Birthing Complications: BREECH

Question 1

Breech Birth

Answer 1

When presenting part is feet or buttocks, frank meconium or swollen/bruised genitals.

Any sign of second stage of labour? BABY MUST BE BORN ON-SCENE!!

Question 2

Birthing Position

Answer 2

Upright or on all-fours

Allows gravity to play vital role; hands off!

Question 3

Birthing Process

Answer 3

Hands Off

Buttocks will advance similarly to head; meconium will appear, don’t obstruct.

When widest part of hips born ‘rumping’

Push continuously throughout second stage, not just with contractions; to assist birth of baby within 3-5 minute threshold.

Once rumping has occurred, ensure Baby’s Tum to Mum’s Bum.

Question 4

Birthing Process Cont 1.

Answer 4

When baby born up to umbilicus, 3-5 minute timer set. Births much quicker than normal births.

Hands off.

Baby will do ‘tummy crunches’, normal to encourage birth of arms and head.

If baby does not crunch? May need resus.

Question 5

Slow Descent

Answer 5

If slow descent:

1. Encourage movement; mum can rock her hips.
2. Get mother to adopt running start like a runner in a race with one knee lifted, helps pelvis position.
3. A gentle shoulder press or Mauriceau-Cronk manouvre WHEN CHIN VISIBLE; gently push backwards on baby’s chest which can help birth of the head by moving it backwards.

Question 6

Other presenting parts

Answer 6

Any body part other than head, buttocks or feet (e.g. hand or arm), immediate transfer.

Question 7

Hands Off

Answer 7

Do not pull on infant’s trunk to expedite birth as it may cause baby to raise its arms and cause issues.

Once arms free, leave baby, do not hold or lift it upwards, by holding it the head will not engage with the pelvis and may stop baby from being born at all.

Question 8

Hands on when…

Answer 8

…once you see the chin, the head is almost there, can touch it from this point and catch it as head is freed from birth canal.