Q: I am eight months’ pregnant and my baby is in the breech position. Will I need a C-section?
A: Possibly. At this stage, however, it’s too early to tell.
In most cases, babies are programmed to enter the world head-first. But in about 4 percent of pregnancies, the baby is in the breech position — its bottom and legs, rather than its head, are at the base of the uterus.
In the early stages of pregnancy, this is nothing to worry about — babies move around a lot. At the beginning of the ninth month, though, they begin to settle in one position (usually head-first).
If the baby has not turned and there are no contraindications (such as hypertension and a previous Cesarean-section), your doctor can try to reposition the baby with a technique called external cephalic version.
This is done after 36 weeks — and should be done only in a setting where doctors can perform an emergency C-section if there are signs of fetal distress.
The doctor lifts the baby’s bottom upward with one hand while pressing on the baby’s head with the other. The baby is then rolled either forward or backward. Sometimes two doctors do this to get a better grip.
Before this procedure, you must have an ultrasound to make sure there is ample amniotic fluid, there are no uterine abnormalities and that the placenta is in the right position (not covering the cervix).
The baby’s heart rate should be monitored to make sure the technique hasn’t caused tension or a knot in the umbilical cord, thereby diminishing the oxygen supply.
You may also receive an intravenous medication to prevent contractions. Some doctors think you should have an epidural in place in case you need an emergency C-section.
The success rate of this technique averages 58 percent. If it doesn’t work, or if your doctor has reasons not to try it, you are better off having a C-section rather than a vaginal breech delivery.
This is certainly something to take seriously: Statistics show a 5.7 percent chance of infant death after a breech delivery, vs. 0.4 percent for a regular delivery. What’s more, few doctors today have sufficient training and/or experience to perform breech deliveries.
Breech deliveries bring a risk of complications if the baby’s head gets stuck. In a vertex (head first) delivery, if the head doesn’t fit, labor stops progressing and the doctor has time to decide whether to perform a C-section.
Dr. Reichman’s Bottom Line: If your baby remains in the breech position and can’t be turned, you should have a planned C-section.
Dr. Judith Reichman, the “Today” show's medical contributor on women's health, has practiced obstetrics and gynecology for more than 20 years. You will find many answers to your questions in her latest book, "Slow Your Clock Down: The Complete Guide to a Healthy, Younger You," which is now available in paperback. It is published by William Morrow, a division of .
PLEASE NOTE: The information in this column should not be construed as providing specific medical advice, but rather to offer readers information to better understand their lives and health. It is not intended to provide an alternative to professional treatment or to replace the services of a physician.