Turn baby, Turn….
A natural birth is what many women plan for, but what happens when a persistent breech baby puts a spanner in the works?
As your pregnancy progresses, your baby naturally turns into the head-first position, but a small number of babies will not turn and remain in a persistent breech position, or bottom first in the final weeks of pregnancy. There are a variety of reasons for this ranging from placental location, fibroids or uncommon-shaped uterus, laxed uterine muscle tone from multiple pregnancies or lots of fluid around baby in utero.
This can be a source of great stress and anguish for a woman in those last weeks of pregnancy as discussions around turning baby (External Cephalic Version) and alternative delivery plans may arise.
AMY’S STORY
Amy was 35 weeks pregnant with her third baby on the way when she came to see me with a persistent breech baby on board. She had been discussing her choices and delivery plan with her obstetrician and was wanting to wait and see if her baby would turn head first within the following weeks, as a normal birth was something she really wanted and an External Cephalic Version did not appeal to her.
Her Obstetrician agreed to give Amy time to see if her baby would turn head first over the next three weeks & this is when Amy came to see if massage or acupuncture would help to turn her baby and prepare her for natural birth. Her obstetrician was informed that Amy was seeking my assistance and was not resistant to her trying massage or acupuncture.
I approached the consultation as I always do with a thorough medical history and background of Amy’s condition. I had discovered that this was Amy’s third pregnancy and she had suffered from Pubic Symphysitis with each pregnancy and this had been an ongoing problem with this pregnancy as well. This prompted me to concentrate on Amy’s hips and pelvis and thoroughly assess how the hips are functioning and positioned as this may narrow the pelvic outlet reducing the baby’s ability to turn headfirst. It couldn’t hurt to try.
I commenced my assessment by comparing both hips for symmetry, movement and position and observed that Amy’s right hip was sitting slightly higher & turned anteriorly when compared to the left hip… When I observed Amy’s gait there was an obvious tendency to raise her right hip higher than her left when taking a step forward. This conformed my suspicions that the hips have been drawn out of alignment during pregnancy while under the affect of pregnancy hormones. This can be a source of pain and discomfort because the position of the hips has been altered placing strain on the pelvis & the gluteal muscle groups are over working to support the hips & pelvis and assist with walking. The treatment kicked off by applying massage to the lower back & hips focusing on the gluteal muscles to improve blood circulation and movement of smooth muscle tissue. This will reduce discomfort & allow the hips to move more freely as well as target hip alignment.
After discussion with Amy and her commitment to turning her baby to the head first position I decided to introduce acupuncture & moxibustion into the treatment to amplify the focus on turning baby and re align the right hip that had been affected. Acupuncture was applied to improve pubic symphisitis pain as I have had encountered some good effects with reducing pubic symphsitis pain over the years in clinical practice and wanted to turn down the discomfort for Amy & assist with her mobility. Acupuncture is complementary medical practice that involves stimulating certain points on the body, most often with a needle penetrating the skin to alleviate pain or to help to treat various health conditions.
The final layer to the initial treatment was moxabustion and this was applied while Amy was comfortable lying on her side and the acupuncture needles were in place…. Moxabustion is used in Traditional Chinese medicine to stimulate specific therapeutic effects and is the practice of burning a type of herb called Artemesia vulgaris to stimulate acupuncture points… The key point to stimulate with moxabustion is BL67 located on the outer corner of the fifth toe. The application of moxabustion increases blood flow creating an environment of movement and activity in the growing baby promoting optimal positioning in utero.
The recommended application of moxabustion is 20 mins daily for 10 days in succession… I performed the initial application so that Amy was confident to continue using it at home independently and tolerated the treatment, as with burning any substance there is a smoke burn off & I wanted to be sure that Amy was aware of this & knew how much heat the moxabustion should generate on the skin.
After this initial treatment Amy was confident to continue using the moxabustion treatment & tolerated this therapy well… her baby did move around a lot during the treatment & I was hopeful that this would do the trick of the next 9 days. At the conclusion of the appointment I had given Amy enough moxa herb to apply of the next 9days and gave her instructions on postural techniques that she could adopt at home because this combination is optimal to turn baby into the head first position. Amy was overdue, but had a spontaneous normal birth. A happy outcome :-)
References
Author: Kyla Mayer, Chinese Medicine Practitioner. Kyla began her acupuncture journey in 2007, when she embarked on her 4-year, full time training that included an internship in BeiJing. After graduating from UTS in 2010 and working in many styles of clinics it was very clear that her passions lie in women’s health. Women’s health has been the focus of her practice for the last 8 years and with already being a practising midwife for the las1 17 years, combining her acupuncture and Chinese medicine knowledge with her midwifery skills happened organically.Find out more about her work HERE.
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