Suvarna has just had a visit with her obstetrician. She still has 3 weeks to go before her due date. Her obstetrician has told her that the baby is in breech position. Suvarna is a little concerned. Is being in the breech position harmful for the baby? What kind of delivery will she have?

Usually the baby reaches a stable position in the uterus by 36 – 37 weeks and will not move into a different position after that. By this time in pregnancy, most babies move into a head-down position. In some pregnancies, the baby’s buttocks, feet, or both are in the lowest position in the uterus. This is called breech presentation. Most breech babies are born healthy.

Breech presentation

A full-term pregnancy lasts about 40 weeks from the first day of the last menstrual period. In the first 36 weeks the baby is constantly changing positions- this is what is perceived as movements by the mother. In the last few weeks the baby has less place to move around and therefore will not shift positions so often.

Breech presentation happens in 3–4% of full-term births and requires special planning for how the baby will be born. If the baby is in a breech position, a cesarean delivery might be advised, specially if this is your first baby.

Why breech?

Most of the time there is no specific reason why the baby is in a breech position. It can be more common if the woman has had more than one pregnancy, there are twins or triplets, there is too much or too little fluid around the fetus, the uterus is not normally shaped, if the placenta is in an abnormal position or the baby is preterm. Occasionally, the baby might have a birth defect which prevents it from getting into the normal position.

Confirming breech presentation

Every time a pregnant woman has a physical examination, the obstetrician tries to feel the position of the baby. If a breech presentation is suspected, an ultrasound exam may be used to confirm the position. Sometimes a breech presentation is first found during a pelvic exam when the woman is in labour.

The baby’s position can change until the end of pregnancy. In first pregnancies, the chances of the position changing on its own are less. If this is the second or third pregnancy, the baby will usually get into the normal position spontaneously.