Palpating ( which is when the midwife feels for the position of the baby) is beginning to be something of a lost art. Whilst midwives are all trained to do it, there is increasing reliance on late scans for confirmation of a baby’s position, and it seems to diminishing the confidence and therefore the ability of midwives to accurately determine which way around a baby is lying. Admittedly it is very easy to mix up a head and a bottom- whilst the head is rounder and harder than the bottom, a baby’s bottom is fairly bony and fat=free, so the mistake is easily made. Supposedly the best way to check is not simply to focus ont he supposed head or bottom, but also on its position relative to the shoulders.
All too often women in my classes are told at 35, 36 or 37 weeks that their babies are breech. The obvious panic ensues as it is now routine to schedule 38 week c-sections for breech babies. Women then fling themselves down into knee-chest position, call or email me in a panic, and search for every possible alternative method ( acupuncture, incidentally, is probably the most successful of all the ones on offer) to turn their babies before uuuming and aaahing over possibly consenting to an uncomfortable ( but often successful) external cephalic version ( where a doctor manually turns a baby whilst it is still in its mother’s tummy- more on that in another post).
Whilst it is important to be informed in the face of a possible breech baby, my first piece of advice is now always, dont panic. Just because someone has said that they think the baby is breech DOES NOT MEAN IT IS. In my experience, the diagnosis is becoming more frequent, and 9 times out of 10 it is wrong. So the poor mother has read up, panicked, stressed and worried, only to discover at the scan that the baby is happily head down and all her worry has been for nothing. A huge 95% of babies are head down at term, leaving only 3-4% breech and the odd one transverse, but those that are in these more unusual positions can also change position right up until the end. Of course babies are sometimes stubbornly breech, and knowing that in advance of labour is important, but our increasing relaince on scans as a back up, as well as the fear of undiagnosed breech babies ( which few midwives have the experience at delivering now) means that more and more women are being told that their babies are breech when they are not.
So if you are told your baby might be breech, take a deep breath, focus on the ‘might’ and make your decisions once you know for sure.