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Breech baby

A breech baby is when their head is not facing downwards towards the opening of the cervix and the vaginal canal. There are three types of breech presentation, depending upon the baby’s position inside the womb:

  1. Frank breech. The legs are straight up in front of the body, with the feet near the head, making the buttocks the first part of the baby to be delivered.
  2. Complete breech. The buttocks are down near the birth canal. The knees are bent and the feet are near the buttocks.
  3. Incomplete breech (footling breech). One or both legs are stretched out below the buttocks. The leg or legs are the first part of the baby to be delivered.

Breech babies are quite common. Your midwife or obstetrician may offer you an external cephalic version (ECV). This is when an obstetrician tries to turn the baby into a head-down (cephalic) position by applying strong pressure on your abdomen. It is a safe procedure but can be very uncomfortable. You may be offered pain relief during this procedure. Around 50 per cent of breech babies can be turned using an ECV and will stay head-down, allowing you to have a normal vaginal birth.

Moxibuation for breech baby

The gentlest way of turning a breech baby is to use the Chinese medical method called moxibustion. Moxibustion is the application of heat-therapy into a specific acupuncture point on the body. Traditionally, moxibustion used the burning of a specific herb called Ai Ye (mugwort), which is placed around 2cm (1in) above an acupuncture point to pour heat into it. This method has been used in East Asia for thousands of years. I treat a lot of breech babies in my clinic. Rather than using the traditional herb Ai Ye, which produces a lot of smoke, I use smokeless moxa sticks instead, which are easier for patients to use at home and should not set off a fire alarm.

To turn a breech baby, moxibustion (heat) is applied to the acupuncture point Zhiyin (UB 67). This acupuncture point is located on the outer edge of the little toe, at the corner of the toenail (see figure below). Applying a lit moxa stick pours heat into that acupuncture point causing heat to travel up along the urinary bladder meridian, the longest meridian in the body. The heat in the urinary bladder channel rises upwards and moves the baby thereby rectifying the breech position. It works in most cases, but not all. Sometimes there is not enough space for the baby to physically move or the baby does not want to move. The success rate of moxibustion being able to correct a breech position is around 72.5 per cent.

Zhiyin (UB 67)

Instructions for moxibustion home use

  1. If your baby is breech, you can start performing moxibustion from week 35 onwards. Firstly, you will need to purchase a box of smokeless moxa sticks. There are usually five in a box, which should be enough. Before using moxibustion you will need the following:
  2. A lighter, preferably a BBQ or Zippo lighter as a regular lighter can break when the flame is kept lit for long periods of time.
  3. A small ceramic or glass dish (or an ash tray) to place the moxa stick in.
  4. A glass jar, such as a jam jar, with a lid to extinguish the moxa stick when the treatment is finished.

How to apply moxibustion for breech babies

  • Light one end of the moxa stick with the lighter. This can take a few minutes. Blow on to the end to get it nice and red hot and remove any ash that forms by tapping the stick on to the dish.
  • Hold the lit end 2cm (1in) from the outer edge of your little toe, making sure there is never any direct contact with the skin. You will need a steady hand for this. I use my other hand to keep steady the hand that is holding the moxa stick.
  • When the area starts to feel too hot, switch toes.
  • Remember to flick any excess ash on the end of the moxa stick into the dish and blow on the end to keep it red hot.
  • Apply near each little toe for approximately 20 minutes for 10 days. The best time to do this is between 3 and 5 p.m., as this is the time when the urinary bladder acupuncture channel is active.
  • After 40 minutes are up, place the moxa stick in a glass jar with the lid screwed on firmly to extinguish it.
  • When you feel any movement, visit your midwife and have a scan to see if the baby has moved into the correct position.

If the baby has moved into the correct position, reduce the treatment time to 10 minutes for each toe until the tenth day. Before performing moxibustion on yourself, I recommend visiting your acupuncturist first and watch them perform moxibustion on you. They will also be able to instruct you on how to perform moxibustion.

References

Caron, J. Breech Presentation. s.l. : StatPearls Publishing LLC, 2020.
Impey, L and Child, T. Obstetrics & Gynaecology. Chichester : John Wiley & Sons, 2012.
Cost-effectiveness of breech version by acupuncture-type interventions on BL 67, including moxibustion, for women with a breech foetus at 33 weeks gestation: a modelling approach. van den Berg, Ineke. 2, s.l. : Complementary Therapies in Medicine, 2010, Vol. 18.
Moxibustion and other acupuncture point stimulation methods to treat breech presentation: a systematic review of clinical trials. Li, X. 4, s.l. : Chin Med, 2009, Vol. 4.
Effectiveness of acupuncture-type interventions versus expectant management to correct breech presentation: A systematic review. van den Berg, Ineke. 2, s.l. : Complementary Therapies in Medicine, 2008, Vol. 16.
Turning Foetal Breech Presentation at 32-35 Weeks of Gestational Age by Acupuncture and Moxibustion. Brici, Paolo. s.l. : Evidence-Based Complementary and Alternative Medicine, 2019.
Effect of stimulating the BL67 point on fetal correction from breech to cephalic presentation and natural delivery after the 36 weeks of pregnancy: A randomized clinical trial.
Sourani, Khatereh. 2, s.l. : Reproductive and Developmental Medicine, 2020, Vol. 4.
Correction of nonvertex presentation with moxibustion: a systematic review and metaanalysis. Vas, Jorge. 3, s.l. : American Journal of Obstetrics and Gynecology, 2009, Vol. 201.
Betts, Debra. The Essential Guide to Acupuncture in Pregnancy & Childbirth. Hove : The Journal of Chinese Medicine, 2006.

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