When Baby is Breech

Your baby is breech when they are positioned in the uterus feet or bottom first. There is usually nothing to worry about: most babies will turn to a head-down position by their due date. Some breech babies can be born vaginally, but a C-section may be recommended if your baby is footling breech, or remains footling breech later in pregnancy.

This means the baby is positioned feet or bottom first in the uterus. A baby may be breech for many different reasons and it may change position several times before birth. Most breech babies will turn to a head-down position by 36 weeks, but if not the doctor may recommend having a C-section

When a baby is positioned bottom first in the uterus. Ideally, a baby is positioned so that the head is delivered first during a vaginal birth.

babies are usually born head first. In breech position, the baby is positioned feet or bottom first in the uterus. Some babies can be born vaginally while a C-section is usually recommended.

A breech baby is one who is positioned in the womb with the feet or bottom pointing downwards. Ideally, the baby will be positioned with the head pointing downwards by 36 weeks. A vaginal delivery isn’t recommended unless a professional can turn the baby to a head-down position.

Breech births are not common, but they are possible. Learn more about what a breech baby is, why some babies are breech, when a baby can turn from breech to head down and more. If your baby is positioned feet first, reach out to your doctor who will monitor the position and help you create a care plan that’s right for you.

A breech baby, or breech birth, is when your baby’s feet or buttocks are positioned to come out of your vagina first. Your baby’s head is up closest to your chest and its bottom is closest to your vagina. Most babies will naturally move so their head is positioned to come out of the vagina first during birth. Breech is common in early pregnancy and most babies will move to a head-first position by 36 weeks of pregnancy. This head-first position is called vertex presentation and is the safest position for birth.

What causes a breech pregnancy?

There are three different types of breech pregnancies: frank, complete, and footling breech, depending on how the baby is positioned in the uterus. With all types of breech pregnancies, the baby is positioned with its bottom toward the birth canal instead of the head.

Doctors can’t say exactly why breech pregnancies occur, but according to the American Pregnancy Association, there are many different reasons why a baby might position itself the “wrong” way in the womb, including:

  • if a woman has had several pregnancies
  • in pregnancies with multiples
  • if a woman has had a premature birth in the past
  • if the uterus has too much or too little amniotic fluid, meaning the baby has extra room to move around in or not enough fluid to move around in
  • if the woman has an abnormally shaped uterus or has other complications, such as fibroids in the uterus
  • if a woman has placenta previa
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How will I know if my baby is breech?

A baby is not considered breech until around 35 or 36 weeks. In normal pregnancies, a baby usually turns head-down to get into position in preparation for birth. It’s normal for babies to be head-down or even sideways before 35 weeks. After that, though, as the baby gets bigger and runs out of room, it becomes harder for the baby to turn and get into the correct position.

Your doctor will be able to tell if your baby is breech by feeling your baby’s position through your stomach. They will also most likely confirm that the baby is breech using an ultrasound in the office and in the hospital before you deliver.

What complications can a breech pregnancy have?

In general, breech pregnancies aren’t dangerous until it’s time for the baby to be born. With breech deliveries, there is a higher risk for the baby to get stuck in the birth canal and for the baby’s oxygen supply through the umbilical cord to get cut off.

The biggest question with this situation is what is the safest method for a woman to deliver a breech baby? Historically, before cesarean deliveries were common, doctors, and more commonly midwives, were taught how to handle breech deliveries safely. However, breech deliveries do have the risk of more complications than a vaginal delivery.

2000 studyTrusted Source that looked at over 2,000 women across 26 countries found that overall, planned cesareans were safer for babies than vaginal births during breech pregnancies. The rates of infant death and complications were significantly lower with planned cesareans for breech babies. However, the rate of complications for mothers was about the same in both cesarean and vaginal birth groups. A cesarean is major surgery, which could account for the rate of complications for mothers.

The British Journal of Obstetrics and GynecologyTrusted Source also looked at the same study and concluded that if a woman does want to have a planned vaginal delivery with a breech pregnancy, she might still have a chance to have a safe delivery with a trained provider. Overall though, most providers would prefer to take the safest route possible, so a cesarean is considered the preferred method of delivery for women with breech pregnancies.

Can you turn a breech pregnancy?

So what should you do if you have a breech pregnancy? While you will most likely have to talk with your doctor about scheduling a cesarean, there are also ways you can try to turn your baby. Success rates for turning a breech pregnancy depend on the reason your baby is breech, but as long as you try a safe method, there’s no harm.

External version (EV)

An EV is a procedure in which your doctor will try to manually turn your baby into the correct position by manipulating the baby with their hands through your stomach.

