As you near the final weeks of your pregnancy, your provider will closely examine your baby’s position in the womb. And believe it or not, there are a lot of different ways your baby can be positioned in such a small space! Here’s your guide to the different positions, or fetal presentations, your baby might be in before birth.
Why Does My Baby’s Position Matter?
Vaginal births can become complicated quickly—and the odds of complication are much higher if your little one isn’t in an ideal position, or presentation, for delivery. For instance, if your baby is head-down when you go into labor, there are less risks than if baby is turned upside down or sideways. In cases where baby isn’t in a favorable position, risks of a vaginal delivery include:
- Head entrapment, where baby’s head becomes stuck in the uterus
- Umbilical cord compression, which affects baby’s oxygen levels
- The umbilical cord slipping around baby’s neck or arms during delivery
Most babies settle into their final position somewhere between 32 to 36 weeks gestation.
Head Down, Facing Down (Cephalic Presentation)
This is the most common position for babies in-utero. In the cephalic presentation, the baby is head down, chin tucked to chest, facing their mother’s back. This position typically allows for the smoothest delivery, as baby’s head can easily move down the birth canal and under the pubic bone during childbirth. While that’s not to say there can’t be complications, this is the ideal position for your baby to be in when it’s time to enter the world.
Head Down, Facing Up (Cephalic, Occiput Posterior Presentation)
In this position, baby is still head down towards the cervix, but is facing its mama’s front side. This position is also known as “sunny side up,” and is associated with uncomfortable back labor and a longer delivery. While not as ideal as a cephalic presentation, it’s very likely that you can still deliver your baby vaginally in this position.
While some babies turn to face backwards on their own during the labor and delivery process, some might need some assistance. If the second stage of labor is taking too long and baby’s vital signs aren’t ideal, your provider may use their hand to help baby rotate in the birth canal (also known as manual rotation).
Breech Presentations
Breech presentation happens when your little one’s feet or buttocks are in position to be delivered first, and make up just under 5 percent of all pregnancies. Your provider will likely order an ultrasound toward the end of your pregnancy if they suspect your baby is in a breech position. Breech positions come with a higher likelihood of a C-section delivery in order to protect both you and your little one during childbirth. There are several different types of breech presentation:
Head Up, Legs Up (Frank Breech Presentation)
This presentation occurs when your baby’s head is up near your ribs, and both feet are up by their head (like they’re bent perfectly in half). Baby’s buttocks points down towards the cervix.
Head up, Legs down (Complete Breech Presentation)
In a complete breech presentation, both hips are flexed, and both knees are bent. Baby’s head is near their mama’s ribs, with their feet or knees below their buttocks.
Head up, one leg up and one leg down (Incomplete or Footling Breech Presentation)
In this position, one or both feet or knees are below baby’s buttocks. One of baby’s feet points towards the cervix and is in position be delivered first.
Lying Sideways (Transverse Lie)
When baby is positioned horizontally—or side to side—across the uterus, it’s known as a transverse lie. While your baby will likely have been sideways at some point in your pregnancy, it’s uncommon to remain this way by the time your labor starts. Most babies in transverse lie are delivered via C-section, to avoid their shoulder entering the pelvis first.
Your provider will keep close tabs on your little one as they near their due date, and discuss all of your options with you. In some cases, your provider may be able to perform an external cephalic version (ECV), a non-invasive way to turn your baby to a more favorable position. No matter which position your baby is in—and what method you’ll use to deliver them—rest assured you and your little one are in good hands!