Breech Presentation and Acupuncture Treatment
Types of breech presentations
(a) Complete or full breech (5-10%) – This involves flexion of the fetus legs. It looks like the fetus is sitting in a tailor fashion. The buttocks and feet appear at the vaginal opening almost simultaneously.
(b) Incomplete breech (10-30%) – The fetus feet or knees will appear first. His feet are labeled single or double footing, depending on whether 1 or 2 feet appear first.
(c) Frank and single breech (50-70%) – The fetus thighs are flexed on his abdomen. His legs are against his trunk and feet are in his face (foot-in-mouth posture). This is the most common and easiest breech presentation to deliver.
What causes a breech presentation?
The causes of breech presentations are not fully known, however, a breech birth is more common when:
· Pregnancies are insubsequent.
· There are multiple pregnancies.
· When there is history of premature delivery
· When the uterus has too much or too little amniotic fluid
· In an abnormal shaped uterus or a uterus with abnormal growths, such as fibroids.
· For women with placenta previa
: Placenta previa is an obstetric complication in which the placenta is attached to the uterine wall close to or covering the cervix. It can some times occur in the latter part of the first trimester, but usually during the second or third. It is a leading cause of antepartum haemorrhage (vaginal bleeding). It affects approximately 0.5% of all labours.
How is a breech presentation diagnosed?
A few weeks prior to the due date, the health care provider may place his/her hands on the mother’s lower abdomen to locate the baby’s head, back, and buttocks. If they think the baby is in a breech position, an ultrasound may be used to confirm. Special x-rays can also determine the baby’s position and measure the pelvis to determine if a vaginal delivery of a breech baby may be attempted.
Can a breech presentation mean something is wrong?
Most breech babies are born healthy. However, they do have a higher risk for certain problems than babies born head first. Birth defects are slightly more common in breech babies. A birth defect may be the reason they have not moved into the right position before birth.
Can a breech presentation be changed?
The best time to try to turn a breech baby is between 32-37 weeks of pregnancy. There are many different types of methods to use and all have different levels of success. Talk with your health care provider about which options they feel would be best for you to try.
Breech presentation occurs in 3-4% of all deliveries. The percentage of breech deliveries decreases with advancing gestational age from 25% of births prior to 28 weeks’ gestation to 7% of births at 32 weeks’ gestation to 1-3% of births at term.
Predisposing factors for breech presentation include prematurity, uterine malformations or fibroids, polyhydramnios, placenta previa, and fetal abnormalities (eg, CNS malformations, neck masses, aneuploidy), and multiple gestations. Fetal abnormalities are observed in 17% of preterm breech deliveries and in 9% of term breech deliveries.
Perinatal mortality is increased 2 to 4-fold with breech presentation, regardless of the mode of delivery. Deaths are most often associated with malformations, prematurity, and intrauterine fetal demise.
How helpful is acupuncture treatment for Breech Presentation?
Sometimes as delivery progresses, the fetus moves into the proper delivery position without any assistance. In most cases however, once a fetus is in breech position, a breech delivery ensues. If you do not choose to take action prior to your due date, a C-section is probable. Should you wish to have a natural birth, it is advisable to consider acupuncture in advance. The successful rate for breech presentation by acupuncture is overall 70-90%. Transverse presentation has the highest success rate; Complete the second and Incomplete the lowest respectively. A multipara is generally more successful than first delivery. Acupuncture treatment for Breech presentation is most effective around the 7th month and tends to decline after the 8th month. In general 7sessions of UB67, Zhiyin moxibustion are effective.
Although clinically, direct moxa is more effective than indirect moxa, indirect moxa is preferred due to possibility of pain and skin burn. Additional acupuncture or electro-acupuncture increases the efficacy. In general, “7-10 sessions” of acupuncture is recommended.
Common Questions & Concerns
Can I have acupuncture during pregnancy?
There is a misconception that acupuncture is not advised for pregnant women. Therefore, during pregnancy, women endure symptoms such as lower back pain, foot pain, morning sickness, common cold, Bell’s palsy and much more, believing that they simply must suffer. Pregnant women in fact, may have a variety of symptoms that can be lessened and/or remedied by acupuncture. I advise pregnant patients to call and see which acupuncture/other treatments are viable for their own particular symptoms. There are ways to make a pregnancy progress far smoother than one might expect naturally.
However, there was the book, Fu Ren Lian Fang Da Quan – Complete Collection of Fine Formulas for Women by Chen Zi Ming AD 1237 which first advised; you should be cautious in treating pregnant women by acupuncture. Wupo claimed that if you give acupuncture to pregnant women without caution, the fetus inside would be shocked. *Correct Transmission of Medicine by Yu Tuan in 1515.
For example, during the first month, the liver meridian nurtures the fetus. Do not place the needles on the points along the liver meridian. Although this sounds very conceptual, it gives the practitioners the idea of how to choose the acupuncture points according to each different month of 10 months of pregnancy.
These doctors promoted acupuncture for pregnant women only when needed, and to proceed cautiously in each case.
Many doctors succeeding them presented contraindicated acupuncture points for a pregnant woman; ST25, REN6, 7, 9,10, 11,12 in the abdomenal region and LI4, SP6, UB67, UB60 which are to remove the blood stasis and invigorate blood. These were said to be able to cause miscarriage or premature birth.
All the points for treatment on pregnant women are mainly located away from the abdomen and around arms, lower legs, hands, feet and ears.
For what symptoms can acupuncture be used during pregnancy?
Bell’s Palsy (trigeminal neuralgia)
Lower Back Pain
If you want to know more about our treatment for breech baby or the other conditions during pregnancy, call us at 310-401-3347