According to the American College of Obstetricians and Gynecologists, most doctors will suggest an EV between 36 and 38 weeks of pregnancy. The procedure is usually performed in the hospital. It requires two people to perform and the baby will be monitored the entire time for any complications that might require delivering the baby. The ACOG notes that EVs are successful only about half of the time.

Essential oil

Some mothers claim to have had success using an essential oil, like peppermint, on their stomachs to stimulate the baby to turn on its own. As always, however, check with your doctor before using essential oils, as some are not safe for pregnant women.

Inversion

Another popular method for women with breech babies is inverting their bodies to encourage the baby to flip. Women use different methods, like standing on their hands in a swimming pool, propping up their hips with pillows, or even using the stairs to help elevate their pelvis.

When to talk to your doctor

Your doctor will probably be the one to let you know if your baby is breech. You should talk to them about your concerns for your baby’s breech birth, including the risks and benefits of choosing a cesarean, what to expect from surgery, and how to prepare.

Causes of Breech Baby

About 3-4 percent of all pregnanciesTrusted Source will result in the baby being breech. A breech pregnancy occurs when the baby (or babies!) is positioned head-up in the woman’s uterus, so the feet are pointed toward the birth canal.

In a “normal” pregnancy, the baby will automatically turn inside the womb into a head-down position to get ready for birth, so a breech pregnancy presents a few different challenges for both mother and baby.

How common is a breech baby?

There is a small chance that your baby will not move into a head-first position before 37 weeks of pregnancy. Breech babies account for about 3% to 4% of all full-term pregnancies.

What are the types of breech position a baby can be in?

There are several fetal positions your baby may present in. Ideally, your baby is positioned head-down, facing your back, with their chin tucked to their chest.

Breech babies can be in a few different positions:

  • Frank breech: The baby’s buttocks are aimed at the vaginal canal with its legs sticking straight up in front of their body and the feet near their head.
  • Complete breech: The baby’s buttocks are pointing downward and both the hips and the knees are flexed (folded under themselves).
  • Footling breech: One or both of the baby’s feet point downward and will deliver before the rest of their body.
  • Transverse lie: This is a form of breech presentation where your baby is positioned horizontally across your uterus instead of vertically. This would make their shoulder enter the vagina first.

How does a breech baby affect pregnancy?

Your pregnancy is usually not affected. Most breech babies are born healthy, although there is a slightly elevated risk for certain birth defects. Your baby’s movements may feel a little different. You will feel your baby’s kicks lower in your belly. You may feel a hard lump closer to your ribs. This is your baby’s head.

If you planned a vaginal delivery, a breech baby 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 will recommend a Cesarean birth (C-section).

How does a breech baby affect delivery?

If your baby presents in a breech position after 36 weeks of pregnancy, your birthing plan will likely change. It’s usually unsafe for a breech baby to be born vaginally due to risks of injury. In most cases, a planned C-section is the safest way to deliver your baby. Some healthcare providers may be comfortable with a vaginal breech birth. In some cases, turning your baby to a head-down position while they are still inside your uterus is an option. Your baby is then born head first.

SYMPTOMS AND CAUSES

How can you tell if your baby is breech?

You may be able to tell if your baby is breech, especially if you have had past pregnancies where your baby was head-first. The places where you feel lumps and kicks might indicate that your baby is breech. Let your healthcare provider know where you feel movement. They will feel your belly or do an ultrasound to confirm that your baby is breech.

What causes a baby to be breech?

It’s not always known why a baby is breech. Some factors that may contribute to this position are:

  • You are expecting multiples (twins or more). This makes it harder for each baby to get into the right position.
  • There is too much or too little amniotic fluid.
  • The uterus is not normal in shape or has abnormal growths such as fibroids. Most of the time, the uterus is shaped like an upside-down pear. If it’s shaped differently, there might not be enough room for a full-grown baby to move into position.
  • The placenta covers all or part of the cervix (a condition called placenta previa).
  • The baby is preterm. This means they are less than 37 weeks gestation and may not have turned to a head-first position.
  • Your baby has a birth defect that causes them to not turn head-down.

DIAGNOSIS AND TESTS

How is a breech baby diagnosed?

Your healthcare provider may be able to tell which way your baby is facing by placing their hands at certain places on your abdomen. By feeling where the baby’s head, back and buttocks are, it’s usually possible to find out what part of the baby is positioned to come out of the vagina first. An ultrasound may be used to confirm the baby’s position.

When is a breech baby diagnosed?

