Combined Complementary and Alternative Therapies for the Management of a Breech Fetus: A Feasibility Study.

OBJECTIVE

Cesarean rates are rising in the United States, especially for breech presentations, which complicates 3 to 4% of term pregnancies and contributes to maternal morbidity. Complementary and alternative therapies (CT) like moxibustion, chiropractic, and hypnosis have been suggested as noninvasive options to encourage fetal version. This study assessed the feasibility and acceptability of combined CT for breech management.

STUDY

DESIGN

Women aged > 18 with a singleton breech fetus at 34 to 37 weeks engaged in three study visits within 2 weeks. The intervention included therapies such as Spinning Babies techniques, yoga postures, mindset techniques, and chiropractic adjustments. Stress levels were assessed pre- and postintervention.

RESULTS

Of 24 referrals, 11 completed the study. No fetuses converted to vertex, but participants reported significantly reduced stress ( p  = 0.02). After the intervention, 54.5% opted for an external cephalic version, with a 50% success rate leading to two vaginal deliveries. All participants found the program beneficial, reporting high satisfaction with program duration, structure, and exercises.

CONCLUSION

Although fetal version was not achieved, this CT-based program significantly reduced maternal stress, suggesting its value as an emotional management tool in breech pregnancies. Larger trials are needed to evaluate its efficacy in promoting fetal version and improving maternal outcomes.

KEY POINTS: Approximately 86.9% of breech fetuses are delivered by cesarean section.Complementary therapies are often employed for a breech fetus with varying success.Combined complementary therapies for a breech fetus led a significant reduction in stress.