Patient education: Breech pregnancy (The Basics)

What is a breech pregnancy? — 

"Breech" describes the position of a baby in the uterus. Before birth, babies lie in the uterus in different positions. They can lie with their head, shoulders, legs, or buttocks closest to the vagina. It is called "breech" when a baby's feet or buttocks are closest to the vagina (figure 1).

Early in pregnancy, it is common for babies to be in a breech position. Toward the end of pregnancy, most babies lie with their head closest to the vagina (figure 2). This is called "vertex presentation." The head-down position is the safest position for a baby to be in for a vaginal delivery. But in some cases, the baby is still in the breech position toward the end of pregnancy.

What causes a breech pregnancy? — 

Most happen by chance. But some happen because of a problem with the baby, the uterus or placenta, or the amount of amniotic fluid around the baby.

Does a breech pregnancy cause symptoms? — 

Sometimes. You might feel discomfort under your rib cage, where the baby's head presses. You might also feel your baby kicking in your lower belly.

How will my doctor or midwife know if I have a breech pregnancy? — 

They will do an exam to check your baby's position. This involves pressing on your belly to feel the position of your baby's head. In the last 3 months of pregnancy, your doctor, nurse, or midwife will check your baby's position at each visit.

You might also have an ultrasound to check your baby's position. An ultrasound uses sound waves to create pictures of your baby in your uterus.

What happens if my baby is breech? — 

Most breech babies turn head-down (by themselves) before labor.

If your baby is still in a breech position near your due date, your doctor or midwife might recommend trying to turn your baby around to a head-down position. To do this, they will press on your belly and try to move your baby while watching with ultrasound. This is called "external cephalic version." If this works, and your baby moves to a head-down position, you can wait to go into labor and try to have a vaginal delivery. If it doesn't work and your baby stays in the breech position, your doctor or midwife will likely recommend you have a cesarean birth (also called a "c-section"). This means surgery to get the baby out (figure 3).

In some cases, babies who are breech are delivered vaginally. This is called a vaginal breech delivery. But during this type of delivery, problems involving the baby or mother are more likely to happen. Because of this, vaginal breech deliveries are not usually done.

What if I am having twins? — 

Your doctor or midwife will check the position of each twin. If the first twin (the baby closer to your cervix) is in a breech position, your doctor or midwife will probably recommend a cesarean birth. If the first twin is head-down and the second twin is breech, your doctor or midwife will discuss your choices with you.

More on this topic

Patient education: Labor and childbirth (The Basics)
Patient education: External cephalic version (The Basics)
Patient education: Cesarean birth (The Basics)
Patient education: Vaginal birth after a cesarean (The Basics)
Patient education: Having twins (The Basics)
Patient education: Prenatal ultrasound (The Basics)

Patient education: C-section (cesarean birth) (Beyond the Basics)