What is the breech presentation?

Breech presentation is when the fetus' feet or butt present first to the vagina, as compared to vertex presentation where the head presents first.

About 1 in 4 fetuses are in breech position by 28 weeks and about 1 in 30 fetuses are in breech presentation close to the due date. After 9 months of the pregnancy, no mom wants to hear that her baby is in the breech position and that a Cesarean section (C-section) may be needed for a safer delivery. If a prenatal ultrasound is not performed, and mom is not prepared, breech births can be even scarier when the feet appear during the pushing phase instead of the crowning of a head. Here are a few simple facts about breech birth to put mom’s mind at ease:

• Only about 3-4 out of every 100 births present in a breech position.
• Around the 36th week of pregnancy, most babies will spin around and the head will make contact with the opening of the cervix in preparation for birth.
• Some doctors will order an ultrasound at this phase of pregnancy to assure the baby is in a head-down position. Even if an ultrasound is not performed, doctors can feel the woman’s belly for the head position.

The three types of breech position

• Frank breech describes a baby who chooses to come out buttocks-first instead of head-first.      
• Complete breech is also a buttocks down position, but the legs are located near the buttocks instead of the head, as is the case with Frank breech.
• Footling breech position denotes the baby's legs are in position to come out before the buttocks or head.

Common causes of breech positioning

The most common causes of breech positioning during birth are premature pregnancy and multiple pregnancies. Shape distortions of the uterus and abnormal placenta position can also cause the baby to present breech instead of head-down. In most cases, doctors will try to turn the baby around inside the uterus, into a head-down position for a vaginal birth before scheduling a C-section. If the baby cannot be turned, a C-section is usually the safest alternative, but both mom and her doctor should discuss all options, as well as the benefits and risks of each option.