Effective alternative treatments for breech presentation.

Breech presentation can be frustrating for women planning a vaginal birth. Most hospitals don't allow breech babies to be born vaginally and many midwives don't attend breech births, either because of the political situation in their area or because they haven't had the training. Fortunately, studies show chiropractic, acupuncture and hypnotherapy can safely turn many breech babies. These alternative treatments can be tried at 28 to 34 weeks gestation before a medical external version is an option and without the risks of external version.

Dr. Carl V. Smith, Professor and Chairman at the Department of Obstetrics and Gynecology at the University of Nebraska Medical Center, says, "as with most things involving complementary and alternative medicine, there is a lack of data about the effectiveness and safety" of these techniques. But, he adds, "in my opinion, there is little harm in hypnotherapy and acupuncture." He also says, "it is unlikely that such chiropractic manipulation would be harmful. The degree of abdominal pressure is the variable that is difficult to control and could potentially cause injury if done too vigorously. A randomized trial comparing manipulation versus no manipulation in a population of similar patients is the only way to truly answer the question of effectiveness and safety."

Chiropractic Version Works

An International Chiropractic Pediatric Association (ICPA) study showed the Webster Technique was successful in resolving breech presentations 92 percent of the time. ICPA defines this technique as "a specific chiropractic analysis and adjustment that reduces interference to the nervous system and improves the function of the pelvic muscles and ligaments, which in turn removes constraint of the woman's uterus and allows the baby to get into the best possible position for birth." Dr. Jeanne Ohm, ICPA executive coordinator, explains, "this specific sacral analysis and adjustment is an asset to the pregnant woman throughout pregnancy as a means of preventing or limiting the potential of intrauterine constraint." It can prevent not only breech and transverse (sideways) presentations, but also posterior (backward) and asynclitic (head cocked to one side) presentations.

Andrea Smith of Redford Township, Michigan, recalls, "twenty minutes after the third Webster's adjustment, while driving in my car, I felt the baby flip. I knew it was in the correct position because I felt the first kick in the ribs." She went on to birth her healthy seven-pound baby girl at home with her midwife, husband and sister present.

In 20 years of practice, Dr. Martin Rosen, a chiropractor in Wellesley, Massachusetts, has only had one case where the baby did not turn. "It's a noninvasive procedure and, when applied correctly, has no negative side effects," he says. The Webster Technique involves an evaluation, gentle contact on a ligament near the tailbone, then gentle thumb contact on the abdomen. It takes five minutes and usually needs to be applied one to three times. "When dealing with breech pregnancies it is important that all options be considered before more drastic measures are necessary. The Webster Technique is a ... safe and reliable alternative," Rosen adds.

Acupuncture Is Effective

Another study showed that the Zhiyin technique, which involves applying heat on an acupuncture point on the little toe, was successful 75 percent of the time, compared with a 50 percent turning rate in an untreated group. The best time for this procedure is between 30 and 34 weeks gestation, although it can work as late as 36 weeks. "Outside of the risk of an irritation to the local tissue if incorrectly applied, there are really no significant complications to this approach," says John Frostad, a licensed acupuncturist in Milton, Washington.

Sue Fendrick of Newton, Massachusetts, was 35 weeks pregnant with twins when she tried acupuncture needles and moxibustion (a process in which a grain-sized cone of dry, yellow, spongy substance made from mugwort [moxa] is placed on the acupoints and lit with an incense stick. The burning moxa is then pinched out or taken away by the therapist before it burns down to the skin). Fendrick's babies were "everywhere but vertex," she remembers. They were "transverse and breech, breech and transverse, and then, after the acupuncture and moxibustion, they were lined up like two little hot dogs, heads straight down, lying next to each other, like they are right now in their bassinet," she says.

Fendrick saw her acupuncturist about five times over a two-week period and also had her husband burn the moxa on the acupoint on her toe between appointments. "Not only was it successful beyond my expectations since both babies turned and there was no question that I'd be able to have a vaginal birth when I was admitted, but the acupuncture was very relaxing," she says. She had a vaginal birth with midwives, which she says was difficult, but incredibly meaningful.

Hypnotherapy Turns Babies

Hypnotherapy is "extremely effective," says Yvonne Schwab, a certified hypnotherapist in San Jose, California. None of the babies she has turned have reverted. She thinks that is because she asks them for their help. "I don't tell them to turn or manipulate them physically at all," Schwab says. A study at the University of Vermont College of Medicine compared 100 women with a matched control group and found that hypnotherapy was successful 81 percent of the time compared with 48 percent in the untreated group.

"If there is a reason for the baby to remain breech, then the woman's subconscious will override the suggestions and have the baby remain breech," Shawn Gallagher, a clinical hypnotherapist and registered midwife in Toronto, Ontario, says. "Many parents elect to start with hypnosis as their first line of intervention because it is so safe." The optimal time is between 34 and 37 weeks gestation.

Susan Lynch of Plano, Texas, turned her second child using hypnotherapy when she was 36 weeks pregnant. Her HypnoBirthing[R] teacher first helped her get into a relaxed state. Then, "'the practitioner spoke directly to the baby. She asked him to turn to the head-down position if it were safe and appropriate for him to do so ... While I was still deeply relaxed, she had me visualize him in the perfect position for an easy and comfortable birthing," Lynch says. The practitioner also suggested that she ask her baby several times a day to get into the best position for birth.

Lynch says she would definitely recommend hypnotherapy. "'It is completely gentle to both room and baby, carries no risk and is incredibly effective." It also enabled her to feel connected to her baby. "I able to communicate with him, and I believe that he heard what I was asking him to do ... Using hypnosis not only encouraged me to believe that I was in control of my body and the pregnancy/birth, but also helped me to realize the immense power of my mind." Her son turned head-down by the following morning and was born 17 days later after only six hours of labor.

Julie Brill is an ALACE certified childbirth educator and homeschooling mother of two daughters, Rebecca, 8 and Sophie, 5. In 1999, she turned her second daughter with chiropractic and acupuncture and went on to have a fabulous homebirth with midwives. The experience inspired her to write this article. She has been teaching childbirth classes for 12 years. You can contact her through her website, www.wellpregnancy.com.