Breech Position and Breech Birth

Topic Overview

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 about 4 out of 100 births, the baby does not naturally turn head-down late in the pregnancy. Instead, the baby is in a breech position.¹ Babies in breech position usually must be delivered by C-section.

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 birth canal. 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(s) are in place to come out first during delivery.

See a picture of breech positions .

What causes breech position during pregnancy?

In more than half of breech births, there is no clear reason why the baby did not turn head-down.² In other cases, breech position might be linked to:³

• Labor that begins before the 37th week of pregnancy, before the baby is likely to turn head-down on its own.
• Twins or more. Limited space for two or more babies can prevent them from moving into the head-down position before delivery.
• Too much or too little amniotic fluid in the uterus.
• Problems with the uterus, such as an oddly shaped uterus or uterine fibroids, which are noncancerous growths in the uterine wall.
• Stretched and weakened uterine muscle from past pregnancies.
• Problems with the baby, including heart, digestive tract, and brain problems, such as Down syndrome, anencephaly, or hydrocephalus.

What are the signs that your baby is in breech position?

You probably will not 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 and/or you feel kicking in your lower belly, see your doctor for an exam.

How is a breech position diagnosed?

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

How is breech position treated?

Sometimes it is possible for a doctor to turn a baby from a breech position to a head-down position by using a procedure called an external cephalic version. If the baby can be turned head-down before labor starts, 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. There is no research to prove that this works, but it’s not harmful. It may work for you.

It’s normal to 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 do not have problems after birth. Talk to your doctor if you're concerned about your baby’s health.

How is a breech baby delivered safely?

Most of the time a planned cesarean delivery (C-section) is safest for the baby. But sometimes it is possible to have a planned vaginal delivery with a breech birth. Talk to your doctor about how to have the safest delivery for your breech baby.

If you are using a midwife and your baby is in breech position, your midwife will refer you to a doctor for a C-section or vaginal breech delivery.

No matter what position a baby is in, every labor and delivery is unique. Even though you and your doctor have a birth plan for labor and delivery, plans can change. If something unexpected happens, your doctor may need to make some quick decisions to keep you and your baby safe.

Frequently Asked Questions

Learning about breech position and breech birth:	What is breech position? What causes breech position near the end of pregnancy? What types of fetal problems are linked to breech position? What are the signs of breech position?
Being diagnosed:	How do I know if my baby is breech?
Getting treatment:	How is a breech pregnancy treated before birth? How is a breech baby delivered? What can I do at home for a breech pregnancy?

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Author:	Bets Davis, MFA	Last Updated: April 28, 2008
Medical Review:	Joy Melnikow, MD, MPH - Family Medicine William Gilbert, MD - Perinatology
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