pregnant

What to Do when Baby is Breech

Finding out your baby is breech can be an emotional experience.

I know for my friend who just gave birth, the last few months were filled with anxiety and doing everything possible to get baby to turn. As her due date approached, she slowly began to accept that baby may know best for position, even though she continued to work hard to give baby the opportunity to move into a head down position.

For most of us, even if we don’t know why, we know that the best way for baby to be born is head first.

Sticking with the physical aspects of birth, having the head birth first follows the natural curve of the spine and allows the body to follow along smoothly.

However, when baby is feet or bum first, this does not happen.

Since the dawn of cesarean birth, babies who are [known to be] breech for the most part have been scheduled to be born through a cesarean. The medical community feels the pros of a cesarean out way the risks of of a breech vaginal birth, for most moms.

So if you are a woman who really wants to have a vaginal birth, the fear of a cesarean can be very strong.

But how you handle that fear can be even stronger. Having an experienced provider who is open to assisting a breech vaginal birth would be wonderful, unfortunately, that is not always available.

So what can you do?

Fortunately, most babies turn on their own, with 3-4% remaining breech at birth (source). But there are ways to support your body and baby through this process when there are no other medical complications preventing baby from turning.

Inspired by my friends journey I put together my top 6 strategies (in no particular order) to help baby turn into a head down position.

The main focus to all these strategies is to create space in the pelvis. The pelvis is the outlet for birth. There is the upper ring and lower ring made up of two bony sides (or wings I call them), the sacrum, and soft tissue. These rings can expand and shrink depending on posture, muscle and tissue tension, and joint movement. Performing techniques that target softening and expansion of these rings is the goal!

  1. Pelvic Opening Exercises

    Doing stretches that promote widening of the pelvis and gentle mobility of the sacroiliac joints does just that. These exercises involve a lot of stretching the muscles and tissues around the low back, trunk, pelvis and hips.

    An example of one exercise sequence I teach my patients are pelvic tilts, circles & sways.

    These can be done in various positions but there are 3 that I find most effective: hands and knees, a birth ball or standing. They can be performed from small to large movements, slow or fast, and as many as feel comfortable.

    They are great to do throughout pregnancy as well as while in labor.

  2. Spinning Babies

    Spinning Babies was created by Gail Tully as strategies to help optimize babies position. They provide exercises and hands on techniques to create space for baby to “spin” in utero to be in the best position for birth.

    They offer online support and in person care through providers trained with Spinning Babies.

  3. Fascial Release Bodywork

    Sometimes muscles and joints that become tight over years of imbalance may need more than stretching and movement to create space.

    Using a form of manual therapy that targets the fascial system. This system is a network of connective tissue that surrounds and is interwoven into every fiber of the body and provides the support necessary for optimal functioning.

    When the fascial system is dehydrated and restricted it inhibits muscles and joints. Fascial release nourishes these tissues, allowing them to open up and create space. Performing releases around the spine, ribs, pelvis and hips improves babies chance of finding optimal position.

  4. Webster Technique

    This technique is used by Chiropractors to analyze the sacrum for subluxation and provide adjustments accordingly to restore neuro-biomechanical function.

    While this technique does not necessarily create more space, sacral subluxation can cause baby mal-position, due to the imbalanced of space in the pelvis. Bringing the sacral into alignment allows baby to find a better position.

  5. Osteopathic Manipulation

    Osteopathic manipulation are hands on techniques that Doctors of Osteopathy use to balance joints and surrounding tissues. Again, various techniques can be utilized to manipulate the spine, pelvis and sacral joints to target the uterine and cervix ligmants and muscles to bring alignment to the area and remove mechanical interferance to baby’s position.

  6. Acupuncture

    Acupuncture is another technique that can be used to open the pelvis and hips to create space for baby to turn into optimal birth position. Acupuncture points are targeted in the back, arms, hands, legs, and feet to remove restrictions and improve energy flow in the sacrum, surrounding muscles and uterine ligaments.

    Some acupuncturists are also trained to do Moxabustion, a Traditional Chinese Medicine technique where moxa (Chinese herb) is burned over a point in the outer toe. This has been shown to be effective in turning babies for hundreds of years in China and recently validated with randomized controlled-studies.

I invite you to an informational consult call to learn more about how I can help your baby find optimal position as a maternal pelvic health physical therapist!

Survive Camping While Pregnant

Living so close to the White Mountains of New Hampshire is such a joy.

My husband and I loved getting up to hike and bike before our daughter was born and now that our house renovations (that we are doing ourselves) are winding down our weekends are opening up to get back up there to share with our daughter.

We ventured up to the Whites this past weekend to camp with my brother and family and my parents.

The weekend started off raining, so luckily my parents were able to set up our tent prior to arriving, but I wanted to go over to tips on how to survive camping (and I mean tenting) for a weekend while pregnant.

We knew the nights were going to be on the cool end, so we needed to bring extra blankets and decided the most comfortable way to go would to bring our air mattress.  I don't know if I would do this again.

Here's why...

Air mattresses deflate and move whenever the other person (or in my case people, yes our daughter slept between us) shift. So I a nice firm mattress in the beginning of the night may not be so by the morning.

I found that every time I needed to shift positions I had a hard time getting enough leverage to rotate without disturbing my daughter.

Plus my hips were sore by the morning even with the support of a pillow between my legs.

Tip #1

Make sure the surface that you are sleeping on is comfortable.

There is nothing worse that sleeping outside while pregnant if you are waking up in the morning super stiff or in pain and can't enjoy the activities planned for that day.

