Right before birth, most babies are in a headfirst position in the mother’s uterus. Sometimes, the baby is in a bottom-first (or feet-first) position. This is called a breech birth or breech baby. Babies can be breech early in pregnancy. Most of them turn on their own to be headfirst by the time of delivery. As you get closer to your due date, your doctor will be able to tell if your baby is breech. They can check by a physical exam, ultrasound, or both.
Babies are more likely to be breech if:
- They are early, or premature.
- They are part of a multiple birth (two or more babies).
- There is an abnormal level of amniotic fluid.
- The mother has an abnormal shaped uterus.
Path to improved health
It’s important to see your doctor regularly throughout your pregnancy. Your doctor can tell if your baby is breech and help plan what to do. There are several ways to try and turn your baby. Your doctor may suggest methods to help turn the baby naturally. These could be the first attempt if it is still early and there are no health problems or concerns. Another option is to do a procedure called external cephalic version. Or your doctor may want to schedule a cesarean delivery (C-section).
External cephalic version (ECV)
ECV is one way to turn a baby from breech position to head down position while it’s still in the uterus. It involves the doctor applying pressure to your stomach to turn the baby from the outside. Sometimes, they use ultrasound as well.
Many women who have normal pregnancies can have ECV. You should not have ECV if you have:
- Vaginal bleeding.
- A placenta that is near or covering the opening of the uterus.
- A low level of fluid in the sac that surrounds and protects the baby.
- An abnormal fetal heart
- Premature rupture of the membranes.
- Twins or other multiples pregnancy.
ECV usually is done in a hospital toward the end of pregnancy, around 37 weeks. Before the procedure, the doctor will do an ultrasound to confirm that your baby is breech. They also will monitor your baby’s heart rate to make sure it is normal. The doctor may give you medicine to relax the muscles in your uterus. This can help decrease discomfort and increase the success of turning your baby. The medicine may be given as a shot or through a vein (IV). It is very safe, with no risk to your baby.
During the ECV, you will lie down and the doctor will place his or her hands on your stomach. After locating the baby’s head, the doctor will gently try to turn the baby to the headfirst position.
After the procedure, your doctor will monitor your baby’s heart rate again. If the procedure is successful, you shouldn’t have to stay in the hospital. Your chance of having a normal vaginal delivery is high. However, there is a chance that the baby can turn back around to the breech position. The success rate of ECV depends on several factors:
- How close you are to your due date.
- How much fluid is around your baby.
- How many pregnancies you have had.
- How much your baby weighs.
- How the placenta is positioned.
- How your baby is positioned.
If the procedure is not successful, your doctor will talk to you about delivery. He or she will discuss the pros and cons of having a vaginal delivery or a C- section. The doctor may suggest repeating the ECV.
The risks of ECV are small, but include:
- Early onset labor.
- Premature rupture of the membranes.
- Minor blood loss for either the baby or the mother.
- Fetal distress leading to an emergency C-section.
Some people look to natural ways to try and turn their baby. These methods include exercise positions, certain stimulants, and alternative medicine. They may help but there is no scientific evidence that they work.
- Breech tilt, or pelvic tilt: Lie on the floor with your legs bent and your feet flat on the ground. Raise your hips and pelvis into a bridge position. Stay in the tilt for about 10 to 20 minutes. You can do this exercise three times a day. It may help to do it at a time when your baby is actively moving in your uterus.
- Inversion: There are a few moves you can do that use gravity to turn the baby. They help relax your pelvic muscles and uterus. One option is to rest in the child’s pose for 10 to 15 minutes. A second option is to gently rock back and forth on your hands and knees. You also can make circles with your pelvis to promote activity.
- Music: Certain sounds may appeal to your baby. Place headphones or a speaker at the bottom of your uterus to encourage them to turn.
- Temperature: Like music, your baby may respond to temperature. Try placing something cold at the top of your stomach where your baby’s head is. Then, place something warm (not hot) at the bottom of your stomach.
- Webster technique: This is a chiropractic approach. It is meant to align your pelvis and hips, and relax your uterus. The goal is to promote your baby to turn.
- Acupuncture: This is a form of Chinese medicine. It involves placing needles at pressure points to balance your body’s energy. It can help relax your uterus and stimulate your baby’s movement.
Things to consider
It is not always possible to turn your baby from being breech. Some breech babies can be safely delivered through the vagina, but usually doctors deliver them by C-section. Risks involved with a C-section include bleeding and infection. There also can be a longer hospital stay for both the mother and her baby.
Other risks can occur for breech babies who are born vaginally. These include:
- An injury during or after delivery.
- An injury where the baby’s hip socket and thigh bone become separated.
- Problems with the umbilical cord. For example, the umbilical cord can be flattened during delivery. This can cause nerve and brain damage due to a lack of oxygen.
Questions to ask your doctor
- How can I tell if my baby is breech?
- If my baby is breech, does it mean there is something wrong with them?
- What are the benefits and risks of ECV?
- 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?
Copyright © American Academy of Family Physicians
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.