Breech Baby

What is a breech baby?

A breech baby (breech birth or breech presentation) is when a baby's feet or buttocks are positioned to come out of your vagina first. This means its head is up toward your chest and its lower body is closest to your vagina.

Ideally, your baby is in a head down, or vertex presentation, at delivery. While most babies do eventually turn into this position, some will not. If a baby is still breech at 37 weeks of pregnancy, your options for delivery may change. This is because there are risks to a vaginal delivery when a baby is breech. In many cases, a C-section is the best and safest option for birth.

When does a baby turn head down?

Breech is common in early pregnancy, but most fetuses will move to a head down position by 36 weeks of pregnancy.

Is a breech baby normal?

Breech position isn’t a typical position for full-term pregnancies — it accounts for 3% to 4% of all full-term pregnancies (39 and 40 weeks of pregnancy).

What are the types of breech positions?

There are four different breech positions:

• Frank breech: The baby's buttocks aim towards your vagina. Its legs are sticking straight up in front of its body (its feet are near its face).
• Complete breech: The baby's buttocks point downward, and both its hips and knees are flexed (the fetus is sitting on its folded legs).
• Footling breech: One or both of the baby's feet point downward and will deliver before the rest of its body.
• Transverse lie: This is when the baby lays across your uterus horizontally instead of vertically. This would make its shoulder enter your vagina first.

The ideal fetal position is when the baby is head down, facing your back, with its chin tucked to its chest. The back of its head is ready to enter your vagina.

Is a breech birth safe?

If you’re planning a vaginal delivery, a breech birth could change these plans. When your baby is breech, a vaginal delivery can be complicated and dangerous. Your healthcare provider may feel comfortable attempting a vaginal breech delivery, but in most cases, they’ll recommend a C-section.

How can you tell if your baby is breech?

You may be able to tell if the fetus is breech, especially if you’ve had past pregnancies where your baby was head down. The places where you feel lumps and kicks might indicate that the fetus is breech. For example, you may feel kicks in your pelvis instead of under your ribs. You may feel one hard lump at your ribs.

Beginning around the third trimester, your provider will press certain areas of your belly to determine if the fetus is breech. If they detect a breech position before 36 weeks, they’ll allow some time for it to turn into a preferable position.

Are breech babies more painful to carry?

No, the position of the fetus doesn’t usually affect your pain or discomfort during pregnancy. The movements you feel are just different from if the fetus was head down.

What causes a baby to be breech?

It’s not always known why a fetus is breech. Some factors that may contribute to a fetus being breech are:

• You’re expecting twins, triplets or more.
• You’ve been pregnant before.
• There’s too much or too little amniotic fluid.
• Your uterus is irregularly shaped. This can be due to a growth like fibroids, a uterine septum or other medical conditions.
• The placenta covers all or part of your cervix (placenta previa).
• Your baby is preterm. This means it may not have turned to a headfirst position yet.
• The fetus has a condition that causes it to not turn head down.

Do birth defects cause breech position?

Yes, a birth defect can cause a fetus to be breech. Certain muscular or skeletal conditions can increase the chance that a fetus is breech because they can’t move to the head down position when they have a condition that affects their movement.

What are some complications of having a breech baby?

A breech baby doesn’t usually affect your pregnancy. The complications mainly occur when it’s time to deliver. Some breech births can happen vaginally, but there are risks.

The risks of a vaginal breech birth include:

• Injuries to your baby’s legs or arms such as dislocated or broken bones.
• Your baby’s head can get stuck or trapped.
• Umbilical cord problems. The umbilical cord can flatten or twist during delivery. This can cause nerve or brain damage due to a lack of oxygen to your baby’s brain.

How is a breech baby diagnosed?

Your pregnancy care provider may be able to tell which way the fetus is facing by placing their hands at certain spots on your abdomen. By feeling where the head, back and buttocks are, it’s usually possible to find out what part of the baby is positioned to deliver first. An ultrasound can confirm if a baby is in a breech position.

When is a breech baby diagnosed?

A fetus is typically breech at some point during pregnancy. But a breech position matters when you approach 36 weeks of pregnancy. Up until this point, fetuses often move into a head down position. Your provider will feel your belly during your appointments in the third trimester of pregnancy to check if the fetus is in a breech position. An “official” diagnosis isn’t typically made until 37 weeks.

How late can a breech baby turn?

After 37 weeks, a baby usually doesn’t turn on its own due to having limited space. Your healthcare provider will discuss delivery options with you.

