What Is a Breech Position?

A breech baby happens when the baby is positioned in the birth canal with feet down (or bottom-down). This position is perfectly safe for the baby to be in inside the birth canal, until it is time for delivery. Typically, by 36 weeks, most babies move into a head-down position for delivery. This is known as a vertex presentation.

If, however, the baby remains in a breech position, it can sometimes make for a more difficult or complicated delivery. If the doctor determines the risk is too great to have a vaginal delivery, oftentimes, a C-section will be performed.

Types of Breech Baby Positions

There are 3 primary types of breech positions for babies. They include:

• Frank breech. This is when the baby’s buttocks is positioned lowest in the birth canal. In this position, the knees are extended toward the abdomen and hips are flexed (legs are straight up in front of the body, with feet near the head). This is the most common breech position.
• Complete breech. In this position, the baby’s knees and hips are flexed, and folded under each other. 
• Footling breech. This happens sometimes when one or both feet of the baby are pointed down toward the birth canal.

What Is a Kneeling Breech and How Common is it?

A kneeling breech is when the baby’s knees are folded underneath its legs, while the latter are extended at the hips (making it different from a complete breech). The baby appears to be kneeling in the uterus. In this type of breech birth, the knees are the first part of the baby to appear. It is one of the rarest birth presentations and typically requires a cesarean or C-section delivery.

How Common is a Breech Baby?

Only three to four percent of all full-term pregnancies are breech births (meaning delivery during the 39th or 40th week of a pregnancy). The percentage runs higher in babies born earlier than full term.

Symptoms of a Breech Baby at 36 Weeks

There are not usually symptoms associated with a breech baby. However, if you are 36 weeks pregnant and notice the baby’s head is pressing higher up in your abdomen or feel kicking in your lower abdomen, you may want to consult your doctor at your next appointment.

Diagnosis of Breech Position

To determine whether your baby is breech, a routine exam later in the pregnancy will help to assess this. During the exam, your doctor will feel the lower and upper abdomen to determine if the baby is breech, and may use an ultrasound or perform a pelvic exam to check the baby's position.

Remember that the breech position (baby’s head up and feet down) is common up to the 36th week of pregnancy. Your physician won’t make a formal diagnosis of a potential breech birth until your pregnancy’s 37th week.

Risks and Complications of Breech Positioning

Vaginal delivery of a baby in a breech position can be dangerous and difficult. The medical risks include:

• Getting stuck: A baby can get wedged against the bones of the pelvis, unable to move.
• Broken or dislocated bones: The unusual path taken by a breech baby during delivery can stress the infant’s unsupported limbs. Broken or dislocated bones are sometimes the result.
• Umbilical cord prolapse: This occurs when the umbilical cord is squeezed flat or wraps around the baby during delivery, reducing or cutting off the oxygen supply to the brain.

Cesarean or C-sections are a lower-risk alternative to vaginal breech deliveries.

Common Causes of Breech Positioning

Most of the time, doctors don’t know the exact cause of having a breech baby. However, there are conditions that correlate with a greater likelihood of a breech birth. These conditions include:

• Previous pregnancies
• A history of one or more premature births
• Being pregnant with twins, triplets, or more
• Variations in amniotic fluid levels, which can alter the environment for movement
• Structural differences in the uterus, such as fibroids, which can impact fetal positioning
• Potential obstructions to the baby’s movement, such as placenta previa
• Delivery at a premature gestational age, before vertex presentation
• Any fetal conditions that hinder normal adjustments in positioning

Treatment and Techniques for Turning a Breech Baby

There are no scientific studies to support the following suggestions, but sitting on a birthing ball or assuming a child pose, as practiced in yoga, may help a baby change position. Walking daily may also help, if approved by your doctor.

A more scientific approach is called external cephalic version (ECV). This procedure is performed in a healthcare facility on an outpatient basis. Your obstetrician or a similarly trained healthcare provider will apply external pressure to your belly in a sustained effort to turn the baby from a breech to a vertex position. This procedure can last as long as two hours. Your baby’s heart rate will be monitored throughout, and ultrasounds are performed to track fetal progress. ECV is most commonly performed at 37 weeks and is successful in changing the birthing position about 50 percent of the time.

Delivery Options for Breech Babies

Breech deliveries require the mother to have a cesarean section in order to deliver the baby safely. Want to know more about cesarean section deliveries? Attend a cesarean section class at Baptist Health. Select a location on our Patient Education Classes page to view classes at each of our hospitals.

Why Choose Baptist Health for Breech Birth Support

To many of us, there is nothing more important than the healthy delivery of a baby. That’s why there is nothing more important to us at Baptist Health than delivering safe and supportive healthcare in every patient setting. If you’re pregnant and have questions, we have resources and answers. We’re here for you and for the baby that you’re about to bring into the world.

FAQ

Do breech babies have problems later in life?

Most children born as breech babies are healthy, but some experience long-term medical conditions, including improperly developed hip joints or shoulder and neck weakness. More serious conditions, such as brain or spinal damage, can result from cases of umbilical cord prolapse.

Do you have to have a C-section if the baby is breech?

Technically no, but C-sections are the medically preferred option for delivering a breech birth. The medical risks associated with a vaginal delivery are much higher, especially for the baby.

Can you still dilate with a breech baby?

Yes, dilation can occur when a baby is in breech position (feet first rather than headfirst). However, dilation is less effective and labor is more prolonged because the pressure applied by the feet is less than that applied by the head, delaying anatomical changes that are necessary for facilitating birth.

Is a breech baby considered high risk?

If properly delivered, no. However, there are certain risks associated with breech births, especially if delivered vaginally. The feet-first positioning of a breech baby makes it more prone to injury during the birthing process.