All you need to know about moxibustion to turn the Breech.
If your baby is in the breech position in the last few weeks of pregnancy there are some options for you to try before considering external cephalic version or booking a date for caesarean section, which is currently the preferred mode of birth. Most babies will spontaneously turn to the head down position by 37 weeks but 2-4 % will remain breech up until labour begins.
Once the baby’s bottom engages in the pelvis it is difficult for it to move from that position. There are some positions that you can adopt to help prevent engagement of the bottom so that the baby has the best chance of turning from about 32- 35 weeks gestation. It is advised to adopt the positions approximately 3 times a day for 15-20 minutes on an empty stomach and when the baby is active.
Lie on your back with your feet on the wall and your back supported with pillows and lift your hips as high as you can, definitely above your shoulders. An alternative to this is to prop an ironing board securely on a sofa or chair and lie face up with feet at the upper end, knees bent and feet flat on the board to dis encourage engagement in the pelvis.
Another way is to adopt the ‘knee/chest’ position whereby your bottom is high in the air and your head and chest are on the floor.
Moxibustion and acupuncture are complementary treatments that have proven success in encouraging the baby to turn to the optimum head down position and can be used along side the positions described. The treatment is cheap and easy. Non-invasive and safe to carry out.
Moxibustion is an externally applied Traditional Chinese Medicine (TCM) treatment using a Chinese herb called Moxa (Artemisia argyi or ‘mugwort’). The herb is dried and rolled into a cigar shape stick, then lit and held over a specific acupuncture point. The radiant heat that is produced has the effect of warming and stimulating the point to encourage warmth to flow to the uterus via the bladder channel.
The acupuncturist will take a comprehensive case history, make a diagnosis and choose the appropriate points to needle. The acupuncture point used to warm with the moxa in this context is Bladder 67/ Zhi yin, which is located on the outer lower edge of the little toes, because it is known to be the most dynamic point to activate the uterus and encourage movement in the baby. This treatment is also effective in encouraging baby’s to move from other sub-optimal positions such as a posterior or ‘back to back’ location.
According to TCM theory moxa has a tonifying and warming effect that promotes rising movement, which encourages the baby to become more active (the baby will usually start to become active after a few minutes of the treatment) and gain momentum so that it is more likely to turn around by itself. The primary aim is to encourage the baby to move around and increase the effect of gravity to help the head (the heaviest part of the baby) to turn and descend into the pelvis.
If the baby doesn’t turn around easily it must be assumed that it needs to stay where it is and then options for birth need to be considered.
The technique will be demonstrated so that the patient, and most likely the partner can carry it out at home twice a day for approximately 20 minutes until baby turns. I will always place a tiny press needle on the point both to keep it stimulated and so the partner can see clearly where to direct the heat.
In My own practice I have noticed that babies will start kicking and changing position with needling and moxa, but if not then patients report increased activity following the treatment.
Patients certainly find the treatment itself relaxing and calming and the partners enjoy being able to be involved too.
There are many reputable trials from China and Europe that demonstrate positive results with moxibustion. It is always difficult to conduct trials in acupuncture (and other complementary treatments that are robust enough to satisfy Western scientific scrutiny as there are many un-measurable variables which effect the success or not of any treatment. However it is my belief that it doesn’t really matter if there is not conclusive evidence as long as the desired result is achieved!
In my own practice over the last two and a half year period over three quarters of babies have turned to a head down position following treatment with acupuncture and moxibustion and all but one were birthed vaginally. The one that was born by caesarean section was because after the baby turned it was discovered that the placenta was lying too low for the baby to be birthed normally.