Vertex Presentation

What is the vertex presentation?

The vertex presentation describes the orientation a fetus should be in for a safe vaginal delivery. It becomes important as you near your due date because it tells your pregnancy care provider how they may need to deliver your baby. Vertex means “crown of the head.” This means that the crown of the fetus’s head is presenting towards the cervix.

A vertex presentation means a fetus is in a headfirst, head down position with its chin tucked towards its chest, facing your spine.

Does vertex presentation mean labor is near?

No, the fetus being in a vertex presentation doesn’t indicate labor is near.

Is vertex presentation the same as cephalic position?

Yes, they essentially mean the same thing. Cephalic presentation means a fetus is in a head-down position. Vertex refers to the fetus’s neck being tucked in. There are other types of cephalic presentations like brow and face. These mainly describe how the fetus’s neck is flexed.

When does a fetus turn into a vertex presentation?

Most fetuses settle into a presentation around 32 to 36 weeks of pregnancy. It’s possible for a fetus to rotate into a cephalic presentation after 36 weeks.

Your pregnancy care provider will check the presentation of the fetus during your prenatal appointments. They do this by feeling around your abdomen for physical landmarks — like a fetus’s bottom and head — using a method called Leopold’s maneuvers. They can also use ultrasound.

How is a baby delivered in a vertex presentation?

A vertex presentation means your baby comes out headfirst through your cervix and out your vagina (or birth canal).

Why is a vertex presentation good for a vaginal delivery?

Many decades of research shows a vertex presentation is the safest way to deliver a baby vaginally. Your pregnancy care provider’s goal is to deliver a healthy baby with the least amount of complications. If a baby is in any position other than headfirst, it becomes more challenging to deliver your baby safely during a vaginal delivery.

Are there any complications to a vertex presentation?

The most common complication is having a large baby that doesn’t fit through the birth canal. A large baby runs the risk of getting its shoulders or head stuck during delivery if they’re in a vertex position. Most healthcare providers will recommend a C-section if they suspect your baby is too large to fit through your vagina safely.

What is the difference between vertex presentation and breech presentation?

Breech is when a fetus is presenting in such a way that its feet or bottom would come out of your vagina first.

While a vertex position is ideal, some fetuses settle into a breech position. Keep in mind, a fetus moves freely and can take up until the end of 36 weeks of pregnancy to settle into a vertex position. The fetus’s position becomes critical when you’re nearing your due date and deciding on which method of delivery is safest.

About 3% to 4% of all babies are breech at term. If this occurs, your healthcare provider will talk to you about delivering your baby via C-section. A vaginal delivery for a breech baby comes with too many risks.

In some cases, your provider may discuss turning your baby to a vertex position. This is called external cephalic version or ECV and it involves moving the fetus by pushing on your abdomen. This also comes with risks, so it’s important to discuss the pros and cons with your provider.

Can a vertex baby turn breech?

Once a fetus turns into a vertex presentation, it rarely switches to a breech position. In rare cases, people with polyhydramnios (excess amniotic fluid) may be at risk for having their baby turn at delivery.

Can my doctor turn my baby to a vertex position?

Yes, some pregnancy care providers can turn the fetus to a vertex position. Keep in mind there are many factors that go into deciding to turn a fetus and it’s not guaranteed to work.

Methods for turning your baby can include:

• External cephalic version (ECV): ECV requires two providers — one lifts the fetus’s bottom in an upward position and the second provider applies pressure through the abdominal wall to your uterus to rotate the fetal head forward or backward.
• Changing your position: Sometimes, you can encourage the fetus to move by changing your position. These positions typically involve doing yoga-like poses. Again, there’s no guarantee these will do anything.
• Using stimulating sounds to encourage movement: Another thing you can try to get the fetus to change position is stimulation. Music, talking, temperature changes and light could make the fetus move. These methods are all extremely low risk.

A note from Cleveland Clinic

Hearing your baby is in a vertex presentation may sound confusing, but it’s actually a good thing. It means the fetus has settled into position for a vaginal delivery. And, if the fetus isn’t in a vertex position, try not to worry. There’s usually still time for it to move before delivery. Pregnancy and delivery come with a lot of questions. Don’t be afraid to ask your pregnancy care provider any questions you have throughout the process. They’re there to answer your questions and make sure your childbirth goes as smoothly as possible!