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What is breech presentation during labor?

Jeanne Falk, MD
OBGYN (Obstetrics & Gynecology)
A breech position is any position where the baby is not head down. Head down is obviously our safest preferred presentation for vaginal delivery. Depending on the type of breech and at what gestational age it's diagnosed, it may be possible to discuss a version with your provider. That's where doctors actually physically try to rotate the baby from a nonvertex presentation to being head down. This has its own risks and benefits that you can discuss with your individual provider and see if it's an opportunity that's possible for you. If it's not an opportunity, then that means you're looking at a C-section for delivery for the safety of the baby.
Paula Greer
Midwifery Nursing

Babies somersault throughout the pregnancy and are often in many different positions. The breech position is when the baby's butt or even its feet are coming first.

A breech presentation in labor means the baby has entered the birth canal and not by our preferred presentation of head first. There are many kind of breech presentation from one where the baby is coming totally butt first to one or both legs coming first.

Depending on the size of the baby, the type of breech presentation, how dilated mom is, where she is laboring and the skill of her provider, and how quickly the baby is coming will affect the type of delivery mom will have. Finding a breech presentation in labor may cause mom to get an emergency cesarean section.

 

A breech presentation is when the fetus’ buttocks or feet are positioned to enter the birth canal first. There are different types of breech presentations:

  • Frank Breech:  The fetus’ buttocks are positioned to enter the birth canal first. The fetus’s legs are straight up in front of the body and the feet are near the head.
  • Complete breech:  The fetus’ buttocks are positioned to enter the birth canal first, but the legs are bent at the knees and the feet are near the buttocks.
  • Footling breech: One or both of the fetus’ feet are positioned to enter the birth canal first.

Weeks before the onset of labor most fetuses will assume a vertex position with their head down near the cervix as they ready themselves for the journey through the birth canal. However a small number of fetuses do not assume the head-down or vertex position and remain in a breech position.

Sometimes the baby's feet or buttocks come out first, instead of the head. That happens to about three or four of every one hundred full term babies, mostly for no apparent reason. In most cases, the baby is discovered to be in the breech presentation before labor begins. Occasionally, it is not discovered until labor starts or is well established. Sometimes the baby may have turned just prior to labor. An ultrasound can be used to determine the baby's position.

Even very experienced providers occasionally fail to spot a breech baby until labor begins, and thus miss the opportunity to try to turn the baby. Studies have shown very low rates of success of turning the baby once the waters have broken, so most providers won't try to do it at that point.

Our Bodies, Ourselves: Pregnancy and Birth

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Our Bodies, Ourselves: Pregnancy and Birth

ALL THE INFORMATION YOU NEED TO MAKE WISE DECISIONS ABOUT YOUR PREGNANCY AND THE BIRTH OF YOUR CHILD -- FROM THE EDITORS OF THE CLASSIC "BIBLE OF WOMEN'S HEALTH" Pregnancy and birth are as ordinary...

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.