What are the options for delivering a breech baby?

If a baby is breech at 37 weeks of pregnancy, there are three possible options:

• Turn the baby at 37 to 38 weeks.
• Plan a C-section birth at 39 to 40 weeks.
• Most providers will avoid a vaginal breech birth unless the baby is crowning and ready to deliver.

Will my provider try to flip my baby if it’s breech?

If the baby is breech, your provider may consider turning it so that you can have a vaginal delivery. It really depends on your health history, pregnancy and desires for childbirth. In some cases, trying to turn a baby is too risky and unsafe.

An external cephalic version (ECV) is the most common method providers use to turn a baby. Your pregnancy care provider performs this procedure in a hospital. It involves placing hands on your abdomen and applying firm pressure to turn your baby into a head down position while it’s still in your uterus. There are risks to ECV, and it doesn’t always work. Your pregnancy care provider will discuss if turning your baby is an option for your pregnancy. If the maneuver works, you’ll be able to have a vaginal delivery. If it doesn’t work, your provider will schedule a C-section at a later date.

Will a breech baby flip on their own?

Most fetuses will flip to a head down position before they reach full-term (37 weeks). If a baby is still in a breech position at this time, your healthcare provider will monitor you with routine prenatal care and determine a time to schedule an external cephalic version or a C-section.

How can I flip my baby if it’s breech?

You can try to nudge your baby into a head-first position on your own at home. Keep in mind, there isn’t any scientific evidence that these methods work:

• Bridge position: Lie on the floor with your legs bent and your feet flat on the ground. Raise your hips and pelvis into a bridge position. Hold this position for 10 or 15 minutes several times a day.
• Child’s pose: Rest in the child’s pose for 10 to 15 minutes. It can help relax your pelvic muscles and uterus. You can also rock back and forth on your hands and knees or make circles with your pelvis.
• On all fours: While on a comfortable surface, get on your hands and knees to dangle your pregnant uterus, you can also rock back and forth or side to side.
• Music: Place headphones or a speaker at the bottom of your uterus to encourage your baby to turn.
• Temperature: Try placing something cold at the top of your stomach where your baby’s head is. Then, place something warm at the bottom of your stomach.

A chiropractic technique, called the Webster technique, can also help your uterus relax. Some providers even recommend acupuncture. Both techniques need to be done by a professional that your healthcare provider recommends.

How can I reduce my risk of having a breech baby?

There is nothing you can do to prevent a fetus from being in a breech position.

Can you deliver vaginally with a breech baby?

It’s possible to deliver vaginally when a baby is breech. But it can be more dangerous, and the risk of injury is much higher. The biggest risks involve injury to your baby’s limbs and oxygen deprivation due to issues with the umbilical cord (compressing it or twisting it) or difficulty delivering your baby’s shoulders and head.

Healthcare providers have various levels of expertise with vaginal deliveries when a baby is breech. Talk to your provider about the risks and benefits of different types of birth and what they recommend based on your situation.

Are C-sections more difficult when a baby is breech?

Performing a C-section when a baby is breech might be slightly more difficult, but obstetricians are usually familiar with doing a C-section this way. It involves a few different steps, such as making a wider incision (cut) or maneuvering your baby in a different way than they would if your baby wasn’t breech.

Do breech babies have health problems later in life?

No. Most children who were breech at delivery are healthy without health complications due to their presentation at birth. Pediatricians will examine your breech baby’s hips after delivery and make follow-up recommendations if needed.

When should I see my healthcare provider?

Contact your healthcare provider if you experience any of the following symptoms during pregnancy:

• Severe pelvic cramping or contractions.
• Vaginal bleeding.
• Your water breaks.

What questions should I ask my provider?

Learning your baby is breech may give you concerns about your delivery. It’s completely natural to have questions. Some questions to ask your doctor can include:

• What are the benefits and risks of turning my baby?
• Do you recommend a C-section if my baby stays in the breech position?
• What are the health risks to me and my baby if they’re born vaginally?

Will I need a C-section if my baby is breech?

Most of the time, a C-section is the safest way to deliver. Your risk of developing complications is much higher if your provider tries to deliver vaginally. But some providers feel comfortable performing a vaginal breech birth. You should discuss the risks with your provider.

How does labor start if your baby is breech?

Having a breech baby doesn’t change some of the first signs of labor, like contractions or your water breaking. If your provider schedules a C-section because your baby is breech, they typically schedule it around 39 weeks to reduce the chances of you going into labor (and needing an emergency C-section).