Hesperian Health Guides

Turning a breech or sideways baby

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HealthWiki > A Book for Midwives > Chapter 19: Advanced skills for pregnancy and birth > Turning a breech or sideways baby

A baby is much safer if he is born head first instead of breech (bottom first). A baby lying sideways cannot be born vaginally. If you have been trained to do so safely, there may be times when you could turn a baby so that his head is down.

WARNING!   Turning a baby has many serious risks. The biggest dangers are pulling the placenta off of the wall of the womb or tearing the womb. These can kill the baby and the mother.
Turning a baby can also start labor.

Only turn a baby if:

  • you have been trained to do so by someone with experience.
  • you can get medical help if you need it.
  • you are sure the baby is breech or sideways.
To see the danger of turning the baby:
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Try putting a small plastic doll inside a small balloon or plastic bag and filling it with water. Then try to turn the doll. The womb, like the balloon, can tear easily if not handled with extreme care.

Turning a baby

The best time to turn a baby is 2 to 3 weeks before his due date. If you turn a baby earlier, he may move back to a breech or sideways position. Also, if labor starts, it will probably be safe for the baby to be born at that time.

If possible, you should have a helper when you turn a baby. This person can listen to the baby’s heartbeat the whole time.

WARNING!   If the heartbeat speeds up, or slows down and does not go back to normal, stop turning the baby. If the heartbeat stays fast or slow, turn the baby back to the position he started in. If the heartbeat still does not go back to normal, give the mother oxygen if you have it, and have her lie on her left side. If the baby’s heartbeat still does not go back to normal, take her to a medical center immediately.

1. Ask the mother to urinate and then lie down on her back with her knees bent. It is important for her to relax her body as much as she can. It may help for her to take slow, deep breaths.
2. Listen to the baby’s heartbeat.
3. If the heartbeat is normal, feel the baby’s position again to be sure he is breech.
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4. Grasp the baby’s head with one hand. Put your other hand under the baby’s bottom, and push up, towards the top of the womb, to move the baby out of the pelvis.
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5. Gently but firmly move the baby in the direction he is facing. If he does not move easily, try moving him in the other direction. Try to keep the baby’s chin tucked into his chest.
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6. Each time the baby moves — even a little — stop and listen to his heartbeat. If the heartbeat is not normal, stop.
7. Keep turning the baby until his head is down.
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WARNING!   Never force a baby to turn. If the baby feels stuck, or the mother is in pain, stop.

Turning a sideways baby

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Turning a sideways baby is the same as turning a breech baby. Turn the baby in the direction he is facing. If he cannot turn in that direction, you may need to turn him the other way so that he is in a breech position. Breech is not as safe as head-down for birth, but he will be able to be born vaginally this way. If a sideways baby does not turn easily, you must stop and the baby must be born in a medical center by cesarean surgery.

This page was updated:11 Sep 2019