Breech Babies and the Power of Massage: Creating Space for Baby to Turn

This month, as part of our ongoing commitment to refining our skills, my team focused on a topic that can significantly impact birth outcomes: breech presentation. Our goal is always to help women across the reproductive spectrum—fertility, pregnancy, and postpartum—through skilled and thoughtful touch. When a mother comes to us with a breech baby, her birth options are often narrowed, leading to increased stress and anxiety. We strive to offer gentle, supportive care that helps her body create more space, potentially allowing the baby to turn.

Understanding Breech Presentation and Delivery Options

Breech presentation occurs when a baby’s buttocks or feet are positioned toward the birth canal instead of the head, affecting about 3-4% of full-term pregnancies. While breech positioning is common earlier in pregnancy, most babies turn head-down by 37 weeks. However, some babies remain in this position as they near birth. As maternity massage therapists, we hold space for the fact that it may just be right position for this particular baby, but we also ask: Could it be that restrictions in the mother’s or baby’s tissues are preventing the baby from turning?

When a baby is breech, birth plans are often derailed. Healthcare providers usually force a cesarean as the only option, and in California, midwives are no longer allowed to attend breech birth at home. 

While some hospitals offer External Cephalic Version (ECV)—a manual attempt to turn the baby head-down—the procedure has a success rate of 50-60% and can be painful and stressful for both mother and baby. Many of our clients find that massage provides a gentler, less invasive alternative, creating space in the mother’s body for the baby to turn naturally.

Exploring the Causes of Breech Positioning

There are varying perspectives on why breech presentations occur. Some view breech simply as a “variation of normal,” with nothing to be “fixed,”  while others see it as a complication requiring surgical intervention. Anecdotally, we’ve observed a rise in breech positioning, and though we can’t be certain of the causes, several factors may contribute:

- growing prevalence of uterine fibroids that restrict space in the uterus
- sedentary lifestyles with lots of desk work or car travels leading to tension and restriction in the pelvic tissues
- high stress levels that impact proper breathing and diaphragm expansion, limiting space for the baby

As maternity massage therapists, our priority is not to focus on the “why,” but to explore whether the mother’s tissue restrictions are influencing the baby’s position and what we can do to support both.

The Body’s Role in Breech Positioning

What if the baby’s breech position is influenced by factors like maternal posture, fascia tightness, or connective tissue restrictions? Postural patterns, tension in the diaphragm, or asymmetry in the pelvis may be preventing the baby from turning head-down. 

In our practice, we frequently see that by addressing these restrictions, we can create the space the baby needs to turn. This leads us to consider that breech positioning may sometimes be an invitation for additional support.

The Role of Massage in Supporting Breech Babies

Massage therapy is a non-invasive and nurturing way to open space in the mother’s body, potentially allowing a breech baby to turn. During a 60- or 90-minute session, we focus on areas where restrictions commonly occur, such as the diaphragm, ribcage, and pelvis. Here are some of the techniques we use*:

1. Breathing Enhancement
We help mothers release tension in the diaphragm and increase lateral & posterior lung expansion:
-Paravertebral Deep Tissue Sculpting (DTS)
- Scalene and Pec Major/Minor DTS
- Skin Rolling
- Freeing the Scapula

2. Creating Ribcage Space
- Ribcage Sculpting and intercostal trigger point work help expand the ribcage beyond just the typical "flare" pattern so common in pregnancy
- Quadratus Lumborum Sculpting and active stretching of the lower back create crucial space between the pelvis and ribcage.

3. Opening the Pelvis
- Pelvic Girdle DTS and hip decompressions release tension in the pelvic muscles and fascia.
- Lumbosacral decompressions and SI joint release support pelvic alignment, while infinity mobilizations help the pelvis move fluidly, encouraging balance and space.

Moving Beyond Pathology: Supporting the "Motherbaby"

Instead of viewing breech as a “problem to fix” or a simple variation of normal, we can ask a deeper question: *What support does this motherbaby need, and how can we offer it?* By releasing restrictions and tension through massage, we create the opportunity for the baby to decide and have the freedom to shift into a more optimal position. 

Breech isn’t always a complication that requires intervention, but through compassionate care, we can offer mothers and babies the best chance for their unique version of their optimal birth experience.

If you're expecting and interested in how massage can support your breech baby, reach out to us for personalized care and information on our specialized services. Or, if you're a massage therapist looking to expand your knowledge, come study with us and gain the skills to support the motherbaby dyad.

The majority of techniques mentioned come from “Pre- and Perinatal Massage Therapy, 3rd Edition” Osborne, Kolakowski, and Lobenstine