Kneeling breech - the baby is in a
kneeling position, with one or both legs extended at the hips and
flexed at the knees. This is extremely rare, and is excluded from
many classifications.
As in labour with a baby in a normal
head-down position, uterine contractions typically occur at regular
intervals and gradually cause the cervix to become thinner and to
open. In the more common breech presentations, the baby’s bottom
(rather than feet or knees) is what is first to descend through the
maternal pelvis and emerge from the vagina.
At the beginning of
labour, the baby is generally in an oblique position, facing either
the right or left side of the mothers back. As the babys bottom is
the same size in the term baby as the babys head. Descent is thus as
for the presenting fetal head and delay in descent is a cardinal
sign of possible problems with the delivery of the head.
In
order to begin the birth, internal rotation needs to occur. This
happens when the mothers pelvic floor muscles cause the baby to turn
so that it can be born with one hip directly in front of the other.
At this point the baby is facing one of the mothers inner thighs.
Then, the shoulders follow the same path as the hips did. At this
time the baby usually turns to face the mothers back. Next occurs
external rotation, which is when the shoulders emerge as the
baby’s head enters the maternal pelvis. The combination of
maternal muscle tone and uterine contractions cause the baby’s
head to flex, chin to chest. Then the back of the babys head emerges
and finally the face.
Due to the increased pressure during
labour and birth, it is normal for the babys leading hip to be
bruised and genitalia to be swollen. Babies who assumed the frank
breech position in utero may continue to hold their legs in this
position for some days after birth.