What Is Breech Birth?

When it comes to childbirth, most people expect the baby to emerge headfirst. This is called a vertex presentation. But in about 3–4% of full-term pregnancies, the baby is in a different position: feet or buttocks pointing down toward the birth canal. This is called a breech presentation, and it presents a unique set of challenges and decisions for expecting parents and their care teams.

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What Is Breech Birth? A breech birth can be completely safe in certain circumstances, while in others, it may require interventions such as a cesarean section. Whether you’re newly pregnant or facing a breech diagnosis late in your third trimester, this blog will walk you through everything you need to know about breech birth types, causes, management options, and what to expect.

What Exactly Is a Breech Birth?

A breech birth refers to a baby being positioned in the uterus with its feet, knees, or buttocks closest to the birth canal, rather than the typical head-down position.

Normally, babies flip head-down between 32 and 36 weeks of pregnancy. In breech presentations, this rotation doesn’t occur, or occurs too late, leaving the baby in a less optimal position for vaginal delivery.

Breech presentation becomes a real concern around 36 weeks of gestation. Earlier in pregnancy, it’s quite common for babies to be breech, but most will turn spontaneously before labour begins.

Types of Breech Presentation

Understanding the different types of breech presentation helps healthcare providers determine the safest course of action. The main types are:

1. Frank Breech

• Most common type (about 65% of breech cases)
• Baby’s buttocks are aimed at the birth canal
• Legs are straight up in front of the body, feet near the head

2. Complete Breech

• Baby’s buttocks are downward
• Legs are folded at the hips and knees in a “crisscross” or lotus position

3. Footling Breech

• One or both feet point downward and may come out first
• More common in premature births
• Riskier due to the potential for umbilical cord prolapse

4. Kneeling Breech (Rare)

• The baby is in a kneeling position
• Knees are down, thighs are extended upward

Each type presents different levels of difficulty during delivery, and understanding the baby’s exact position is crucial for safe delivery planning.

What Causes Breech Presentation?

There are several possible reasons a baby may not turn head-down before birth. These include:

• Premature birth (before 37 weeks)
• Uterine abnormalities (such as fibroids or unusual shape)
• Placenta previa (when the placenta covers the cervix)
• Multiple pregnancies (twins or more)
• Too much or too little amniotic fluid
• Short umbilical cord
• Fetal abnormalities affecting movement
• Maternal history of breech births

However, in many cases, the cause is unknown. Breech presentation is not necessarily a sign of something being “wrong,” but it does require thoughtful management.

How Is Breech Presentation Diagnosed?

Typically, a breech position is first suspected during a routine prenatal exam when the healthcare provider feels the baby’s position by palpating the abdomen.

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If breech presentation is suspected, it’s confirmed by:

1. Ultrasound Scan

• The most accurate method to determine the baby’s position
• Helps assess the type of breech, fetal size, and fluid levels

2. Physical Examination

• Your provider may feel a hard, round object (the baby’s head) near the top of the uterus

3. Pelvic Exam

• Sometimes used later in pregnancy to feel if the baby’s feet or buttocks are descending into the birth canal

What Are the Risks of Breech Birth?

Breech presentations carry a higher risk than head-down (cephalic) positions, especially during vaginal delivery. Some of the key risks include:

• Umbilical cord prolapse – The cord may slip through the cervix before the baby, cutting off oxygen.
• Birth trauma – The Head can become stuck as it is the largest part to deliver last.
• Fetal distress – Lack of oxygen during labour and delivery.
• Injury to the baby’s spine or limbs.
• Cesarean section complications (if surgical delivery is necessary).

These risks are why many breech babies, especially footling and complete breeches, are delivered via planned C-section.

Can a Breech Baby Be Turned?

Yes, and one of the most common and effective methods is called External Cephalic Version (ECV).

What Is ECV?

ECV is a procedure where a healthcare provider uses their hands on the mother’s abdomen to gently try to turn the baby into a head-down position.

When Is ECV Done?

• Usually performed between 36–38 weeks
• Done in a hospital setting in case complications arise

How Effective Is It?

• Success rate: about 50–65%
• If successful, it can help avoid a C-section
• Some babies turn back to breech even after a successful ECV

Risks of ECV

• Temporary fetal heart rate changes
• Premature rupture of membranes
• Placental abruption (rare)

Your doctor will monitor the baby throughout the procedure using ultrasound and fetal heart rate monitoring.

Are There Natural Ways to Turn a Breech Baby?

While not always backed by scientific evidence, some parents and practitioners explore natural or complementary methods to encourage babies to turn:

1. Spinning Babies Techniques

• A popular program that uses specific exercises and body positioning to help achieve optimal fetal positioning

2. Acupuncture or Moxibustion

• Traditional Chinese Medicine technique where burning herbs are used near the little toe to stimulate fetal movement

3. Swimming or Pelvic Tilts

• Some midwives recommend certain physical movements to give the baby space to turn

4. Chiropractic (Webster Technique)

• A method that focuses on pelvic alignment to help the baby find a better position

Always consult your healthcare provider before trying alternative therapies.

Delivery Options for Breech Birth

When a baby remains breech at term, parents must choose between attempting a vaginal breech birth or having a planned cesarean section.

1. Planned Cesarean Section (C-Section)

• The most common recommendation in developed countries
• Generally considered the safest option for breech births
• Minimises the risk of birth trauma, especially for footling or complete breech

2. Vaginal Breech Birth

• Possible with experienced providers
• Best for a frank breech with a baby of average size
• Requires close monitoring and specific criteria (e.g., fetal position, estimated fetal weight, mother’s pelvis size)

Not all hospitals or providers offer this option, so you may need to find a specialised care team if you want to attempt it.

What Happens During a Breech C-Section?

A planned breech cesarean is usually scheduled between 39–40 weeks, unless earlier delivery is necessary due to other risks.

The Process:

• Performed in a surgical suite
• Regional anesthesia (usually spinal block or epidural)
• The baby is carefully delivered feet- or buttocks-first
• The placenta is removed, and the incision is closed
• Baby and parent are monitored closely afterwards

Planned C-sections are generally very safe, but they do carry typical surgical risks like infection, bleeding, and longer recovery time compared to vaginal birth.

Postpartum Considerations After Breech Birth

Whether you give birth vaginally or via C-section, there are some unique things to consider postpartum:

1. Newborn Evaluation

• Breech babies may have temporary issues like hip dysplasia or minor limb stiffness due to their in-utero position
• Doctors may recommend an ultrasound of the hips

2. Emotional Support

• A breech diagnosis can be stressful or disappointing if it alters your birth plan
• Talking to a therapist, doula, or birth support group can help

3. Recovery

• C-section recovery typically takes longer; vaginal breech birth may involve perineal trauma depending on delivery

Frequently Asked Questions

Can breech babies be delivered vaginally?

Yes, but only under specific conditions and with experienced providers. Many hospitals recommend a C-section for safety.

Is breech birth dangerous?

It can be riskier than head-first birth, but with proper medical care, outcomes are

generally good.

Can my baby still turn after 36 weeks?

Yes, but the chances decrease each week. After 37–38 weeks, spontaneous turning is rare.

Final Thoughts:

A breech presentation might not be what you envisioned, but it doesn’t mean your birth can’t be empowering, informed, and safe. The key is understanding your options, communicating with your healthcare team, and making choices that align with your health, values, and circumstances.

Every breech birth story is unique. Whether you deliver via C-section or attempt a vaginal birth, what matters most is that you and your baby are supported and well cared for. Trust your body, trust your team, and trust your instincts.