Towards the end of pregnancy, most babies will rotate into a head down position in preparation for birth. Breech, or head-up position, occurs in 3-5% of pregnancies at term, and typically indicates a cesarean birth. There are many techniques mothers can use to encourage baby to move into optimal position for delivery. Any and all interventions should be discussed with the mother’s midwife or OB prior to treatment.

There are a number of interventions, used by a variety of healthcare providers, that can encourage a baby to turn.  I will generally recommend the least invasive and safest as a first option, including acupuncture, moxibustion, chiropractic, and movement based strategies.  External Cephalic Version (ECV) carries a greater risk potentially leading to emergency cesarean, so I believe it best to save this technique for last.  Also, many midwives have reported that babies are more responsive to ECV when mom has been using acupuncture and moxibustion.

The earlier in pregnancy that treatment begins, the more successful it is.  I consider 32-34 weeks ideal, but will focus on breech presentation as early as 30 weeks, and have seen babies turn as late as 39 weeks.

Not sure how to tell what position your baby is in? Try belly mapping.

Moxibustion

Moxibustion, or moxa, is a method of warming points using the herb mugwort.  This technique has been a part of acupuncture therapy for 2000 years, and is an essential tool in Eastern medicine.  Practitioners may use moxa in the leaf, or loose, form, or rolled into moxa ‘cigars’, or placed on the ends of needles.  Moxa sticks for home treatment are typically made of mugwort charcoal that can be held near a point to provide gentle warmth and stimulation.  

Moxibustion Home Treatment

Moxibustion treatment at home is a highly effective way to encourage your breech baby to turn.  This treatment must be done daily for 10 days, making home treatment more practical than visiting your acupuncturist every day.  You should first learn the technique and point location from your acupuncturist, and I find that the moxa treatment works best in conjunction with acupuncture also.

Before beginning moxibustion treatment at home, gather the following supplies:

• Moxa stick
• Lighter or small candle
• Ceramic or glass dish, such as an ash tray
• A small towel to place under the area being treated to protect the surface from any falling ash
• A glass jar with air-tight lid, such as a mason jar, that is large enough to fit the whole moxa stick

How to Treat with Moxa

Begin by lighting one end of the moxa stick by holding it in a steady flame.  It can take a couple of minutes to fully light, especially with a brand-new stick.  When properly lit, the moxa stick will be glowing red, and the whole end will be lit.

As the moxa stick burns, any extra ash needs to be scraped or tapped into your ash tray. Be careful not to let too much ash accumulate, as it can fall and cause burns.

Hold the litend of the moxa stick 1 to 2 inches from the skin.  You should feel a comfortable, radiating warmth.  Move the moxa stick further away if the heat becomes intense, and never allow the stick to directly contact the skin.  Move the moxa stick up and down slightly, or in small circles around the point.  This allows the greatest penetration of warmth and prevents the heat from becoming too strong.

The main point used to turn breech babies, is Bladder 67 (UB67), located at the outside corner of the pinky toenail.  Treat this point with the moxa stick 20 minutes each side, daily for 10 days.  This can be broken up into 10 minutes per side, twice per day.  It is recommended to continue the treatment, even after baby has turned.

As a woman with a 32-40 week pregnant belly, it can be a challenge to reach your feet, and especially to hold that position for 20-40 minutes. I highly recommend giving the job to your partner if possible, which lets them be involved and makes moxa time a wonderful opportunity to relax together.

Most women report that baby becomes very active during the moxa treatment and for a period of time after.  Right after the treatment is a great time do inversions or spend some time on hands and knees to give baby the most space possible to move around and find a head-down position.

When you have finished the treatment, place the moxa stick in the glass jar, lit side down.  Firmly screw on the lid, which will help to put the moxa stick out.  Be very careful not to touch the end of the moxa stick, even if it appears not to be lit, and be aware that the jar may become hot as well.

Acupuncture for Breech Babies

Acupuncture can assist breech babies in several ways.  Often, mothers have physical and/or emotional tension patterns that may be restricting baby’s movement and are preventing baby from turning.  Acupuncture is a great treatment for reducing muscular tension, relieving pain that may contribute to tension patterns, and working with mother’s alignment.  It is also a powerful tool for reducing stress and alleviating any restraining emotions that might be playing a role.  Acupuncture points are chosen on an individual basis, and will therefore be different for each person.

Webster Technique for Breech Babies

The Webster Technique is a chiropractic technique to create more space for baby to allow baby to turn.  According to the International Chiropractice Pediatric Association (ICPA) the Webster technique “improves the function of the pelvic muscles and ligaments, which in turn removes contraint of the woman’s uterus and allows the baby to get into the best possible position for birth.”  Just like acupuncture and moxibustion, this technique is safe, comfortable, and effective.

If you’re in Chicago, get in touch with Kat Aleman, prenatal chiropractic doctor, at Kindred Chiropractic.

Movement and Alignment

Strength, flexibility, and alignment of the mother’s body, especially the pelvis, can have a big impact on baby’s ability to turn. Staying active is vitally important to mom and baby’s health, as well as giving baby the best chance to turn.  Sitting for many hours at a desk, or on the couch, or while driving has a tendency to encourage tucking of the pelvis which decreases the amount of space baby has to move.

• Spend less time sitting.  Stay active as much as possible. Walk everyday.  Look for ways to stand or walk during your day- walk or stand while talking on the phone, folding clothes, and use a counter or standing desk while working on the computer.
• If you must sit, trade your regular chair for an exercise ball.
• Use movement to help baby turn. Spinning Babies is an amazing site with tons of helpful information.
• Spend some time learning to squat an untuck your pelvis.  See http://nutritiousmovement.com/you-dont-know-squat/.
• Don’t wear heeled shoes, especially high heels.  Heeled shoes change the angle of many of your body’s joints, especially the pelvis.  This sets you up for back pain and makes it more difficult for baby to turn.

Download the Handout on Moxibustion for Breech Babies

References

• Breech Birth: A Collections of Articles from Midwifery Today Magazine
• Cephalic Version by Moxibustion for Breech Presentation http://www.ncbi.nlm.nih.gov/pubmed/22592693
• Debra Betts http://acupuncture.rhizome.net.nz/
• http://nutritiousmovement.com/spinning-babies/
• Turning Breech Babies with Acupuncture & Moxibustion http://acupunctureprofessional.com/  Debra Betts, Becks Armstong & Sarah Budd
• http://spinningbabies.com/
• https://www.scienceandsensibility.org/can-moxibustion-help-turn-breech-babies/