Researching how to encourage breech babies to turn

We often share information, especially with professionals, on the Breech Birth Network FaceBook group. We had a post recently promoting hypnotherapy to turn breech babies.

This was my response:

I have approved this post, but I will not in the future approve posts that make claims that do not present the evidence that supports them. This includes training in complementary therapies such as moxibustion.

We now have a wonderful OptiBreech database, which collects data from the point anyone is referred for care related to breech presentation at the end of pregnancy and has a breech presentation confirmed by ultrasound – this can be as early as 32 weeks. It also collects information on how often these babies turn without intervention, and the different types of therapies and advice women receive.

A randomised controlled trial is the best way to test claims for the success of a therapy like hypnotherapy to encourage breech babies to turn head-down. Second-best is a prospective observational study of women who choose and receive hypnotherapy. Because we collect information on women who do not choose and receive hypnotherapy, we still have a point of comparison that would enable us to tell if hypnosis increases turning compared to none.

If any of you providing or teaching complementary therapies would like to collaborate on a trial, please do e-mail me at Shawn.Walker@kcl.ac.uk. We have a team of people who can help design a study and apply for funding. If hypnotherapy is effective, it should be offered to all women within the NHS and included within the OptiBreech care pathway. If not, professionals should not be suggesting it to women.

If you are promoting a therapy, please provide links to the evidence that supports it, to enable women to consider the evidence available before spending money at a time when they are vulnerable. Without evidence, future posts will not be approved.

Shawn

As you can see from the image below, based on previous research, a certain percentage of babies will turn on their own, without intervention. We know the number that turn is higher when we attempt a manual turning (external cephalic version or ECV). But we also know not everyone wants an ECV, and many women report trying alternative or complementary therapies to encourage their babies to turn. As these are popular and acceptable to large numbers of women, it would be best for us to have high-quality evidence about which therapies are effective at helping more babies to turn.

Image: Westgren, M., Edvall, H., Nordström, L., Svalenius, E., Ranstam, J., 1985. Spontaneous cephalic version of breech presentation in the last trimester. Br. J. Obstet. Gynaecol. 92, 19–22. https://doi.org/10.1111/j.1471-0528.1985.tb01043.x
video from Nesta, UK

For more information on Randomised Controlled Trials, see this simple explanation from Nesta in the UK.

What do you think?

We would love to hear from women about whether you think it would be a good idea to test hypnotherapy for turning breech babies at the end of pregnancy.

  • Why or why not?
  • Would you be willing to help us design a test to see if it works?
  • Are there other therapies you would like to see tested?

Thanks as always for your feedback. You can comment on this post or e-mail our team using the form below.

We are also keen to hear from professionals who would like to work with us to deliver research in this area.

Author: midwifeshawn

Midwife with a special interest in complex normality, especially breech.

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