Breech Presentation: Causes & Signs of Breech Birth Position

Your baby is head-up instead of head-down. Should you be worried?

As your due date gets closer, you might hear your doctor mention something called a breech presentation. Naturally, questions follow. Why hasn't the baby turned? Can you tell from the way your baby moves? And does this mean you'll need a C-section?

First, take a breath. Babies change positions throughout pregnancy and many who are breech earlier on turn head-down before birth.

But if your baby remains breech towards the end of pregnancy, it's worth understanding what that means, why it happens and what your options are.

Let's start with the basics.

What Is a Breech Presentation?

Towards the end of pregnancy, most babies settle into a head-down position, ready for birth. This is called a cephalic presentation.

In a breech presentation, the baby's buttocks or feet are positioned to come out first instead of the head.

Breech presentation is fairly common earlier in pregnancy. By the time a pregnancy reaches full term, however, only around 3–4% of babies remain breech.

There are different types of breech positions:

Frank breech: The baby's bottom is down, with the legs extended upwards and the feet near the head.

Complete breech: The baby is positioned bottom-first, with the hips and knees bent.

Footling breech: One or both feet are positioned below the baby's bottom, closer to the birth canal.

These positions matter because they can influence the options your doctor discusses for delivery.

What Causes a Baby to Be in the Breech Position?

Here's something important to understand: a breech position doesn't necessarily mean anything is wrong with your pregnancy.

Sometimes, there's no identifiable reason. Your baby may simply remain in that position as the pregnancy progresses.

However, certain factors can make a breech presentation more likely:

1. Too much or too little amniotic fluid

The fluid surrounding your baby allows them to move inside the uterus. When the amount is unusually high or low, it can affect how easily the baby changes position.

2. Multiple pregnancy

If you're expecting twins or more, there may be less room for each baby to move into a head-down position.

3. The position or shape of the uterus

Conditions such as uterine fibroids or certain differences in the shape of the uterus may affect the space available for your baby to turn.

4. A low-lying placenta

If the placenta lies close to or covers the opening of the uterus, it may affect the baby's position and can also influence delivery planning.

5. Premature birth

Babies born before term are more likely to be breech because they may not yet have turned into the head-down position.

Even with these factors, many breech babies are otherwise healthy. And sometimes, there is simply no clear explanation for why a baby hasn't turned.

What Are the Signs of a Breech Baby?

This is where things can get a little confusing.

You might notice that your baby's movements feel different or you may feel kicks in an area where you didn't expect them. Some women notice pressure or a firm, rounded shape higher up in the abdomen.

However, there is no reliable set of symptoms that can tell you whether your baby is breech.

Feeling kicks near your ribs, for example, doesn't confirm the baby's position. Babies move, stretch and change their posture, so guessing based on movement alone can be misleading.

Your doctor may suspect a breech presentation by gently examining your abdomen to feel where the baby's head and bottom are positioned. An ultrasound scan can then confirm the baby's position.

This is one reason your antenatal appointments become particularly important as you approach your due date.

If you're concerned about your baby's position, ask your obstetrician rather than trying to work it out from movements alone.

What Happens If Your Baby Is Still Breech at 36 Weeks?

First, it doesn't automatically mean you need to panic or that a C-section is your only option.

If your baby remains breech around 36 weeks, your obstetrician will discuss the available options based on your pregnancy and medical history.

One option may be External Cephalic Version (ECV). This is a procedure in which a trained healthcare professional uses their hands to apply controlled pressure to your abdomen to encourage the baby to turn head-down.

ECV is usually considered around 36–37 weeks, depending on your circumstances. It's performed in a setting where your baby can be monitored and emergency care is available if needed. It isn't suitable for every pregnancy, so your doctor will assess whether it's appropriate for you. 

If the baby remains breech, a planned C-section is commonly recommended. A vaginal breech birth may be an option in carefully selected situations, depending on factors such as the baby's position and the experience of the medical team.

The decision should be made after discussing the benefits and risks of each option with your obstetrician.

Can You Prevent a Breech Presentation?

Not really. There is no guaranteed way to prevent your baby from being breech.

You may come across exercises, particular sleeping positions or home techniques that claim to turn a breech baby. 

Evidence supporting many of these approaches is limited and some may not be appropriate for your pregnancy.

Before trying anything intended to turn your baby, speak with your obstetrician. Avoid attempting to push or turn the baby yourself.

The most useful step you can take is to attend your antenatal appointments and discuss your options if your baby remains breech towards the end of pregnancy.

A Final Word

Finding out that your baby is breech can leave you with plenty of questions, especially if you had pictured your delivery happening a particular way.

But the first thing to remember is that a breech presentation is a position, not a diagnosis of a problem with your baby.

If your baby is breech, Dr. Dhwany can help you understand what this means for your pregnancy and discuss the options available for your delivery. Don't hesitate to bring up your concerns at your next appointment. 

Sometimes, knowing what is happening and understanding your choices can make the situation feel much less overwhelming.