I received a text message yesterday to say a woman I had worked with the day before had felt her babies foot kicking n the upper left of her belly! She was on the way to a presentation ultrasound scan (at 35 weeks) and we had done a one to one rebozo turning session the day before (Spoiler: baby was now head down!)
I have been offering malpresentation one to one sessions in the North West (and North/Mid Wales) to encourage babies to turn head downwards and stay head down. I use a variety of techniques including rebozo and Spinning babies.
Babies position in the womb is usually head down by 32 weeks (the head becomes heavy enough at 5-7 months for gravity to pull it downwards resulting in a vertical position) prior to this babies are usually transverse (until 24-26 weeks) or breech (24-29 weeks).
Due to the shape of the uterus babies usually stay in this position (unless the uterus is stretched after many pregnancies when babies can often change position-this is known as an unstable lie).
A malpresentation is a position in the uterus that is not head down (breech, transverse, oblique).
If a baby is not presenting head down towards term, women may be offered an ECV (external cephalic version) to try to turn baby round, or women may opt to birth their baby vaginally (if breech) or plan an ELCS .
I will be publishing a follow up post looking at the evidence on ECV, breech vaginal birth and ELCS for malpresentation.
There are also a number of alternative techniques that women may try to encourage baby to turn head down (including yoga, acupuncture, moxibustion)
I have supported a variety of Mums… including twins (both head down at term and born in a MLU at 40+4), First time mum with an oblique baby at 36 weeks to turn head down, transverse at 38 weeks to turn head down and breech.
Tips for malpresenting babies:
1 Use rebozo manteada followed by inversion for 30 secs, 3 times in a row to promote balance and relaxation in the uterus.
2. Use rebozo of the bottom/hips, in knee chest for 5-10 minutes to help back baby out of pelvis
3. Use turning rebozo technique
After the visit women can continue doing inversions (up to 3 in a row, 3 times a day) followed by breech tilt for 10 minutes
If baby turns head down, she will feel feet kicking where the head was, so in the top right or left of womb.
Some women who have had many babies may benefit from wearing a support belt once baby is head down, this can be a physio belt or a sling can be used
There is a clinical trial underway looking at rebozo use as an adjunct to ECV for breech babies
“Selina came to visit me twice to help turn my baby from transverse to breech to head down and engaged. Using a mixture of rebozo, pelvic tilts, inversions, ball circles and moxibustion. Also a little shoulder massage at the end which helped me to relax after my exercises. Fantastic work, saved me from being poked and prodded getting baby manually turned at the hospital or ending up with a c-section. Cannot thank you enough”
“I’m nearly 37 weeks now with my second baby and was told at 34 weeks… by my midwife that my baby was breech. Selina came to my house to do a one-to-one session to provide advice on techniques I could use to encourage the baby to move to the right position. I found the session very relaxing and really useful in understanding the different techniques and how best to do them. I have been doing them for the last week and today I had a scan which has shown the baby has moved to the right position 🙂 this has made me feel very happy and relieved as I want to have a home birth and the hospital had been advising if the baby was still breech I would have to have a c-section. A lot of the exercises Selina has taught me will also be great for labour and I hope to have a relaxing, peaceful home birth. Thanks Selina for your help and advice. (has since had a sucessful homebirth”