Turn the baby that comes from the buttocks

The news has come out in the media that the Hospital de Cruces, in Barakaldo (Vizcaya), has developed a “pioneer” technique in Spain that allows to modify the posture of the fetus inside the uterus when it is placed on the buttocks, reducing the number of caesarean sections by 54%.

For starters, the technique is not new, but a fairly old technique that they have rescued. The maneuver is called external cephalic version, that is to say to turn the baby by means of movements of the hands on the belly of the pregnant woman. The doctor (with the help of a midwife) performs a maneuver to try to change the position of the baby so that the head is placed down to facilitate vaginal delivery. It can only be done after the 37th week of pregnancy, in case the birth occurs.

Apparently the risk of the maneuver is very small. It is done without anesthesia in a few minutes and while the doctor practices it the baby is controlled through a monitor to detect if he could suffer fetal stress.

We must say that not all babies who are placed on the buttocks must be born by caesarean section. There are several paths before resorting to a “first” caesarean section. In addition to the external cephalic version (in some women it is contraindicated), there are also certain exercises that can help the baby turn around.

If there is no way to turn it around and the baby will continue in a podic position, in some cases vaginal delivery can also be attempted, provided that the mother wants it and the doctor considers that there is no risk for her or the baby.

The external cephalic version can be performed in any woman with normal pregnancy who has not had vaginal bleeding, placenta previa, low level of amniotic fluid, rupture of membranes or multiple pregnancy.

What are the risks that this technique can have? There may be premature delivery, premature rupture of membranes, small blood loss and fetal distress that can lead to emergency cesarean delivery.

The doctors who practice this technique at the Baracaldo hospital, where 300 caesarean sections have been avoided in the last three years, believe that the technique is almost not practiced in the maternity hospitals “due to lack of knowledge, lack of skill or because it is more comfortable to do caesarean sections. "

Although in 70% of the cases it can be predicted, it is not always possible to turn the baby around, or it can be achieved and the baby turns back to the breech position.

The technique is not infallible, but it is another option to avoid a C-section, which is so abused and that poses a greater risk for the mother and the baby.

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