How your baby lies in the womb
Most babies are born head first with their faces looking down, their back against your stomach and their chin tucked in on their chest. This position is called occipito anterior.
Other ways a baby can lie in the womb
Some babies can lie in a:
- posterior position (occipito-posterior) - facing the opposite way with their backs to your back
- breech position - where their bottom leads first, and their head is at the top
- transverse position - across your womb from side to side
It can be more difficult for babies to be born in these positions. They may need:
- help from your midwife or doctor
- a ventouse or forceps delivery, or caesarean section
A posterior position (occipito-posterior) is when your baby’s back is lying against yours.
While they’re in this position their head presses against your lower back, causing backache. This can worsen when you’re in labour.
Turning in this position
In earlier stages it doesn’t matter but once you’re ready to go into labour, your baby needs to turn all the way around to the front.
Sometimes your contractions help your baby to turn. Your baby can also turn round when you're pushing.
If your baby doesn’t turn, then your pushing can result in your baby being born in the posterior position but this is less likely to happen with a first pregnancy.
If your baby doesn’t turn following pushing, your obstetrician can help to turn your baby to face the right way and then deliver your baby with the help of forceps.
Breech position is when your baby’s bottom, or sometimes their foot, is the part that'll be born first.
Around 1 in 5 babies are in the breech position at 30 weeks of pregnancy. By the end of pregnancy only about 3 in 100 are breech.
Some babies lie with their:
- legs bent at the knees
- knees straight and their legs up in front of their face
Your baby may move into a head-down position on their own.
Turning in this position
If your baby's still breech by about 36 to 37 weeks they may not turn by themselves.
Your doctor will usually try turning your baby by external cephalic version (ECV). If your baby can’t be turned, your doctor may suggest trying again on another day.
Up to half of babies in a breech position can be turned like this and you can try to have a vaginal delivery.
External cephalic version (ECV)
ECV means gently massaging your tummy to encourage your baby to turn by doing either a forward or backward flip in the womb.
It can be uncomfortable, but it shouldn’t be painful. You may be given some medication to relax the muscles in your womb before you have this.
When is ECV done?
ECV is carried out after you've had an ultrasound showing your baby needs help to turn.
When the ECV is being carried out, your baby will be monitored all the time. There’s a small chance that ECV can cause distress to your baby, which is why their heart rate's monitored.
If ECV was done before 37 weeks your baby still has room to change position again afterwards.
If you need ECV your obstetrician will explain what will happen and answer any questions you have.
If your baby will be born breech
If you know your baby's going to be born breech:
- there are only some places where you’ll be able to give birth - your midwife or doctor wouldn’t recommend having your baby at home
- a caesarean section may be recommended - sometimes this is the safest option and least likely to harm them
Your obstetrician will talk to you about your choices and make a plan for the birth with you.
Some babies lie across your womb from side to side – you might hear this called a transverse lie.
If your baby's still in this position when your labour starts or you get to full term, you'll either need:
- an ECV to turn your baby to head down
- a caesarean section for your baby to be born
You're also likely to be admitted to the maternity hospital for a week or 2 before your baby's born. This is because there's an additional risk of complications during the birth.
Further information and other languages and formats
Translations and alternative formats of this information are available from Public Health Scotland.
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25 January 2023
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