Getting the diagnosis of a breech presentation is not so much fun. I have had two of those myself, one frank and one transverse, so I am no stranger to the news. I have done everything under the sun to get a baby to turn and both did ultimately-but with two totally different births.
Encouraging a baby to turn is normal. There is a point however to TRUST that some things are beyond our understanding.
There are so many suggestions for turning a breech baby:
- Laying inverted on an ironing board (this can become really uncomfortable fast)
- Hanging around the house on all fours doing continuous cat/cows (yoga moves where you gently rock your pelvis)
- Cold peas on the top of your abdomen or wherver the babies head is.
- Playing music into your pubic bone with head phones etc.
- Moxibustion, otherwise known as mugwort, burned over the baby toe.
- Chiropractic -namely the webtser technique.
- Clothes pins on the baby toes.
- Handstands in the pool.
- Visualization.
- Meditation.
- Homeopathic remedy pulsatilla
- External cephalic version.
As an acupuncturist I utilize moxibustion and acupuncture to help turn babies. I am always honest when dealing with a woman with a breech. Sometimes there are reasons way beyond our understanding that contribute to a babies lie.
My treatment usually consists of a systemic treatment to help address what is going on with mom. This could include; stress (obviously), reflux, back pain, sciatica, tight muscles, insomnia. I often open the Dai Mai which is a meridian called “the Girdle Vessel”. This extraordinary meridian runs transverse across the belly and its main function is to hold up the other meridians. Opening the Dai Mai can often help the baby find a little room to flip drop down.
A lot of times I find that babies are breech because the hip-flexors and pelvic floor needs to loosen up. Some tight ladies include runners, pilates aficionados, athletes etc. Other times babies are breech because the mom has too much water or the uterus is stretched and weak and isn’t holding the baby as tightly at term. In this case I use treatments to help strengthen her Qi.
I do burn the moxa of the baby toe in a few different ways. Occasionally I use warming needle (moxa attached to a needle) and other times direct moxa placed on cream and other times I use pole moxa. I provide mom with moxa sticks and tell her to go home and continue treatment for ten consecutive days. If baby has not turned by then to come back for another treatment. No one really understands why moxa over the baby toe works? One Western explanation may be that the baby toe is the dermatome for the sacrum. One thing is for sure moms report (and I experienced) a lot of fetal movement during the moxa treatments.
The one thing I feel that I must urge continuously is that you must TRUST that the baby and your body know what to do. Let go, relax and try not to become obsessive. This may be your first interaction with the will of your little one!
A good online resource is Spinning Babies
The following is a clinical trial done on the efficacy of moxa in turning a breech baby:
Cardini et al in 1998[7] had the following randomised controlled trial published in the Journal of American Association (JAMA)
The objective was to evaluate the efficacy and safety of moxibustion on Zhiyin BL-67 to correct breech presentation. 130 women having their first baby (primigravidas) at 33 gestation received moxibustion to Zhiyin Bl 67 while 130 women, also primigravidas, received no intervention.
The moxibustion was administered for 7 days .Women were then assessed and a further 7 days of moxibustion treatment given if the position had not changed.
Outcomes were measured in terms of fetal movements, as counted by the mother for one hour each day for one week and the number of cephalic presentations both at 35 weeks gestation and at delivery
At 35 weeks gestation 75.4% in the intervention group were cephalic (47.7% in the control).
Women in both groups then had the option of undergoing external cephalic version (ECV). One woman took this option from the intervention group and 24 from the control group
At delivery the presentation of 75.4% of the intervention group were cephalic compared to 62.3% in the control group.
The presentation did not change in any of the groups after 35 weeks except in those undergoing ECV. In terms of fetal movement the moxibustion group experienced a greater number of movements (a mean of 48.45 compared to the control group with a mean of 35.35).
Conclusion
That in prigravidas at 33 weeks gestation with breech presentation moxibustion treatment for 1 to 2 weeks at Zhiyin BL-67 increased fetal activity during the treatment period and cephalic presentation at 35 weeks and at delivery.
Treatment method
The women and their partner (or a person to help with the treatment) were given a treatment and taught how to use the moxibustion in a hospital appointment within 24 hours of the scan confirming the breech position. They then applied the treatment to Zhiyin BL-67 daily at home. Moxa sticks were used with the women sitting or in a semisupine position and the partner delivering the treatment.
Clinical Perspective
As part of this study an attempt was made to assess if there was a difference in delivering moxibustion sessions once or twice a day.
87 women used moxibustion for a total of 30 minutes (15 minutes to each point) while 43 women used moxibustion in the same way but received treatment twice a day.
At the end of the first week 79% of the cephalic versions were obtained in the women using moxibustion twice a day compared to 55.2 % in the daily treatments. But by the end of the second week 15 additional cephalic versions were obtained in the group having moxibustion treatment once a day.
This meant that at 35 weeks the results were termed as a nonsignificant difference (72.4% in the once a day moxibustion group compared to 81% for the women having moxibustion treatment twice a day).
From a safety perspective it was reassuring that no adverse events (such as intrauterine death or placental detachment) were noted in the treatment group. It was also interesting that while the number of premature rupture of membranes was similar in both groups the number of premature births was lower in the intervention group and that the use of oxytocin, before or during labour, was also reduced in the moxibustion group (8.6% compared to 31.3%).
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