Saturday, December 7, 2013

Gentle Methods to PREVENT & TURN a Breech Baby



Gentle Methods to PREVENT & TURN a Breech Baby

Interview with Dr. Daoshing Ni and Dr. Jessica Chen, by Allie Chee


 Just the word “breech” can strike fear in pregnant womenand rightfully so.


 In the U.S. hospital environment, a breech presentation would “almost certainly mean a cesarean section, considered major abdominal surgery that generally leads to longer hospital stays, longer recovery and, like all surgery, the risk of complications[1]—and loss of any hope of a natural childbirth experience.

In the case of home birth with a midwife, some midwives will deliver breech babies and some won’t. World-acclaimed midwife, birth educator and activist Ina May Gaskin said in one of her lectures, “At first, we brought breech pregnancies to the hospital, but we found after a while that we could deliver them here just fine. Footling breeches, which are thought to be the most difficult, in our experience, they often just slid right out.”[2]

However, today more than 90% of breech babies are born by Caesarean [2]. A woman will be hard-pressed to find a provider who will happily encourage a vaginal birth with a breech presentation and she will likely find herself in the OR on her big day.

But for any woman wanting to avoid that scenario—great news!

Traditional Chinese Medicine (TCM) offers an extremely gentle, painless procedure with a high success rate for turning breech babies.  Further, TCM offers suggestions and ideas for how to avoid a breech presentation in the first place.

To find out more, I interviewed two doctors considered top in the field:
Dr. Daoshing Ni (known by his patients as Dr. Dao) and Dr. Jessica Chen of the Tao of Wellness in Santa Monica, CA.

Can you explain in TCM terms why a baby fails to turn?
Dr. Dao and Dr. Chen:  From the TCM point of view, the root cause of why a breech baby fails to turn can be due to various reasons. It can range from uterine abnormalities to uterine weakness. It occurs also in women who might have a weak constitution or be anemic. 

One of the most common reasons in TCM is due to stagnant energy, or a lack of smooth flow. This stagnancy prevents the baby from freely moving in the womb. From the TCM perspective, stagnant energy can stem from emotional or physical stress.

Emotional stress can be anxiety, depression, overwork and lack of proper sleep. Physical stress can be chronic constipation and sitting at a desk working for prolonged periods of time.  Each of these can contribute to a lack of smooth flowing energy in the womb, which is required for the baby to turn.

How does TCM address this situation and help the baby turn?
Dr. Dao and Dr. Chen:  TCM uses moxibustion to help turn a breech baby to its normal position for birth. A moxa stick made from Mugwort leaves is heated up and placed above an acupuncture point UB 67, located at the lateral tip of the fifth toe.  This acupuncture point is directly connected to the uterus.  When stimulated with the heat of the mugwort leaves, its warming effect travels up the acupuncture channel toward the baby, and then relaxes the environment of the womb, encouraging the baby to move.  Once the baby moves, gravity takes over, so the baby’s head naturally moves down toward the pelvis.  Acupuncture is also provided to address the individual need of the mother along with Moxibustion.
  
Are there any side effects with the treatment?
 Dr. Dao and Dr. Chen:  There are no known side effects. The advantage of this treatment is that it is completely noninvasive and a natural way to assist the baby in her movement.

 A question that will be on some mothers’ minds is: Does it hurt?
 Dr. Dao and Dr. Chen:  It is not painful.  The heat from the moxa can be very soothing!

How many treatments are usually required for the baby to turn?
Dr. Dao and Dr. Chen:  The treatment course consists of 10 consecutive daily moxibustion treatments with the Mugwort stick and few treatments of acupuncture.
  
What is the success rate of moxibustion and acupuncture treatments on breech babies?
Dr. Dao and Dr. Chen:  If the treatment is performed near 34 weeks, studies have shown the effective rate to be 70%. The later the treatment starts (38 weeks plus), the more difficult it is for the baby to turn. The treatment works best when it is within 34-36 weeks.

By what week in the pregnancy should a mother start treatment if her baby hasn’t turned?
Dr. Dao and Dr. Chen:  As soon as possible, ideally around 34 weeks.

Is there time in the pregnancy before labor that is too late to commence treatment if the baby is breech?
 Dr. Dao and Dr. Chen:  It is never too late to give it a try.


