Breech Position and Breech Birth

Condition Basics

What is breech position?

During most of pregnancy, there is enough room in the uterus for the baby (fetus) to change position. By 36 weeks of pregnancy, most babies turn into a head-down position. This is the normal and safest fetal position for birth.

But in some births, the baby doesn't naturally turn head-down. Instead, the baby is in a breech position.

There are three main breech positions:

• Frank breech. The buttocks are in place to come out first during delivery. The legs are straight up in front of the body, with the feet near the head. This is the most common type of breech position.
• Complete breech. The buttocks are down near the cervix. The knees are bent, and the feet are near the buttocks.
• Footling breech. One leg or both legs are stretched out below the buttocks. The leg or legs are in place to come out first during delivery.

What causes it?

Most of the time, there is no clear reason why the baby did not turn head-down.

In some cases, breech position may be linked to early labor, twins or more, or problems with the uterus or placenta.

What are the signs?

You probably won't be able to feel whether your baby is breech. But if you are 36 or more weeks pregnant and think you feel the baby's head pressing high up in your belly or you feel kicking in your lower belly, see your doctor or midwife for an exam.

How is it diagnosed?

During a routine exam late in your pregnancy, your doctor or midwife will feel your upper and lower belly and may do a fetal ultrasound to find out if your baby is breech. Your doctor or midwife may also learn that your baby is breech when they check your cervix.

How is breech position treated?

Sometimes a doctor can turn a baby from a breech position to a head-down position by using a procedure called an external cephalic version after 36 weeks of pregnancy. (If you are using a midwife and your baby is in breech position, your midwife will refer you to a doctor for this procedure.) If the baby can be turned head-down, you may be able to have a vaginal birth.

You also can ask your doctor if you can try certain positions at home that may help turn your baby. This is called postural management. There is no research to prove that this works, but it's not harmful. It may work for you.

If your baby is still in a breech position near your due date, a planned cesarean delivery (C-section) is usually safest for the baby. Your doctor will likely schedule a cesarean. If you are using a midwife, your midwife will refer you to a doctor for a scheduled cesarean.

You may feel disappointed and worried about a breech pregnancy, especially if the doctor has tried to turn the baby without success. But most breech babies are healthy and don't have problems after birth.