Breech Pregnancy: Diagnosis, Risks, and Delivery Options Explained

Your baby might twist, tumble, or stretch in the womb during pregnancy. Generally, before the start of labour, they usually take a head-first position. When a baby stays in a feet-first or bottom-first position, it's called a 'breech position.' Knowing about it can make you feel more prepared for childbirth.

Pregatips
breech pregnancy
The position of the baby in the uterus right before birth greatly impacts labour and delivery. Such baby positioning is called “foetal presentation.”
During most pregnancies, your baby gradually moves into a head-down position before birth. This position usually makes vaginal delivery safer and easier. However, sometimes your baby may remain in a different position inside the uterus. One such position is called a breech presentation.

In around 3-4% of all pregnancies, the foetal presentation remains breech until labour. With timely detection and the right care, such pregnancies can be managed well.

However, a breech pregnancy presents a few different challenges for both you and your baby.

What Is a Breech Presentation?


A breech foetal position means your baby is positioned with their buttocks, feet, or both facing downwards toward the birth canal instead of their head.

Normally, your baby lies head down, or in vertex presentation, in your womb at delivery.

However, in some pregnancies, the baby remains breech near labour. In such cases, there might be certain risks related to vaginal delivery.

If a baby stays in breech position even at 37 weeks of pregnancy, your doctor may plan your delivery differently. Your doctor may plan a C-section for the safest outcomes.


Common Types of Breech Positions


Type of Breech

Position of the Baby

Frank breech

Buttocks down with legs lifted upward near the head

Complete breech

Buttocks down with knees bent

Footling breech

One or both feet positioned downward


Among these, a frank breech is the most common type.



Why Does a Breech Pregnancy Happen?


The exact reason why breech pregnancies happen is still unclear. As per research, there are certain factors that increase the risk.

Possible Causes and Risk Factors

You may have a higher chance of breech pregnancy if:

  • You are pregnant with twins or multiples
  • You have given birth to a premature baby in the past
  • Your uterus has excessive or scanty amniotic fluid (your baby either gets too much space to move around in or less fluid to move around in)
  • You have an abnormal shape of the uterus
  • You have complications, like fibroids in the uterus
  • You have placenta praevia
Importantly, your lifestyle choices, food habits, levels of physical activity, or sleeping position might not be responsible for breech pregnancies.


How Is Breech Pregnancy Diagnosed?


Your obstetrician may be able to tell you how your baby is lying inside your womb by doing a physical examination of your abdomen.

Your doctor may suspect a breech position during a routine antenatal check-up.

Sometimes, you may also notice:

  • Strong kicks in the lower abdomen
  • Pressure under the ribs
  • A hard round structure near the upper abdomen, which may be the baby’s head
However, confirmation usually requires a medical examination.

An ultrasound is the most reliable way to confirm the following:

  • Baby’s position
  • Placenta location
  • Amount of amniotic fluid
  • Baby’s growth

When is a Breech Pregnancy Diagnosed?


A baby is often in a breech position at some point during pregnancy. By this stage, most babies naturally move into a head-down position. However, a breech position becomes concerning when you are near 36 weeks of pregnancy.

After 37 weeks, a baby usually doesn’t turn its position on its own. This is because of limited space for movement.

At this point, your doctor considers it a breech presentation and plans the delivery accordingly.

What Is External Cephalic Version (ECV)?


If your baby remains breech near term, your doctor may discuss a procedure called 'external cephalic version' (ECV).

During ECV, the doctor gently applies pressure on your abdomen to try turning the baby into a head-down position.


Important Facts About ECV


Aspect

Details

Usually done around

36–37 weeks

Procedure location

Hospital setting

Monitoring required

Baby’s heart rate monitored carefully

Success rate

Varies depending on pregnancy factors



When ECV May Not Be Suitable


ECV may not be advised if:

  • You have placenta praevia
  • There is vaginal bleeding
  • Multiple pregnancy is present
  • Certain uterine abnormalities exist
  • Foetal distress is suspected
Although ECV is generally safe when performed by trained specialists, it may not always successfully turn the baby.


What Are the Risks of Breech Pregnancy?


A breech pregnancy itself does not always harm your baby during pregnancy. However, breech positioning during labour may increase certain delivery risks.

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Possible Risks During Labour

These may include:

  • Difficulty during vaginal delivery
  • Umbilical cord prolapse
  • Delayed delivery of the baby’s head
  • Birth injury in rare cases
  • Increased chance of emergency C-section
The level of risk depends on:

  • The type of breech position
  • Baby’s size
  • Your pelvic measurements
  • Whether labour starts naturally
  • Your overall pregnancy health
Because of these factors, delivery planning becomes especially important in breech pregnancies.


Delivery Options for Breech Pregnancy


The safest delivery method depends on your individual pregnancy condition.

Your obstetrician usually considers the following:

  • Type of breech presentation
  • Gestational age
  • Previous deliveries
  • Baby’s estimated weight
  • Hospital facilities and emergency support availability

Planned Caesarean Section


In many breech pregnancies, a planned C-section may be recommended because it may reduce certain delivery-related complications.

This is especially common if:

  • The baby is a footling breech
  • The baby appears large
  • There are additional pregnancy complications
  • It is your first delivery in some cases

Vaginal Breech Delivery


Sometimes, vaginal breech delivery may still be possible under strict medical supervision.

It may be considered if:

  • The pregnancy is full-term
  • The baby is not too large
  • Frank breech presentation is present
  • No additional complications exist
  • Skilled specialists are available
However, careful monitoring remains essential throughout labour.


If you are carrying a breech pregnancy, it's normal to have many questions. However, with proper monitoring and delivery planning, many breech pregnancies can be managed safely.

Most babies turn on their own before labour. But if that doesn't happen, your doctor may adjust your birth plan and plan a C-section delivery.

Your doctor will guide you on what to expect during a breech delivery and how to prepare for it. Understanding your options can help you make informed and appropriate decisions.

Whether you’re pregnant, a new mom, or navigating postpartum, you don’t have to do it alone. Join our support group to connect, share, and support one another.


FAQs on Breech Pregnancy: Diagnosis, Risks, and Delivery Options Explained

  1. Can exercise help turn a breech baby naturally?
    Some exercises and posture techniques are commonly discussed. However, scientific evidence remains limited. You should always speak with your doctor before trying any methods at home.
  2. Is a breech pregnancy always delivered by C-section?
    No, not always. Although many breech pregnancies are delivered by C-section, some people may still have a carefully monitored vaginal breech delivery depending on their condition.
  3. Can a breech baby turn during labour?
    Sometimes, babies may still turn naturally before or during early labour. However, this becomes less common near full-term pregnancy.
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