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Breech Baby

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PREVENTION | O U T LO O K / P RO G N O S I S | LIVING WITH | F R E Q U E N T LY A S K E D Q U E S T I O N S

What is a breech baby?

A breech baby, or breech birth, is when your baby’s feet or buttocks

are positioned to come out of your vagina first. Your baby’s head is up
closest to your chest and its bottom is closest to your vagina. Most
babies will naturally move so their head is positioned to come out of
the vagina first during birth. Breech is common in early pregnancy
and most babies will move to a head-first position by 36 weeks of
pregnancy. This head-first position is called vertex presentation and is
the safest position for birth.

How common is a breech baby?

Types of breech positions during pregnancy.
There is a small chance that your baby will not move into a head-first
position before 37 weeks of pregnancy. Breech babies account for about 3% to 4% of all full-term pregnancies.

What are the types of breech position a baby can be in?

There are several fetal positions your baby may present in. Ideally, your baby is positioned head-down, facing your back, with
their chin tucked to their chest.

Breech babies can be in a few different positions:

Frank breech: The baby’s buttocks are aimed at the vaginal canal with its legs sticking straight up in front of their body
and the feet near their head.
Complete breech: The baby’s buttocks are pointing downward and both the hips and the knees are flexed (folded under
themselves).
Footling breech: One or both of the baby’s feet point downward and will deliver before the rest of their body.
Transverse lie: This is a form of breech presentation where your baby is positioned horizontally across your uterus
instead of vertically. This would make their shoulder enter the vagina first.

How does a breech baby affect pregnancy?

Your pregnancy is usually not affected. Most breech babies are born healthy, although there is a slightly elevated risk for
certain birth defects. Your baby’s movements may feel a little different. You will feel your baby’s kicks lower in your belly. You
may feel a hard lump closer to your ribs. This is your baby’s head.

If you planned a vaginal delivery, a breech baby could change these plans. When your baby is breech, a vaginal delivery can be
complicated and dangerous. Your healthcare provider may feel comfortable attempting a vaginal breech delivery, but in most
cases, they will recommend a Cesarean birth (C-section).

How does a breech baby affect delivery?

If your baby presents in a breech position after 36 weeks of pregnancy, your birthing plan will likely change. It's usually unsafe
for a breech baby to be born vaginally due to risks of injury. In most cases, a planned C-section is the safest way to deliver your
baby. Some healthcare providers may be comfortable with a vaginal breech birth. In some cases, turning your baby to a head-
down position while they are still inside your uterus is an option. Your baby is then born head first.

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Symptoms and Causes

How can you tell if your baby is breech?

You may be able to tell if your baby is breech, especially if you have had past pregnancies where your baby was head-first. The
places where you feel lumps and kicks might indicate that your baby is breech. Let your healthcare provider know where you
feel movement. They will feel your belly or do an ultrasound to confirm that your baby is breech.

What causes a baby to be breech?

It’s not always known why a baby is breech. Some factors that may contribute to this position are:

You are expecting multiples (twins or more). This makes it harder for each baby to get into the right position.
There is too much or too little amniotic fluid.
The uterus is not normal in shape or has abnormal growths such as fibroids. Most of the time, the uterus is shaped like an
upside-down pear. If it's shaped differently, there might not be enough room for a full-grown baby to move into position.
The placenta covers all or part of the cervix (a condition called placenta previa).
The baby is preterm. This means they are less than 37 weeks gestation and may not have turned to a head-first position.
Your baby has a birth defect that causes them to not turn head-down.

Diagnosis and Tests

How is a breech baby diagnosed?

Your healthcare provider may be able to tell which way your baby is facing by placing their hands at certain places on your
abdomen. By feeling where the baby’s head, back and buttocks are, it’s usually possible to find out what part of the baby is
positioned to come out of the vagina first. An ultrasound may be used to confirm the baby’s position.

When is a breech baby diagnosed?

