Your Baby's Position in the Womb

Clinically reviewed by Cindy Richardson, CMPE.

Until the last month of pregnancy, a fetus’ position is relatively unimportant. A baby typically has plenty of room to move around in the womb for the first 7-8 months. 

In the last month, they’re big enough that movement is more difficult. And the baby’s position in the womb as a pregnancy approaches full term is important since their orientation can make delivery easier or more difficult.

Primary Positions for Babies in the Womb During Delivery

In the weeks leading up to their birth, babies typically assume one of four positions.  

Occiput Anterior

This is the best position for a baby to be in before delivery. Their head is down, and their occiput (the back of their head) is toward the front (anterior) of your body. Some people describe it as having their head down and facing your back. This position can be subdivided into left occiput anterior and right occiput anterior, depending on which side of the womb the baby is on. 

Occiput Posterior

This position is when the baby is head down and facing the front. In many cases, they’ll rotate to face the back on their own before delivery. If they don’t, the occiput posterior position increases the likelihood of prolonged labor and significant back pain. 

In some cases, an epidural might be needed to reduce the pain. 

Breech

The breech position is when the baby’s head is up. There are three types of breech positions:

• Complete breech. The baby’s buttocks are pointed toward the birth canal with its legs bent and feet near the buttocks. 
• Frank breech. The baby’s buttocks are down, and their feet are up near their chest.
• Footling breech. One or both feet are pointed downward toward the birth canal. 

Most breech babies are born without complications, but problems can occur since the head is the last part to emerge. This increases the risk of trauma and congenital disabilities. The breech position also increases the risk of a loop forming in the umbilical cord and harming the baby. 

Your doctor may attempt to change your breech baby’s position in the final weeks of pregnancy. They do this using a procedure called external cephalic version (ECV), in which they apply external pressure to your abdomen. It’s successful roughly half of the time. 

The procedure can be uncomfortable for you but isn’t dangerous for you or your baby. Still, your care team monitors the baby’s heartbeat and will stop the process if there are any signs of stress. 

If ECV isn’t successful, your doctor may recommend a cesarean delivery (or C-section) to protect your baby. That’s especially true if they’re in the footling breech position. The risk in that orientation is that the umbilical cord will get compressed during delivery and not supply enough blood and oxygen to the baby. 

Transverse Lie

This is a very rare position where the baby lies horizontally in the uterus. Most babies shift to a head-down position before birth. If yours doesn’t, your doctor will perform a C-section. That’s safest since there’s a small risk of what’s called umbilical cord prolapse. It’s a medical emergency in which the cord emerges before the baby.  

When Should a Baby Be Head Down?

Most babies assume the position they’ll be in for delivery at around 36 weeks. Before that, they may switch orientations occasionally or frequently. If your baby isn’t in the occiput anterior as labor starts, it’s safest for them if you give birth at the hospital. 

How to Tell if Your Baby Is Head Down

Your doctor can explain what to expect in your baby’s position in the womb from week to week and tell you specifically if your baby is head down during your appointments. You can also do what’s called belly mapping. 

Using a non-toxic, washable marker, you draw on your belly to indicate where your baby’s head, buttocks, and legs are. It’s helpful to do this right after an ultrasound when the technician can show you where your baby’s heartbeat is occurring. You can then feel around for your baby’s head and buttocks and note where you sense them kicking to zero in on their legs. Many mothers enjoy the “detective work” of belly mapping. 

How to Help Your Baby Assume the Best Birth Position

There are actions you can take to make it easier for your baby to get into the best position for delivery, including:

• Sit on a birth ball or exercise ball at times throughout your day.
• If you sit a lot at work, take regular breaks to stand, stretch, and walk. 
• Tilt your pelvis forward (rather than backward) when sitting. 
• Get on the floor on your hands and knees for a few minutes at a time a couple of times daily.
• Use a cushion on your car seat to lift your buttocks and keep your pelvis tilted forward.
• Keep your hips higher than your knees when sitting.

As for the best sleeping position to keep your baby’s head down, doctors recommend lying on your left side with a pillow between your legs. 

Get World-Class Mother and Baby Care from Baptist Health

While it’s essential to understand how your baby’s position in the womb affects the birth process, it isn’t something you should worry about. Babies frequently turn just before delivery, and if they don’t, your doctor can take action to address the situation. 

Learn about Baptist Health’s mother and baby care services today.