As your baby grows during pregnancy, they may move around quite a bit in the womb. You might feel kicking or wiggling, or your baby may twist and turn.
During the last month of pregnancy, your baby is bigger and doesn’t have much wiggle room. The position of your baby becomes more important as your due date nears. This is because your baby needs to get into the best position to prepare for delivery.
Your doctor will continually assess the position of your baby in the womb, especially during the last month. Read on to find out what it means when your doctor uses words like anterior, posterior, transverse, or breech to describe the position of your baby. You’ll also learn what to do if your baby isn’t in the best position before your due date.
The baby is head down, with their face facing your back. The baby’s chin is tucked into their chest and their head is ready to enter the pelvis. The baby is able to flex their head and neck, and tuck their chin into their chest. This is usually referred to as occipito-anterior, or the cephalic presentation.
The narrowest part of the head can press on the cervix and help it to open during delivery. Most babies generally settle in the head down position around the 33- to 36-week range. This is the ideal and safest position for delivery.
The baby is facing head down, but their face is positioned toward your stomach instead of toward the back. This is typically called the occipito-posterior (OP) position.
In the first stage of labor, about one-tenth to one-third of babies are in this position. Most of these babies will spontaneously rotate themselves to face in the right direction before birth. But in 10 to 28 percent of cases, the baby doesn’t rotate. A baby in this position increases your chances of having a prolonged delivery with severe back pain. An epidural might be needed to ease some of the pain during delivery.
A breech baby is positioned with their buttocks or feet first. There are three variations of a breech presentation:
- Complete breech: When the buttocks are pointing toward the birth canal (downward), with the legs folded at the knees. The feet are near the buttocks.
- Frank breech: The buttocks are toward the birth canal, but the baby’s legs are straight up in front of their body and the feet are near the head.
- Footling breech: One or both of the baby’s feet are pointing downward toward the birth canal.
A breech position is not ideal for delivery. It occurs in about 1 of every 25 full-term births. Though the majority of breech babies are born healthy, they may have a higher risk of birth defects or trauma during delivery. In a breech birth, the baby’s head is the last part of its body to emerge from the vagina, which makes it more difficult to get through the birth canal. This position can also be problematic because it increases the risk of forming a loop in the umbilical cord that could cause injury to the baby if they’re delivered vaginally.
Your doctor will discuss options for trying to turn the baby into a head down position before you enter into your final weeks. They might suggest a technique called an external cephalic version (ECV). This procedure involves applying pressure to your abdomen. It may be uncomfortable for you, but it isn’t dangerous. The baby’s heartbeat will be monitored very closely and the procedure will be stopped immediately if a problem develops. This technique is successful about half of the time.
If ECV doesn’t work, you may need a cesarean delivery in order to safely give birth to a breech baby. This is especially true in the case of a footling breech. In this case, your umbilical cord could be squeezed as the baby moves toward the birth canal. This could cut off the baby’s supply of oxygen and blood.
The baby is lying horizontally in the uterus. This position is known as transverse lie.
It’s extremely rare at delivery, since most babies will turn themselves to be head down prior to your due date. If not, babies in this position will require a cesarean delivery. This is because there is a small risk of the umbilical cord prolapsing (coming out of the womb before the baby) when your water breaks. An umbilical cord prolapse is a medical emergency, and the baby must be delivered very quickly via cesarean if it happens.
Want to track your baby’s position prior to delivery? You can use a process known as “belly mapping” starting around month 8. All you’ll need are a nontoxic washable marker or paint, and a doll for visualizing how your baby is positioned in the womb. It’s best to do belly mapping right after a visit with your doctor, so you’ll know for sure if your baby’s head is facing up or down. Just follow these easy steps:
- Lie down on your bed and put slight pressure around your pelvic area to feel around for the baby’s head. It’ll feel like a mini bowling ball. Mark it on your belly.
- Use a fetoscope or during an ultrasound, locate your baby’s heartbeat and mark it on your belly.
- Use the doll to start playing around with positions, based on the position of your baby’s head and heart.
- Find your baby’s bum. It will be hard and round. Draw it on your belly.
- Think of your baby’s movement. Where are they kicking? Use their kicks and wiggles as clues to their position. This will give you a good idea as to where their legs or knees are located. Mark it down on your belly.
- Use the markings to draw your baby on your stomach. Some mothers get creative and paint their baby’s position on their stomach like a piece of art.
Occasionally, a baby may not end up in the correct position for delivery. It’s important to know if your baby isn’t in the occipito-anterior position right before birth. Depending on the exact position, it could lead to complications during delivery. There are some methods you can use to coax your baby into the right position.
You can try the following ideas:
- When you sit down, tilt your pelvis forward instead of backward.
- Spend time sitting on a birth ball/exercise ball.
- Make sure your hips are always higher than your knees when you sit.
- If your job requires lots of sitting, take regular breaks to move around.
- In your car, sit on a cushion in order to lift up and tilt your bottom forward.
- Get on your hands and knees (like you are scrubbing the floor) for a few minutes at a time. Try this a few times a day to help move your baby into the anterior position.
Unfortunately, these tips don’t always work. If your baby stays in a posterior position when labor starts, it may be because of the shape of your pelvis rather than your posture. In some cases, a cesarean delivery will be necessary.
Toward the end of your pregnancy, it may feel like your baby has dropped lower into your abdomen. This is referred to as lightening.
The baby is settling deeper into your pelvis. Luckily for you, this means less pressure on your diaphragm, which makes it easier to breathe and also brings fewer baby kicks to the ribs. Your baby dropping is one of the first signs that your body’s getting ready for labor.
Babies toss and turn frequently during pregnancy. You probably won’t feel their movement until the middle of the second trimester. They’ll eventually settle into a position for delivery — ideally head down, facing your back — by week 36.
Before that time, you shouldn’t worry too much about your baby’s position. It’s common for posterior babies to adjust their position themselves during delivery and before the pushing stage. Try to stay relaxed and positive during this time.
A baby who isn’t in the ideal position before your delivery date should always be delivered in a hospital setting for the best care. Emergencies during this type of labor need to be handled by skilled medical staff. Be sure to talk to your doctor if you have any concerns about the position of your baby as your due date nears.