Almost all babies are breech at some point. As your pregnancy progresses, your baby will naturally move to a head-down
position — probably between 32 and 36 weeks. Your healthcare provider will feel your belly and determine where your baby
is positioned. This will happen during most of your appointments in the third trimester. After 37 weeks, a breech baby usually
does not turn on their own. Your healthcare provider will discuss delivery options with you.

Management and Treatment

What are the options for treating a breech baby?

If your baby is breech at 37 weeks of pregnancy, your healthcare provider may:

Try turning your baby in your uterus into the head-first position.
Plan a C-section birth.
Plan a vaginal breech birth.

What are some complications of having a breech baby?

The complications of having a breech baby usually do not occur until it's time to deliver. Some breech babies can be safely
delivered through the vagina.
The risks of attempting a vaginal breech birth are:

Injuries to your baby’s legs or arms such as dislocated or broken bones.

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Umbilical cord problems. The umbilical cord can be flattened or twisted during delivery. This can cause nerve or brain
damage due to a lack of oxygen.

Will my doctor try to flip my baby if it's breech?

If your baby is breech, your healthcare provider may consider turning your baby so that you can have a vaginal delivery. In
some cases, trying to turn your baby may not be safe or the risks outweigh the benefits.

Flipping your baby may not be safe if you have any of the following:

Bleeding from your vagina.

Placenta previa. This is when your placenta covers all or part of your cervix.
A nonreactive nonstress test.
An abnormally small baby.
Low level of amniotic fluid.
Low or high fetal heart rate.
Premature rupture of the membranes.
Twins or multiples.

The most common method used to turn a breech baby is called external cephalic version (ECV). It's performed by your
healthcare provider around 37 weeks of pregnancy. This procedure is performed in the hospital just in case an emergency
occurs. It involves placing hands on your abdomen and applying firm pressure to turn your baby to a head-down position while
your baby is still in your uterus. It is about 65% effective and carries some risks.

What are the risks of turning my breech baby?

The risks of ECV include the following:

Premature labor.
Premature rupture of the amniotic sac.
Blood loss for either you or your baby.
Emergency C-section.
Your baby might turn back to the breech position.

Although the risk of having these complications is small, some healthcare providers prefer not to try to flip a breech baby.

Will my breech baby flip on their own?

Most babies will flip to a head-down position before they reach full term (37 weeks). If your baby is still in a breech position at
this time, your healthcare provider will determine if you can deliver vaginally or if you will need a C-section.

How can I flip my baby if it's breech?

Some women will try at-home methods to flip their baby to a head-first position. They may help, but there is no scientific
evidence that they work.

Bridge position: Lie on the floor with your legs bent and your feet flat on the ground. Raise your hips and pelvis into a
bridge position. Hold this position for 10 or 15 minutes several times a day.
Child’s pose: Rest in the child’s pose for 10 to 15 minutes. It can help relax your pelvic muscles and uterus. You can also
rock back and forth on your hands and knees or make circles with your pelvis to promote activity.
Music: Place headphones or a speaker at the bottom of your uterus to encourage your baby to turn.
Temperature: Try placing something cold at the top of your stomach where your baby’s head is. Then, place something
warm at the bottom of your stomach.
A chiropractic technique, called the Webster technique, can also help your uterus relax. Some providers even recommend
acupuncture. Both of these techniques need to be done by a professional that your healthcare provider has recommended.

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Prevention

How can I reduce my risk of having a breech baby?

There is nothing you can do to prevent your baby from being in a breech position. If your baby is in a breech position, it’s not
because you did anything wrong.

Outlook / Prognosis

Can you deliver vaginally with a baby breech?

It's possible to deliver a breech baby vaginally. It can be more dangerous for the baby and the risk of injury is much higher. If
the umbilical cord is compressed during birth, the baby could be deprived of oxygen and this could harm their brain and
nerves. The cord could also slip around the baby’s neck or arms, causing injury. Healthcare providers have various levels of
comfort with vaginal deliveries of breech babies. Talk to your provider about the risks and benefits of different types of birth
for a breech baby.

Living With

When should I see my healthcare provider?

