The Best and Worst in Baby Position

4154099868_6a669a0449_z (1)Babies are little wigglers inside the womb; they kick, punch, and even turn over and change positions. All that movement is fine and normal. However, when labor begins, there is a lower chance for complications if your baby is in the proper position, or presentation. Delivery presentation refers to the way the baby is positioned to descend the birth canal. With certain presentations, it is unsafe for both mother and baby to deliver vaginally and a C-section (Cesarean) may be required. Near the end of your pregnancy, your doctor will determine baby position so that you can make appropriate preparations for labor and delivery.

Baby Presentations

  1. Occiput anterior – By 34 weeks, most babies are in a head-down position facing towards mother’s back. In this position, baby can pass through the birth canal with the greatest ease.
  2. Occiput posterior – Baby is still head-down, but instead of facing mother’s back he is flipped and facing the front. In this presentation, babies can still be delivered vaginally but often the labor takes longer.
  3. Transverse – Babies typically lie vertically in the womb, but on the rare occasion a baby does lie horizontally, it’s called transverse (also shoulder or oblique) presentation. Vaginal delivery is too risky for babies lying in a transverse position, so if your doctor cannot turn the baby you will need a C-section.
  4. Brow/Face-first – With these presentations, baby is still head-down but the head is tilted back (like baby is looking up) rather than tucked against his chest. This causes the forehead or face to emerge first. For the first days after birth, baby’s face will be bruised and swollen.
  5. Breech – Breech presentation means that baby is positioned bottom-down. According to the American Pregnancy Association, one in twenty-five deliveries are breech births. Babies in a breech presentation are very rarely delivered vaginally as descending the birth canal in this position runs a high risk of baby getting stuck. Breech may qualify as the worst in baby position! There are three different types of breech presentations:
    1. Complete – Bottom-first with knees bent
    2. Frank – Bottom-first with legs extended up towards baby’s head. This is the most common type of breech presentation.
    3. Footling – Bottom-first with one leg stretched out over mother’s cervix

Poor presentation is full of major risks

If a mother attempts vaginal delivery when her baby is in a compromising presentation, serious injury or death can result for both mother and baby. The umbilical cord could become blocked or damaged which limits the amount of oxygen to the baby (cord prolapse); or the baby could get stuck in the birth canal. In breech presentation, for example, the baby’s hips deliver first, and many women do not have a large enough pelvis for baby’s head to deliver also.

Getting babies into position

Before a mother begins labor, her doctor can attempt to coax the baby into position by a practice called external version. He or she will push on your abdomen while watching on ultrasound for the placenta, umbilical cord, and baby’s heartbeat. External version is usually performed between weeks 34-37 when there is still a good cushion of amniotic fluid surrounding the baby.

Once labor has begun, sometimes mothers can try walking, using music, or various labor positions that can promote a positive change in baby’s presentation. Your doctor could also try to use tools – such as a special vacuum or forceps (an instrument resembling tongs) – to aid in extracting your baby. If your baby is still not in the proper position, your doctor may recommend an emergency or planned C-section.

Causes of breech or transverse presentation

No one knows exactly what causes a transverse or breech baby position, but they tend to be more common in certain situations if the mother:

  • Has had previous pregnancies
  • Is pregnant with multiples
  • Has placenta previa
  • Has a history of premature delivery
  • Has an abnormally-shaped uterus or growths within the uterus
  • Has too much or too little amniotic fluid in the uterus

A baby’s position has a lot to do with the way labor and delivery progresses. As long as the prenatal appointments are kept, your doctor should have a pretty good idea of your baby’s position before labor begins. It won’t be long before you’ll be holding that little wiggle-worm in your arms!

Have any stories to share about your baby’s presentation? We’d love to hear it in the comments!


Image credit: Mama Loves

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