There is nothing wrong with being a breech positioned baby, the problem lies with the lack of training for OB’s in how to deliver breech babies vaginally. It’s a systemic problem caused by research that has now been refuted, but it will take time and a cultural shift to begin to see more vaginal breech births again.
In the meantime, mother’s have a few strategies that seem to have some effect in helping to turn the baby so that a c-section isn’t necessary. One of those therapies is moxibustion (moxa).
Here’s my answers to the most commonly asked questions about using moxa for breech position:
What do I have to do?
Your homework will be a daily moxa session where you stimulate an acupuncture point on your baby toe with the warmth from the moxa stick. A session is 20 minutes of moxa on each side (for a total of 40 minutes) everyday. Follow-up assessment by care provider is recommended after 7 days to determine fetal position.
What is moxa?
Moxa is a therapy under the umbrella of Traditional Chinese Medicine, much like acupuncture is. A dried herb (mugwort) is rolled into a stick and lit to smoulder (like a cigar). The stick is held near the acupuncture point and the heat from the moxa stimulates the point.
How does it work?
The point for breech is an empirical point, meaning it doesn’t have a clear explanation for the mechanism of action (ie, we don’t really know how it works, but it does). The effect of the moxa treatment is the babies show increased fetal movement as well as some increase in uterine tone. It is speculated that these two effects working together help the baby to turn. (Cardini, 1998)
What if the baby turns and I don’t realize it and I keep doing the moxa?
Moxa seems to help the baby to turn into an optimal position, in fact, we also use it to turn a baby that is facing posterior at 38 or 39 weeks. It doesn’t just make the baby turn somersaults, so once the baby is head down, the moxa will help it to stay that way and not continue to turn.
How effective is it?
When started at 33 or 34 weeks gestation, daily moxa treatment has been shown to increase the odds of the baby turning to 75%, a significant improvement from the 50-50 odds from doing no treatment. (Vas, 2009)
What are the risks?
The greatest risk for moxa treatments comes from the risk of getting burnt with the moxa. There have been no adverse outcomes or preterm labour noted in any of the studies done on breech. In fact, many other benefits for using moxa were noted such as reduction in delivery complications and reduced need for oxytocin during labor (9% vs 31% in the control group) (Cardini, 1998)
Do I need acupuncture too?
Not necessarily. According to the studies, acupuncture has either no effect or a negative effect compared with moxa to the point. Acupuncture is very useful once your baby has turned to help move the baby’s head further into the pelvis and begin to ripen the cervix.
What else can I do?
- I often recommend combining moxa treatment with a chiropractic treatment with a chiropractor trained in Webster technique.
- The Spinning Babies website is full of ideas and strategies to help turn a breech baby that can be used in conjunction with moxibustion.
- ECV – doing moxa treatment for 4-6 days before attempting an ECV seems to help make it easier for the care provider to turn the baby.
Vas J, Aranda JM, Nishishinya B, Mendez C, Martin MA, Pons J, Liu JP, Wang CY, Perea-Milla E.
Am J Obstet Gynecol. 2009 Sep;201(3):241-59. doi: 10.1016/j.ajog.2008.12.026. Review.
Cardini F, Weixin H.
JAMA. 1998 Nov 11;280(18):1580-4.