The best position for your baby inside your uterus at the time of delivery is head down. This position makes it easier and safer for your baby to pass through the birth canal.
In the last weeks of pregnancy, your health care provider will check to see what position your baby is in.
If your baby’s position does not feel normal, you may need an ultrasound. If the ultrasound shows your baby is breech, your doctor will talk with you about your options for a safe delivery.
In breech position, the baby's bottom is down. There are a few types of breech:
You are more likely to have a breech baby if you:
If your baby is not in a head down position after your 36th week, your doctor can explain your choices and their risks to help you decide what steps to take next.
Your doctor may try to guide the baby into the right position. This is called external version and involves pushing on your belly while watching the baby on an ultrasound. The pushing may cause some discomfort.
You may be given a medication that relaxes the muscles of the uterus.
Success is higher if your doctor tries this procedure at about 37 weeks. At this time, the baby is a little smaller, and there is usually more fluid around the baby. The baby is also old enough in the small chance that there is a problem during the procedure that makes it necessary to deliver the baby promptly. External version can not be done once you are in active labor.
Risks are low for this procedure when a skilled doctor does it. Rarely, it may lead to an emergency C-section if:
It depends, but most babies who remain breech after an attempt at turning them will be delivered by C-section. Your doctor will explain the risk of delivering a breech baby vaginally.
The danger of breech birth is mostly due to the fact that the largest part of a baby is its head. So when the breech baby’s pelvis or hips deliver first, the mom’s pelvis may not be large enough for the head to be delivered also.
Other problems may be:
To try to deliver the baby normally:
Even then, fewer and fewer doctors who deliver babies have much or any experience delivering a breech birth. It is the standard in America to deliver most breeches by C-section, given the decreased risks for the baby.
If a C-section is planned, which is likely for most women carrying a breech baby, it will usually be scheduled for no earlier than 39 weeks. You'll have an ultrasound at the hospital to confirm the position of the baby just before the surgery.
There's also a chance that you'll go into labor or your water will break before your planned C-section. If that happens, call your health care provider right away and head for the hospital. It is important to go in right away if you have a breech baby and your bag of water breaks, because there is a higher chance that the cord will come out even before you are in labor. This can be very dangerous for the baby.
Sometimes the baby will move itself into head-down position. If not, the doctor will try to help move the baby. If the baby cannot be moved, you may need to have surgery to deliver the baby safely.
These positions are abnormal (not normal) and may cause problems:
There are other positions that are abnormal, but less common. The rarer positions are:
In some cases, a vaginal birth may be possible.
Updated by: Susan Storck, MD, FACOG, Chief, Eastside Department of Obstetrics and Gynecology, Group Health Cooperative of Puget Sound, Bellevue, Washington; Clinical Teaching Faculty, Department of Obstetrics and Gynecology, University of Washington School of Medicine. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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