Contact your healthcare provider if you experience any of the following symptoms during pregnancy:

Severe cramping or contractions.

Vaginal bleeding.

What questions should I ask my doctor?

Learning your baby is breech may give you concerns about your delivery. It’s completely natural to have questions. Some
questions to ask your doctor can include:

How can I tell if my baby is breech?

Is my baby OK?
What are the benefits and risks of turning my baby?
What are my options for delivery if my baby remains in the breech position?
What are the health risks to my baby and me if they are born breech?

Frequently Asked Questions

Do birth defects cause breech position?

Birth defects are slightly more common in breech babies. It might be the reason that the baby didn’t move to the head-down
position. Most babies who are breech at delivery are born without any health complications.

Will I need a C-section if my baby is breech?

Most of the time, a C-section is the safest way to deliver a breech baby. Your risks of developing complications are much
higher if you try to deliver a breech baby through the vagina. However, some healthcare providers may feel comfortable
performing a vaginal breech birth.

How does labor start if your baby is breech?

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Having a breech baby doesn’t change some of the first signs of labor like contractions or rupturing of your membranes. In
most cases, your healthcare provider will recommend a planned C-section. If your delivery is planned, you may not have any
labor symptoms.

If you are in labor and go to the hospital for delivery, your provider will confirm your baby’s position a final time. Your provider
could attempt a vaginal delivery, but it's more likely they will proceed with a C-section to be safe.

A note from Cleveland Clinic

Having a breech baby can be unexpected and change the vision you had for childbirth. Talk to your healthcare provider about
what to expect during a breech delivery. They can help you understand the risks and benefits of a breech birth so that you and
your baby are kept safe.

References:

Cohain JS. Turning breech babies after 34 weeks: the if, how, & when of turning breech babies. Midwifery Today Int
Midwife. 2007 Autumn;(83):18-9, 65. PMID: 17927112. Accessed 7/21/2021.
Gabbe SG, et al. Normal labor and delivery. In: Obstetrics: Normal and Problem Pregnancies. 7th ed. Philadelphia, Pa.:
Saunders Elsevier; 2017. Accessed 7/21/2021.
American Pregnancy Association. Breech Births. (https://americanpregnancy.org/healthy-pregnancy/labor-and-birth/breech-p
resentation/) Accessed 7/21/2021.
American Academy of Family Physicians. Breech Babies: What Can I Do If My Baby Is Breech. (https://familydoctor.org/bree
ch-babies-what-can-i-do-if-my-baby-is-breech/) Accessed 7/21/2021.
American College of Obstetricians and Gynecologists. If Your Baby Is Breech. (https://www.acog.org/womens-health/faqs/if-
your-baby-is-breech) Accessed 7/21/2021.
American Family Physician. What Can I Do If My Baby Is Breech. (https://www.aafp.org/afp/1998/0901/p744.html)
Accessed 7/21/2021.
American Family Physician. External Cephalic Version. (https://www.aafp.org/afp/1998/0901/p731.html) Accessed
7/21/2021.
Lee HC, El-Sayed YY, Gould JB. Population trends in cesarean delivery for breech presentation in the United States,
1997-2003. Am J Obstet Gynecol. 2008;199(1):59.e1-59.e598. doi:10.1016/j.ajog.2007.11.059. Accessed 7/21/2021.

Terms Linked In This Article:

fetal positions (https://my.clevelandclinic.org/health/articles/9677-fetal-positions-for-birth)

Cesarean birth (https://my.clevelandclinic.org/health/treatments/7246-cesarean-birth-c-section)
twins (https://my.clevelandclinic.org/health/articles/9710-expecting-twins-or-triplets)
fibroids (https://my.clevelandclinic.org/health/diseases/9130-uterine-fibroids)
preterm (https://my.clevelandclinic.org/health/diseases/21479-premature-birth)

Last reviewed by a Cleveland Clinic medical professional on 10/07/2021.

O R I G I N A L A RT I C L E | https://my.clevelandclinic.org/health/diseases/21848-breech-baby
DAT E P U B L I S H E D | November 23, 2022
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