For Many Pregnant Moms, Webster Technique is the Key to a Safer Birth

As a mom navigating her way through a high-risk pregnancy, news of one more complication just leaves you with more questions and concerns. When the news is that your baby is not in the head down (or vertex) position, your questions go something like this: Will my baby turn on its own? Will I need external cephalic version? Can I even have that? Is it safe? Will I need to have a C-section?

If your particular high-risk situation doesn’t automatically require Cesarean, a breech (or transverse or oblique) presentation greatly increases that chance. Even in the case of low-risk pregnancies, abnormal position near the end of term commonly results in surgical birth. In fact, 2003 data from the National Center for Health Statistics shows that 87.2% of all breech presentations were delivered by Cesarean.

If your baby has not turned head-down by approximately 36–37 weeks, your doctor may suggest attempting external cephalic version. In this procedure, your doctor tries to turn your baby while still in the uterus by pushing on the baby with his or her hands through your abdomen. This procedure can bring about complications for any mom, including vaginal bleeding, premature rupture of membranes, fetal distress and premature labor. For many high-risk pregnancy situations, external cephalic version would not be recommended due to these possible complications. For some high-risk pregnancies, external cephalic version is contraindicated, meaning it is not even considered as a possible option due to the high likelihood that it would cause serious problems.

So, once you and your doctor realize that your baby is not positioned head-down, the most likely approach in a highrisk pregnancy is to wait and see if your baby will spontaneously turn. If your doctor is comfortable with the idea of external cephalic version in your case, you may weigh the pros and cons and decide to give it a try. Unfortunately, according to the American College of Obstetricians and Gynecologists (2000), external version only has a 58% success rate. If you cannot try, or are not comfortable trying, external cephalic version, or if it is unsuccessful, you are usually left waiting again for your baby to turn on his or her own. At this point, you will be well aware that if your baby has not turned head-down by the time you begin labor, you will need a C-section. What else can you possibly do other than just wait? What other options do you, as a concerned mother, have to attempt to prevent this scenario?

Let’s take a step back and talk about the “why’s” of abnormal presentation. Remember that your baby has innate programming that helps him or her know what to do during growth and development. Most babies do assume a vertex position before labor, because their instincts direct them to. This is the same way they innately know to push with their feet off the top of the uterus during contractions or to latch on to a breast even when they have never before seen one. So why hasn’t your baby turned vertex? Because your baby didn’t get the programming to know to do that? Of course not.