We sometimes get inquiries from pregnant women if we as osteopaths can “turn” a breech baby. I thought I would explain why we do not turn babies, but that babies can sometimes turn themselves when we treat the mum. I will explain how this works below.
If your baby is in a breech presentation, a procedure called an External Cephalic Version (ECV) may be offered towards the end of the third trimester by your midwife and obstetrician. This is a very direct technique where the baby is encouraged to turn head down by an obstetrician by applying pressure on the woman’s abdomen. The timing of the procedure is key and offered around 37 weeks. Sometimes babies have turned all by themselves by this point, but even if the ECV was successful the baby can still turn breech just before delivery. In healthcare there are no guarantees and ECVs have around a 50%-60% success rate (Felemban et al., 2021). The Royal College of Obstetrician and Gynaecologists and the National Institute for Health and Care Excellence recommend a caesarean section over a breech presentation delivery because it is safer for the baby (NICE, 2021). It is not surprising most women would like to avoid that and will try alternative methods such as acupuncture (moxibustion) to get the baby to turn.
So, if an obstetrician can manipulate a woman’s body to turn her baby, surely an osteopath should be able to do it? The answer is – it is not in our scope of practice, and particularly not when doing an ECV in a controlled setting is the safest for the baby. In a hospital setting the baby’s heartbeat is monitored to make sure the manipulation (ECV) does not cause it distress. An ultrasound is done before and after to check where the placenta and cord are in relation to the baby.
In the USA, osteopaths are medical doctors and some train in obstetrics. It is likely that in the days before the advancement of medical technology that osteopaths performed ECVs in their office. Our reputation for manipulation of the body such as “putting bones into place”, “turning babies”, “treating bones” is part of our professional lore from over 150 years ago. This is perhaps why we sometimes get inquiries by parents to find out if we turn babies. It is something they’ve heard, or someone they know told them.
How do we help a pregnant woman with a baby who is breech? We treat her as we would any pregnant woman. We would never apply any direct pressure to force the baby to turn. So, when I am asked if we turn babies, I always say that we cannot do that, but we can treat mum and offer the baby a bit more space by gently releasing tension in mum’s body. If the baby is safe to turn by itself, it might. We can only try and offer the baby a more spacious environment and hope for the best.
Felemban, A. S., Arab, K., Algarawi, A., Abdulghaffar, S. k, Aljahdali, K. M., Alotaifi, M. A., Bafail, S. A., & Bakhudayd, T. M. (2021). Assessment of the Successful External Cephalic Version Prognostic Parameters Effect on Final Mode of Delivery. Cureus, 13(7). https://doi.org/10.7759/CUREUS.16637
National Institute for Health and Care Excellence Antenatal care [M] Management of breech presentation NICE guideline tbc Evidence reviews underpinning recommendation 1.2.35 DRAFT FOR CONSULTATION Contents. (2021).