Baby Positions In The Womb And What Each Of Them Mean
You’ve heard your doctor throw around terms such as “cephalic” and “occiput posterior” when describing your baby’s position, but what do they mean? Here’s your complete guide…
Most mamas-to-be know that the ideal position for their baby to assume in the womb before birth is head-down. But obstetricians and midwives often use technical terms to describe different fetal presentations that can be hard to understand.
Here’s your complete guide to baby positions in the womb and what they’ll mean for your labor and delivery.
Different baby positions during pregnancy
Your baby moves around during pregnancy and most likely end up in many different positions. The position of your baby in the third trimester as your due date approaches is the most important, and the best position will be head-down (cephalic). This is the one that’s least likely to lead to complications during the birthing process. Here are the 6 baby positions we will explore:
- Cephalic – Occiput Anterior
- Cephalic – Occiput Posterior
- Frank Breech
- Complete Breech
- Footling Breech
- Transverse Lie
Cephalic – occiput anterior
Cephalic position is ideal for childbirth. A cephalic presentation means that your baby is head-down (also known as head-first). Occiput anterior means that the back of your baby’s head (occiput) is at the front (anterior).
In other words, your baby is head-down and facing your back with its chin tucked into its chest. This position makes your baby’s head press against your cervix and helps it to open.
Cephalic – occiput posterior
In the occiput posterior position (also known as back-to-back), your baby is head-down and facing your belly. This can lead to a longer and more intense labor because your baby isn’t able to easily tuck its chin in to get through your pelvis.
If the second stage of labor isn’t progressing, your healthcare provider might use their hands to try to turn your baby, or they may use a ventouse (suction device) or forceps (large tongs) to help it out. The rate of cesarean births is higher for babies who are in the occiput posterior position.
A breech presentation means that your baby is positioned with its buttocks leading the way into the birth canal. The most common type of breech presentation is the frank breech where the baby’s hips are flexed and its knees are extended with its feet close to its head. Most babies turn into the head-down position in the last few weeks before birth, but 3 to 4 percent of full-term births are breech.
When you’re close to your due date or at term, your healthcare provider might attempt to turn your baby around by placing pressure on your abdomen with their hands in a procedure known as an external cephalic version (ECV). This can only be attempted if the placenta is in the right place and you don’t have any pregnancy complications. There’s a risk of preterm labor or changes in your baby’s heart rate with an ECV, in which case a C-section might be necessary.
If an ECV isn’t possible or doesn’t work, most obstetricians will suggest a planned cesarean. But vaginal deliveries are possible in many low-risk cases of breech presentation, and some obstetricians are more experienced than others in vaginal breech deliveries. Talk to your healthcare provider about your options if a vaginal delivery is important to you, or shop around for a new one if you feel that you’re not on the same page.
In a complete breech presentation, both your baby’s hips and knees are flexed so that it appears to be sitting upright with its knees against its chest. As with a frank breech, an ECV might be attempted if your baby doesn’t turn on its own and the conditions are right. If your baby remains breech, you’ll need to discuss the risks of a vaginal versus a cesarean delivery with your doctor or midwife.
In this position, one or both of your baby’s feet are pointing down toward the birth canal and will be delivered first. The considerations are the same as with the other two breech birth positions when it comes to attempting an ECV and deciding on your method of delivery.
If your baby is in a transverse lie, it’s lying horizontally across your uterus. It might have its back to your birth canal, its hands and feet pointing toward your birth canal, or one shoulder pointing toward it. An ECV might be attempted, but a C-section is recommended if your baby is still in this position when labor starts.
Methods to try to turn a breech baby
Although an ECV is the most common medical procedure to try to turn a baby, there are several natural baby turning techniques for women who would like to get their baby into the head-down position before birth. While these methods haven’t been scientifically proven to work, they’re not harmful to your baby and can be worth a try.
Breech tilt method: The Breech Tilt position is used to help create the best angle in the pelvis to allow the baby to slip. It is thought that spending time in this position may also help baby tuck its chin as its head presses down on the uterus. Try the following technique up to 3 times a day for 20 minutes each time.
See more on this technique at Spinning Babies.
- Use a broad plank of wood, or an ironing board and prop it at an angle against the couch or a chair. Stuff a few large pillows around the base to help prevent it from tipping.
- With assistance, carefully lie on the board with your head down and feet resting on either side of the board on the couch. Use a pillow to support your neck.
Forward-leaning inversion method: According to Spinning Babies;
“This position potentially makes room for a good fetal position by untwisting any ligaments to the lower uterus and cervix that may be twisted from sudden stops or a habit of a twisted posture. Kneeling afterward allows temporarily lengthened ligaments to align the uterus with the pelvis. The cervix may become less tipped or tight and then able to let baby’s head to position well, and the cervix to dilate in labor more easily.”
Try this technique once a day for 30 seconds each time if you’re trying to turn a breech baby naturally:
- Carefully kneel on the edge of a couch or bed.
- Hold the edge of the couch or bed. Extend your hands one at a time, and slowly lower yourself to your hands on the floor.
- Then lower yourself more, to gently rest on your forearms. Your elbows should be out with your hands close.
- Let your head hang freely. Tuck your chin to protect your neck — do not rest your head on the floor. Your neck may need a little movement.
- Your knees should be close to the edge, with your bottom in the air. You can tilt or sway your hips if you like, or gently, slowly undulate your spine.
- You can flatten your lower back to give more room for the top of your pelvis.
- Take 3 breaths. Belly loose, shoulders strong. Chin tucked and neck long.
- Come back up on your hands, then lift yourself up to a high kneeling position again (see picture), using a stool, block or help from your helper. Take two breaths here. Then sit on your heels.
- Swing your feet out from under you together. Feet together, moving like a mermaid to prevent a pull on your symphysis pubis (pubic bone). You will protect your pelvic stability this way.
The Webster technique method: This technique is a chiropractic adjustment that reduces stress on your pelvis and relaxes your uterus, which may make it easier for your baby to turn. Some believe that placing headphones on the lower part of your abdomen and playing music can encourage your baby to turn its head toward the sound.
Finally, acupuncture and moxibustion (a form of Chinese medicine) have had promising results in turning babies.
A note on birthing twins
The American College of Obstetricians and Gynecologists (ACOG) now recommends that a vaginal birth be attempted in low-risk twin pregnancies where the first twin is in a head-down position. Once the first twin has been delivered, your obstetrician may try to rotate the second twin with an ECV or deliver it in breech position if it’s safe to do so. If a vaginal delivery isn’t safe, a C-section will be performed to deliver the second twin.
In cases where the first twin or both twins are breech, most obstetricians will recommend a cesarean for both. For more information on birthing twins see our article on Can you have a natural birth with twins.
Finding the right birth provider
There are many skilled midwives and doctors out there who are experienced in delivering babies who aren’t in the perfect position. If your pregnancy is otherwise low-risk and you’d like to attempt a vaginal delivery, interview several healthcare providers until you find one you trust and who supports your wishes. For more information, see our Guide to choosing your hospital or birthing center.
Interviews, stories, and guides on thetot.com contain information that is general in nature and should not replace professional medical advice, diagnosis or treatment. If you have a medical condition or concern or plan on trying a new diet, supplement or workout, it’s best to first consult with your physician or a qualified health professional.
- Do you prefer to give birth in a hospital, in a birthing center or at home? Will a doctor or a midwife deliver your baby? See our article on Birth choices: your guide to pregnancy and childbirth care.
- Love the idea of having a natural birth in the comfort of your own home? Here are some factors to consider before taking the leap. See our article on 7 questions to ask yourself before planning a home birth.