So try out an air mattress at home. If you are early enough in pregnancy and a back sleeper, great. You may not have this issue, but for those who need to sleep on your side or are a side sleeper, make sure you have extra pillows to support you or see how your hips do with the stiff or deflated mattress.

If you are using a sleeping pad instead, again, try it out at home first. Especially if you have to sleep on your side. Our hips expand during pregnancy and the pad may not be enough cushion to reduce the pressure point on them.  You also have the option of building up a ramp to sleep on your back, if you have room in the car to bring extra blankets and pillows. So try this out at home as well.

No matter the surface you are sleeping on it is wise to do a wake up stretching routine.

Tip #2

Stretch in the morning.

When we camp, we go on hikes or swim or are extra active.

Then we tend to stay up later and may not get the greatest night sleep.

Thus, morning stiffness can be more of a problem, regardless of your sleeping environment.

So when that sun wakes you up, crawl out of the tent (or stay in the tent) and stretch your body.

 

Make sure you target multiple areas of the body....hips, side trunk, chest.

Think standing up, reaching for the sky with both hands then bending to the one side.

By warming up your muscles with gentle stretches your setting yourself up to enjoy the other activities lined up for the day.

I don't think I can say this enough......drink water!

Tip #3

Make sure you have another potable water.

Water is the best way to stay hydrated, which is even  more important while pregnant.

If your camp sight does not have potable water, you need to bring enough for your whole stay or having an appropriate method of sanitizing the water. This could be boiling the water or filtering it, the CDC has more information on appropriate water sanitizing while camping.

Other than water, what you eat will also be a factor while you camp.

If the mornings are cool, water water with a lemon is a great way to start the day.

Tip #4

Make sure you plan out your meals so you know you're getting in enough vital vitamins, minerals, calories and proteins.

Of course when you are tenting you don't have all the luxuries of a kitchen, so be reasonable with the meals you pick.

Oatmeal with added goodies like almond butter, flax seeds, cinnamon and dried fruit can be an excellent breakfast.

You can also prepare some food prior to leaving the house. This can help cut down on the dirty dishes. Just make sure you keep the perishable foods cold!

Then once you've figured out your meals you can add in snacks. Easy fruits like apples and bananas are easy to pack and carry around with you. Nuts, roasted chickpeas, sugar snap peas, dried fruit, sandwich crackers are all great snacks to munch on.

And lastly, once all the logistics are figured out....

Tip #5

Have FUN!

Not everything is going to go to plan and while camping you have to have a degree of "let it go" attitude.

Our daughter stayed up much later than we would usually allow her to. But we knew she would be okay and she could take a nap the next day (if she really needed it).

If you want to learn more about safe stretches and a morning routine to get ready for the day while you are pregnant reach out to learn more about my solutions!

So if you are near mountains or pitch a tent in the backyard have fun camping even while pregnant!

Hiking While Pregnant

Being out in nature is a wonderful way to enjoy fresh air while staying active during pregnancy.

Hiking is one way to be in nature.

We are moving into my favorite time of year for hiking, the weather cools off, the streams and rivers still feel refreshing, the leaves start to turn to vibrate reds, oranges and yellows and warm teas are so much more enjoyable.

After camping over the weekend, my daughter went to my brother's for the week to visit more with her cousins and my husband and I decided to go for a hike. We chose our hike without much thought and as we were hiking we discovered the hike was more vertical than expected.

I want you to learn from my hike that day.

Tip #1

Avoid hiking above 6,500 feet  above sea level.

In higher altitudes oxygen levels drop. During pregnancy the demand for oxygen increases, to accommodate this we breath more and our blood volume increases to get the available oxygen in our blood to the fetus, our organs and muscles.

When there is less oxygen in the air it is more challenging for our body to get enough, which puts mom and baby at risk.

To avoid this risk, pick hikes that are below 6,500 feet.

This is easily done on the east coast, but for those who live in or near the Rockies, consider this you're body could already be used to the elevation, so chat with your provider if you are an avid hiker to see if you can continue hiking at higher altitudes.

Tip #2

Don't hike anything more intense than what you were regularly hiking pre-pregnancy.

So if you were an avid hiker prior to being pregnant and were hiking 10 miles hikes, baring no medical complications you can keep hiking 10 mile trails.

Don't get discouraged though, if you have never hiked before, there are plenty of level trails with beautiful views all over the country. Instead of walking around your neighborhood you can take a stroll along a dirt, pine needle and leaf padded trail.....because psst this is a hike!

Research the trail prior to starting and make sure you know what you are getting into.

Tip #3

Warm up and cool down.

Just like any workout, warming up your muscles with dynamic stretching, reduces risk of injury.

It tells your muscles and joints "get ready to move."

It makes it easier for your joints to bend and your muscles to stretch and contract.

Then once you finished your hike, cooling down your muscles with some stretches will help reduce soreness.

Target the following muscle groups...

....quadriceps, hamstrings, hip flexors, glutes, shins and calves.

Tip #4

Use MINDFUL MOVEMENT

Our joints are more susceptible to injury during pregnancy because of the relaxin that prepares our bodies for birth.

What this means is we need to take care of them with proper modifications, muscle control and support.

Hiking trails can be strewn with roots, branches, rocks and uneven terrain.

So pay attention to where you are placing your feet, use your whole foot, and keep a bend in your knees.

Use hiking poles to soften the descent and reduce the strain on your legs.

Tip #5

No matter your ability...take breaks!

Lastly, this should really go without saying, but bring more water than you think you should and plenty of snacks.

Go enjoy the great outdoors!