Almost all babies are breech at some point. As your pregnancy progresses, your baby will naturally move to a head-down position — probably between 32 and 36 weeks. Your healthcare provider will feel your belly and determine where your baby is positioned. This will happen during most of your appointments in the third trimester. After 37 weeks, a breech baby usually does not turn on their own. Your healthcare provider will discuss delivery options with you.

MANAGEMENT AND TREATMENT

What are the options for treating a breech baby?

If your baby is breech at 37 weeks of pregnancy, your healthcare provider may:

  • Try turning your baby in your uterus into the head-first position.
  • Plan a C-section birth.
  • Plan a vaginal breech birth.

What are some complications of having a breech baby?

The complications of having a breech baby usually do not occur until it’s time to deliver. Some breech babies can be safely delivered through the vagina.

The risks of attempting a vaginal breech birth are:

  • Injuries to your baby’s legs or arms such as dislocated or broken bones.
  • Umbilical cord problems. The umbilical cord can be flattened or twisted during delivery. This can cause nerve or brain damage due to a lack of oxygen.

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

If your baby is breech, your healthcare provider may consider turning your baby so that you can have a vaginal delivery. In some cases, trying to turn your baby may not be safe or the risks outweigh the benefits.

Flipping your baby may not be safe if you have any of the following:

  • Bleeding from your vagina.
  • Placenta previa. This is when your placenta covers all or part of your cervix.
  • A nonreactive nonstress test.
  • An abnormally small baby.
  • Low level of amniotic fluid.
  • Low or high fetal heart rate.
  • Premature rupture of the membranes.
  • Twins or multiples.

The most common method used to turn a breech baby is called external cephalic version (ECV). It’s performed by your healthcare provider around 37 weeks of pregnancy. This procedure is performed in the hospital just in case an emergency occurs. It involves placing hands on your abdomen and applying firm pressure to turn your baby to a head-down position while your baby is still in your uterus. It is about 65% effective and carries some risks.

What are the risks of turning my breech baby?

The risks of ECV include the following:

  • Premature labor.
  • Premature rupture of the amniotic sac.
  • Blood loss for either you or your baby.
  • Emergency C-section.
  • Your baby might turn back to the breech position.

Although the risk of having these complications is small, some healthcare providers prefer not to try to flip a breech baby.

Will my breech baby flip on their own?

Most babies will flip to a head-down position before they reach full term (37 weeks). If your baby is still in a breech position at this time, your healthcare provider will determine if you can deliver vaginally or if you will need a C-section.

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

Some women will try at-home methods to flip their baby to a head-first position. They may help, but there is no scientific evidence that they 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 to promote activity.
  • 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 of these techniques need to be done by a professional that your healthcare provider has recommended.

PREVENTION

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

There is nothing you can do to prevent your baby from being in a breech position. If your baby is in a breech position, it’s not because you did anything wrong.

OUTLOOK / PROGNOSIS

Can you deliver vaginally with a baby breech?

It’s possible to deliver a breech baby vaginally. It can be more dangerous for the baby and the risk of injury is much higher. If the umbilical cord is compressed during birth, the baby could be deprived of oxygen and this could harm their brain and nerves. The cord could also slip around the baby’s neck or arms, causing injury. 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.

LIVING WITH

When should I see my healthcare provider?

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

  • Severe cramping or contractions.
  • Vaginal bleeding.

What questions should I ask my doctor?

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:

  • How can I tell if my baby is breech?
  • Is my baby OK?
  • What are the benefits and risks of turning my baby?
  • What are my options for delivery if my baby remains in the breech position?
  • What are the health risks to my baby and me if they are born breech?

FREQUENTLY ASKED QUESTIONS

Do birth defects cause breech position?

Birth defects are slightly more common in breech babies. It might be the reason that the baby didn’t move to the head-down position. Most babies who are breech at delivery are born without any health complications.

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

Most of the time, a C-section is the safest way to deliver a breech baby. Your risks of developing complications are much higher if you try to deliver a breech baby through the vagina. However, some healthcare providers may feel comfortable performing a vaginal breech birth.

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 rupturing of your membranes. In most cases, your healthcare provider will recommend a planned C-section. If your delivery is planned, you may not have any labor symptoms.

If you are in labor and go to the hospital for delivery, your provider will confirm your baby’s position a final time. Your provider could attempt a vaginal delivery, but it’s more likely they will proceed with a C-section to be safe.

A note from Cleveland Clinic

Having a breech baby can be unexpected and change the vision you had for childbirth. Talk to your healthcare provider about what to expect during a breech delivery. They can help you understand the risks and benefits of a breech birth so that you and your baby are kept safe.

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