Breech birth on Call the Midwife

In the first episode of the new series of Call the Midwife, Nurses Trixie and Lucille battled with the snow to get to a home birth. When they got there, they found out that Nadine’s baby was breech.

Working together to support Nadine, the midwives skilfully delivered the baby, who arrived feet-first. Trixie turned the baby to get her into the best position as Nadine approached her final push.

After a little help to breathe, the newborn baby girl let out a small cry before being passed to her frightened new mum. However, after a short spell in hospital to treat jaundice (possibly linked to rhesus disease), Nadine described how she ‘let her in’, bonded with her new baby and fell in love.

Our midwife Amanda answers a few questions about the episode

What does ‘breech’ mean?

If the baby is bottom or feet first in the womb, they are in a breech position.

Most babies will move into a head-down position for birth (by about 36-37 weeks) but sometimes this doesn’t happen. If the baby is still breech at around 36 weeks the midwife or doctor will talk to the mum about how she can give birth safely. Find out more about positions for birth

Is there a way to turn a breech baby?

If a baby is breech, a procedure called 'external cephalic version (ECV)' may be offered at around 38 weeks. It involves a doctor trying gently turn the the baby round. Find out more about ECV.

What happened if the baby doesn’t turn?

If a baby does not turn head first, there are usually two options:

1. A planned caesarean section.
2. A planned vaginal breech birth.

In both cases, the risks and benefits of each should be well explained.

For more information about breech births, download the ‘Breech baby at the end of pregnancy’ leaflet from the Royal College of Obstetricians & Gynaecologists.

What is jaundice?

Jaundice is quite common in newborn babies.

In paler-skinned babies, jaundice shows as yellow-coloured skin, while in babies with darker skins, the yellowing may show only in the whites of the eyes. The degree of jaundice is measured from a blood sample.

Why do babies get jaundice?

Babies get jaundice if they have too much bilirubin in their blood.

Bilirubin is made when red blood cells carrying oxygen break down. It should be passed out of the body in the baby’s poo, after being processed by the liver. However, if a baby has too much bilirubin the liver isn’t yet developed enough to get rid of it.

After about two weeks, the baby’s liver will be better at removing bilirubin from the body, and they will be producing less of it.

What is the treatment for babies with jaundice?

Mild jaundice will often pass on its own after a couple of days. Sometimes, babies will have special light therapy called phototherapy, which involves laying them under a bluish light (with shades on) or on a fibre-optic blanket that emits light at the correct wavelength.

Occasionally jaundice can be the sign of a more serious illness. The healthcare team will assess this and may need to carry out further tests in order to find the right treatment. In very severe cases, this may include a blood transfusion.

What is rhesus disease?

Rhesus disease is a condition where antibodies in a mum's blood attack her baby's blood cells. It only happens when the mother has rhesus negative blood (RhD negative) and the baby has rhesus positive blood (RhD positive).

A blood test in early pregnancy will look at a woman's blood group and rhesus status.

Rhesus disease used to be a common problem but since the 1980s women have been given anti-D in each pregnancy to guard against it.