Breech position affects delivery

At about 34 weeks of pregnancy your baby will find his living quarters getting tight. To maximize space and prepare to enter the world, most babies move so that their heads are down near the birth canal.

When this doesn't happen, it means the baby's bottom or the bottom and feet will emerge first during birth. This is called breech presentation, and it occurs in about 1 in every 25 full-term births. Most breech babies are born healthy, but birth-related problems are more common among breech babies. The baby's positioning will also affect whether you can have a vaginal or cesarean delivery.

No simple cause for breech presentation

The exact cause is uncertain, but certain factors make breech presentation more common:

Presence of multiple fetuses (twins or more)
Previous pregnancy
Preterm delivery (premature babies are more likely to be breech)
Fibroids (growths) in your uterus or an abnormally shaped uterus
Placenta previa
Too much or too little amniotic fluid inside the uterus

Not all breech positions are the same

There are three main types of breech presentation:

Frank breech is when the baby's bottom is at the top of the birth canal and the legs are straight up in front of the body. The feet are near the head.
Complete breech is when the bottom is down with the legs crossed at the knees and the feet near the bottom.
Footling breech (also called incomplete breech) is when the bottom is down with one or both feet pointing down.

Breech position affects delivery

Some breech babies are born vaginally, but it depends on circumstances and on what your healthcare provider recommends. Vaginal delivery is more likely with frank breech position, depending on what the baby weighs and on the doctor or midwife's recommendation. It can be almost impossible to vaginally deliver a baby in the footling or complete breech position. Also, if you go into preterm labor, your provider may recommend a cesarean delivery.

Correcting breech position before birth

Sometimes your provider can change the baby's position using a technique called external version. This means manually turning the baby into the proper position. The provider will place his or her hands at certain points on your abdomen and then gently try to push the baby into position. Sometimes medication is given first so that the mother's uterus relaxes.

Several ultrasounds are usually done first so the doctor can see the position of the baby. The baby's heartbeat will be monitored carefully so that if problems arise, the procedure can be stopped immediately. Most of the time this technique works, but sometimes the baby will shift back into the breech position.

Stay flexible about the birth

If you know your baby is in breech position, it would be great to know whether you will have a vaginal or cesarean delivery in advance. But this isn't always possible until you go into labor. If you do try a vaginal delivery, electronic fetal monitoring will be used so that if there are signs the baby is in trouble, provider may recommend a cesarean. Sometimes a cesarean is safer for the delivery of a breech baby.

Date last reviewed: October 2002.

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