Before birth, most babies move into a head-down position in the uterus, though some do not. When the buttocks, feet or both are in place to come out first during birth it is called breech presentation. If your baby is in the breech presentation when your due date is near, you should know what to expect. You then can plan with your doctor the best way to manage your labor and delivery.

Breech Presentation

A full-term pregnancy lasts about 40 weeks from the first day of the last menstrual period. In the first 36 weeks, the baby changes position many times. In the last weeks, the baby shifts less because there is less room to move around.

By the 3-4 weeks before the due date, most babies move so their heads are down near the birth canal (vagina). If this does not happen, the buttocks, the feet or both may be in place to come out first during birth. This is called breech presentation. It happens in 3-4% of full-term births and requires special planning for how the baby will be born. If your baby is in a breech position, your doctor may recommend cesarean delivery.

Changing the Baby’s Position

If the baby is breech, your doctor may suggest version. This can attempt to turn the baby head down. It can improve your chance of having a vaginal birth.

To turn the baby, the doctor places his or her hands at certain points on your abdomen, then pushes or lifts. this helps the baby move. It is as if the baby rolls forward in slow motion. if this does not work, the doctor may try to get the baby to roll backward. In some cases, the doctor may have a second person help turn the baby. Most often, version is not tried until you are at least 36 weeks pregnant. If it is not done before then, the baby may still change position. Your doctor will assess your health and the state of your pregnancy to see if version is an option for you. Before your doctor tried to turn the baby, an ultrasound exam will be done. This exam shows:

  • How the baby is positioned
  • Where the placenta is positioned
  • How much amniotic fluid is present

Ultrasound also may be used to help guide the turning. The baby’s heart rate is checked with fetal monitoring before and after version. If any problems arise with you or the baby, version will be stopped right away.

Delivery

If your baby is in breech position, your doctor will talk with you about the best type of birth for you and your baby(vaginal birth or cesarean birth). If the baby can be turned around with version, vaginal birth may be an option. If the baby is in breech position as the time nears, cesarean birth may be best. Your doctor will go over the risks and benefits in detail. Together you will decide on the best plan for you and your baby.

It is not always possible to plan for a cesarean birth. The baby may move into breech position just before labor begins. In that case, you will not know that you are going to have a cesarean delivery until you are in labor.

Finally…

Most breech babies are born healthy. If your baby is still in the breech position as your due date draws near, talk with us. We will discuss the risks so that together we can plan the delivery that is best for you. Please feel free to contact us if you have any questions or to set up an appointment.