Breech presentation occurs in about 3 to 4 percent of all pregnancies. A baby in the breech position means that the baby’s feet or buttocks are positioned downwards in the uterus, with the head facing upwards. Most babies turn head-down by the 36th week of pregnancy. If the baby doesn’t turn naturally, the doctor may attempt to rotate the baby manually. Vaginal delivery in the breech position can be risky, so most doctors recommend a cesarean section if the baby remains in this position.
Ideally, the baby should be in a head-down position during delivery. While most babies eventually move into this position, some do not. If the baby remains in the breech position by the 37th week of pregnancy, delivery options may need to be adjusted.
When Does the Baby Turn Head-Down?
Breech presentation is common in early pregnancy, but most babies turn head-down by the 36th week.
Types of Breech Position
The types of breech presentation depend on how the baby is positioned in the womb and in relation to the birth canal. The three main types of breech positions are:
- Complete Breech: In this position, the baby’s knees are bent, with the feet near the baby’s pelvis. The baby appears as if sitting cross-legged in the womb, with knees towards the chest and feet up near the head.
- Frank Breech: In this position, the baby’s buttocks are down, but the legs are straight up and close to the head, with the feet near the ears. This is the most common type of breech presentation.
- Footling Breech: In this position, one or both of the baby’s feet are positioned downward, close to the birth canal. This is the least common type of breech presentation and can be the most dangerous for vaginal delivery.
In all these cases, because the baby’s head emerges last during delivery, there are risks, and many doctors recommend cesarean delivery to avoid complications.
What Causes Breech Pregnancy?
Doctors can’t always pinpoint why breech pregnancies occur, but research suggests several factors that may lead to the baby being positioned incorrectly in the womb, including:
- Multiple pregnancies (twins or more)
- Preterm labor
- Excessive or insufficient amniotic fluid (which provides more or less space for the baby to move)
- Abnormal uterine shape or issues like fibroids
- Placenta previa (low-lying placenta)
How Can I Tell if My Baby is Breech?
Until around 35 or 36 weeks, the baby isn’t considered breech. In normal pregnancies, the baby usually turns head-down in preparation for birth. It’s common for babies to be head-up or even sideways before 35 weeks, but after that, as the baby grows and space in the uterus decreases, it becomes more difficult for the baby to turn into the correct position.
Your doctor can determine your baby’s position by feeling your abdomen. Breech presentation can also be confirmed through an ultrasound during prenatal visits or in the hospital before delivery.
What Are the Risks of Breech Pregnancy?
Generally, breech pregnancy itself isn’t dangerous until the time of delivery. Breech births carry a higher risk of the baby getting stuck in the birth canal and cutting off oxygen from the umbilical cord. Therefore, breech pregnancy can change the type of delivery.
Methods to Encourage the Baby to Turn
To encourage the baby to turn, some women try different positions, such as:
- Standing on hands and knees.
- Elevating the pelvis using pillows.
If you’re concerned about your baby’s position, consult with your healthcare provider to discuss your options and the safest approach to delivery.