Aside from or in addition to treatment with acupuncture and/or moxa, is there anything TCM suggests the mother can do during her pregnancy to reduce the chance of a breech situation?
 Dr. Dao and Dr. Chen:  To begin with, a healthy lifestyle with regular non-impact, moderate strength training and moderately aerobic exercises can help the body stay strong and toned.  This will help prevent breech presentation in the first place. 

Good nutrition and avoidance of excessive weight gain during pregnancy is also helpful. Remember, TCM views the initial cause of breech presentation to be stagnant energy.  An environment of relaxed flowing energy during pregnancy will reduce the chances of a breech baby.


It is suggested that when a baby fails to turn after various, gentle methods have been attempted, it is for good reason—likely involving the baby’s position in relation to the placenta or umbilical cord. In the instances when a baby fails to turn with treatment, are there risks or things to consider with ECV (external cephalic version –when a doctor tries to move the baby manually by rotating the baby from the outside) from a TCM perspective?
 Dr. Dao and Dr. Chen:  When a baby fails to turn after various, gentle methods have been attempted it is most likely for a good reason.  Often, the baby’s position in relation to the umbilical cord or placenta is not correct. ECV is performed in the situation where the baby just won’t turn and has an effective rate of around 60%.  It is usually safe when properly performed.  It is usually performed around the 36th week of gestation.


For many people it will be a surprise to learn how easily TCM addresses a breech situation and how high the success rate is. Can you please tell us briefly about other common issues / problems in pregnancy that can be addressed in TCM—nausea, pain, postpartum issues, etc.?
 Dr. Dao and Dr. Chen:  Besides helping women with breech presentation during pregnancy, TCM also addresses many common and some uncommon issues related to pregnancy. Some of these issues include: nausea and vomiting, heartburn/acid reflux, constipation, varicose veins, musculoskeletal issues (neck and shoulder pain, low back, hip, and leg pain), fatigue, dizziness, insomnia, anxiety and depression, sinus issues, water retention, gestational diabetes, pre-eclampcia, placenta previa, pre-labor preparation and post labor recovery. 

I’m sure many mothers-to-be will be happy to discover this information. Thank you.

____________________

Anyone wanting to learn more about breech presentation and delivery could start with these resources:


  • Midwifery Today has many excellent resources, two to start with: Normalizing the Breech Delivery (DVD) and Breech Birth, a collection of articles from Midwifery Today, edited by Nancy Halseide.
     



Daoshing Ni (Dr. Dao), D.O.M., L.Ac., Ph.D, Dipl.C.H., is a doctor of Chinese Medicine. He holds two doctorates in Oriental Medicine. Dr. Dao has co-authored The Tao of Fertility: A Healing Chinese Medicine Program to Prepare the Body, Mind, and Spirit for New Life (Collins 2008), Sitting Moon: Guide to Natural Rejuvenation after Pregnancy, Crane Style Chi Gong and its Therapeutic Effects.
           

Jessica Chen, D.A.O.M., L.Ac., Dipl. O.M.,  is a Doctor of Acupuncture and Oriental Medicine specializing in women’s health and reproductive medicine. She co-authored Sitting Moon with Dr. Daoshing Ni; is a member of the American Society for Reproductive Medicine; and is certified in Chinese nutrition.



ALLIE CHEE After earning a BA in literature and a 2nd degree black belt in Korean martial arts, 20 years traveling in 50 countries, working in numerous entrepreneurial ventures, and serving as co-publisher of a leading financial industry magazine, Allie Chee lives in Silicon Valley with her husband and daughter and is a student at Stanford.

Her articles have appeared in: 
•  The Well Being Journal
•  The Holistic Networker
•  The Birthing Site
•  Natural Mother Magazine 
•  MidwiferyToday


Her published titles are: New Mother, Free Love, and Go, Jane!

Website: www.alliechee.com  Facebook: www.facebook.com/AllieChee 
NEW MOTHER on Amazon





*When I write about home birth or natural birth, it’s not to persuade those who feel safer in a hospital to change their minds.  It’s to support the women who, as I did, know they want a natural experience and are looking for ideas and inspiration.*






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