Pregnancy Info

Breech and posterior births may present risks to both mother and baby. Read this article to learn about different types of breech and posterior births and the risks to mother and baby associated with either a breech or posterior birth.

The normal position for a baby at birth is head first and “face down”, as though the baby is looking at the floor, rather than looking up. However, babies move around a lot in the uterus, and some do not end up in this normal position, which can change the way the labor and delivery proceeds. The two main departures from a normal birth position for a baby are posterior and breech. With a posterior position, the baby is born “face up”, and with a breech position, the baby is actually born feet first or with his or her buttocks entering the birth canal first.

Breech Births

In many cases, the most common reason for breech birth is early term births. The baby hasn’t turned into the normal position for birth, and so labor forces the baby out backward. There are four main categories of breech birth:

1. Complete Breech: Baby comes out buttocks first, with legs in a position as if the baby is sitting cross-legged.
2. Frank Breech: The buttocks come out first in this position as well, but with the legs situated so that the feet are up near the ears. This is the most common breech position.
3. Kneeling Breech: Baby appears to be in a kneeling position, and the foot emerges first.
4. Footling Breech: Bottom is at a higher position, and one or both feet emerge first.

Due to the way the muscles of the mother contract, a breech birth may result in increased pressure, and the leading hip may be bruised. In some cases, a baby’s genitalia may be swollen.

There are risks associated with breech birth. Due to the fact that a breech baby does not properly fill the space created by a dilated cervix, there is space that the umbilical cord can fall into when the amniotic sac breaks as result, the cord can get stuck beneath the baby, and compressed to a point where oxygen is not flowing properly, possibly causing brain damage if delivery doesn’t happen immediately.

Damage to a baby’s internal organs can also occur as the position of breech birth can squeeze the baby’s legs against his or her abdomen. Incorrect use of forceps during breech birth can cause spinal damage and other damage.

In some cases, health care professionals prefer to quickly deliver the baby via c-section in order to help avoid some of the complications that can come with a breech birth.

Posterior Births

When a baby is born  “face up” it has fewer risks than breech birth, but there are risks nonetheless. Delivery of a posterior baby can be difficult for the mother. In many cases, having a posterior baby means a longer delivery, and sometimes difficulty in pushing. In some cases Pitocin is needed to keep contractions going.

There is no clear reason for babies to be born posterior, other than that babies often switch positions several times during the labor process. While there are plenty of theories and recommendations about how to prevent a posterior birth, none of them have been proven scientifically to be effective. Additionally, there is no substantial evidence that posterior birth causes back labor.

However, mothers who do give birth to a posterior baby do often have other issues. They are more likely to tear, or to need an episiotomy, since the position of the baby makes the delivery difficult. In some cases, posterior babies need help with vaginal delivery and health professionals may use a special vacuum, or forceps, to help the baby out.

There is some evidence supporting a link between epidurals and posterior birth. However, the correlation is incomplete. Researchers do not know whether epidurals cause posterior babies, or whether the stresses of a baby in a posterior position increases the likelihood that mothers will request an epidural for pain management during labor and delivery.

In the end, there are risks associated with any birth, including a normal birth. Your best bet is to do what you can to prepare and remain healthy, carrying your baby to full term. It can also help to have a clear birth plan, letting your health care professional know your delivery requirements, and the situations in which you want a c-section to aid in the birth of your baby.