By Mary Vincent L.Ac.
Breech baby occurs when the presentation of the fetus is buttocks or feet pointing first toward the mother’s pelvis. Between 29-32 weeks gestation, 15 percent of all babies will be in a breech position, but by the time the pregnancy reaches full term (37 weeks or later), only 3 percent of babies remain breech. This bottom-first presentation can lead to increased risks for the fetus and mother during vaginal birth, particularly umbilical cord prolapse and head entrapment, both of which can lead to oxygen deprivation and possible neurological damage or death of the fetus. Though vaginal birth is still possible, it is a controversial topic in midwifery and obstetrics.The risks involved are substantial enough that U.S. hospital policies do not allow for it, and the vast majority of obstetricians are no longer trained to safely perform these types of births.
A TCM treatment known as moxabustion (moxa) has been shown to be around 70 percent effective in turning a breech baby (http://jama.jamanetwork.com/article.aspx?articleid=188144). This technique includes using moxa sticks, which are cigar-shaped sticks comprised of tightly rolled mugwort leaves, burned close to the outside of the acupuncture point UB 67 (at the outside corners of the little toes). The heat on this point causes the baby to become restless in the uterus and increases the chances of it flipping into a head down position. Ideally, the best time to attempt to turn the baby with moxa is between 32 and 35 weeks. Once the baby is big enough to be snug in the womb the odds of turning are low, and if baby has already engaged into the pelvis it will not turn. Many women prefer to try and turn the baby this way first before attempting external cephalic version (a manual manipulation technique to turn the fetus which is sometimes painful).
We get many referrals here at BCA from obstetricians and midwives to aid in turning a breech baby.You will be given an acupuncture treatment to help relax the uterus, and then sent home with moxa sticks and specific instructions on how to apply the technique. We typically like to see you again about every 3-4 days for acupuncture, to keep you as relaxed as possible and to monitor your moxa technique. Your obstetrician or midwife can confirm for you if the baby has turned, however most women will notice the large motion when baby somersaults into a head-first position.