Ideally for labor, the baby is positioned head-down, facing your back, with the chin tucked to its chest and the back of the head ready to enter the pelvis. This is called cephalic presentation. Most babies settle into this position with the 32nd and 36th week of pregnancy. Other fetal positions for birth include different types of breech (feet down) and occiput posterior position (face up).
The presentation of the fetus is how it's positioned in the uterus. Throughout your pregnancy, the fetus will move around in your uterus. It’s normal for the fetus to be in a variety of positions during most of your pregnancy. Early on, the fetus is small enough to move freely. You may have even felt this movement over the last few months. The larger the fetus becomes, however, the more limited the movement becomes. As the end of the pregnancy approaches, the fetus will start to move into position for birth. This typically involves flipping over so that it's head down in your uterus. Then, it starts to move down in your uterus, preparing to go through your birth canal during childbirth.
The birth canal is made up of your cervix (immediately outside of your uterus), vagina and vulva. Think of the birth canal as an expandable tunnel. During labor, your contractions work to stretch this space so that the baby can pass through it during childbirth.
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Ideally for labor, the baby is positioned head-down, facing the mother’s back with the chin tucked to its chest and the back of the head ready to enter the pelvis. This position is called cephalic presentation. Most babies settle into this position within the 32nd to 36th weeks of pregnancy.
Sometimes the baby doesn’t get into the perfect position before birth. There are several positions that the baby can be in and each of these positions could come with complications during childbirth. These fetal positions can include:
A breech birth is when the baby is positioned with its feet down in the birth canal. While in the uterus, the fetus isn’t in any danger. However, in this position, the baby would be born foot first. A vaginal delivery is often a very safe form of childbirth, however, when the baby is breech, a vaginal delivery can be complicated. Because the baby’s head is larger than the bottom, there is a risk of head entrapment where the baby’s head becomes stuck in your uterus. In this situation, the baby can be difficult to deliver. Some babies in the breech position may want to come in a hurry during labor. Some providers are comfortable performing a vaginal birth as long as the baby is doing well. In many cases, your healthcare provider may recommend a cesarean birth (C-section) instead of a vaginal birth. This is a surgical procedure where an incision is made in your abdomen and the baby is removed in an operating room. There’s a lot less risk to the baby during this procedure compared to a breech vaginal birth.
During childbirth, your healthcare provider’s goal is to safely deliver your baby and ensure your well-being. If the baby is in a different position (not a cephalic presentation), this job becomes more challenging. Different fetal positions have a range of difficulties and the risks can vary depending on the position of your child.
Typically, your baby will drop down in the uterus and move into position for birth in the third trimester. This happens in the last few weeks of your pregnancy (often between weeks 32 and 36). Your healthcare provider will check the position of the baby by touching your abdomen during your regular appointments. This will happen during most of your appointments in the third trimester. In some cases, your provider may also do an ultrasound to check the baby’s position.
There are several ways that your healthcare provider can try and turn the fetus before you go into labor. These methods don’t always work and sometimes, the fetus can actually turn back into the wrong position again. You can actually try some of these techniques at home and they won’t harm you or the fetus. They might encourage the fetus to turn on its own, but there’s also a chance that nothing will happen. Even though there isn’t a guaranteed success rate, these methods are still recommended because they’re usually worth a try and could help you avoid a C-section delivery.
Methods for turning your baby can include:
A chiropractic technique, called the Webster technique, can also be used to move your hips. This is meant to allow your uterus to relax. Some providers even recommend acupuncture to help your body relax. Both of these techniques need to be done by a professional that your healthcare provider has recommended. Relaxation could promote movement in the baby and help get the fetus into the best possible position for birth.
It’s always possible that your baby will reposition all on its own. In the weeks leading up to birth, the baby still has time to make adjustments and change position. Most find their own way into the correct position before birth.
Most birth plans begin with the idea of having a vaginal birth. Your provider will look at your medical history, the scans of your baby throughout your pregnancy and the position of the fetus to pick the safest form of delivery. When the fetus is in a breech position or another abnormal position, your healthcare provider may suggest a cesarean section (C-section) delivery. This is a surgical procedure where an incision is made in your lower abdomen. The baby is delivered through this opening instead of through the birth canal.
It is possible to deliver a breech baby vaginally. However, this type of birth can be much more dangerous for the baby and the risk of injury from the umbilical cord is much higher. If the cord is compressed during birth, the baby could be deprived of oxygen and this could harm the brain and nerves. The cord could also slip around the baby’s neck or arms, causing injury. Different healthcare providers have various levels of comfort with vaginal deliveries of breech babies. Talk to your provider about the risks and benefits of different types of birth for a breech baby.
There are several factors that could increase the risk of a fetal position like a breech presentation. These can include:
A note from Cleveland Clinic
Learning that the fetus is in a breech or other complicated position before birth can add to the anxiety that often surrounds childbirth. It’s alright to have concerns and questions about what this means for your birth experience. You may have developed a birth plan during your pregnancy. A birth plan is an ideal plan for your labor and delivery. These plans can be very helpful as a tool. Take your birth plan to an appointment and talk to your healthcare provider about what you are picturing for your labor and delivery. Your provider can help guide you through not only the ideal plan, but an emergency plan. Remember, things can change quickly during childbirth. Having a C-section may not be a part of your birth plan. However, the goal is to safely deliver your child and protect your health. Talk to your healthcare provider about questions and any concerns you might have about your baby’s position.
Last reviewed by a Cleveland Clinic medical professional on 03/04/2020.
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