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If Your Baby is Breech

Toward the end of pregnancy, babies usually turn head down to get in the best position for birth. Sometimes babies do not turn and stay head up with their bottom (bum) or feet pointing down. This is called a breech baby or breech presentation.

Your care provider will check to see what position your baby is in as you get closer to your due date. If your baby is breech, it may cause complications during delivery. Below is some information about your choices for birth if your baby is breech. 

What does it mean?

What does it mean when a baby is breech?

Most babies turn on their own to a head down position by 36 weeks of pregnancy. This is the safest and easiest position for your baby during birth. Your baby’s head helps your cervix open wide enough to let your baby’s body pass through with relative ease.

You may have one of the approximately 4% of pregnancies where your baby does not turn, leaving your baby’s bum or feet pointing down. There is no clear reason why some babies turn and some do not. When your baby is bum or feet-first, your cervix may not open enough to easily allow your baby’s head through. This can increase the risk of complications during labour and birth.

What can you do?

What can you do if your baby is breech?

Talk with your care provider about your options for a safe labour and birth based on your pregnancy. Some options available to you include: 

Some people try acupuncture, massage therapy, and moxibustion to encourage a baby to turn, although there is no medical evidence to support these methods. These options are safe for you and your baby.  Talk to your care provider about your options to try and encourage your baby to turn on its own.


This procedure is called an External Cephalic Version (ECV). An ECV is done in hospital by an obstetrician (pregnancy specialist) who will try to turn your baby to a head-down position. The data from BC Women’s Hospital shows that an ECV has a 10% to 20% success rate if this is your first baby and a 20-40% success rate if you have previously given birth either vaginally or by c-section.

Learn more about External Cephalic Version and its benefits and risks.

3. Leaving your baby in the breech presentation

How you deliver your breech baby depends on your baby’s position, size and other medical factors.

In some cases, it may be safe for you to try to have a breech vaginal birth. However, most babies in the breech presentation are born by c-section. 

A vaginal breech birth may be an option if:

  • Your baby is a normal size.
  • Your baby is in a bum down (not feet down) position.
  • Your labour starts naturally.
  • Your pregnancy is 37-41 weeks in length when labour starts.
  • You and your baby are otherwise healthy.
  • You plan to deliver at a hospital that offers vaginal breech birth; and
  • Your baby’s neck is in the correct position.

During a vaginal breech delivery an IV and epidural will be recommended. Your labour should progress at a normal rate. Your baby’s heart rate will be monitored throughout the labour. Once your cervix is fully open, you will be encouraged to push and deliver your baby. Once your baby’s legs and lower belly are out of your vagina, the obstetrician may need to help deliver your baby’s head. This may require the use of instruments (forceps) or making a small cut in the opening of your vagina (episiotomy).

A vaginal breech birth comes with greater risks than a normal vaginal birth. These risks include an increased chance of:

  • baby’s head becoming trapped, resulting in injury to both mom and baby; 
  • use of forceps or other means to deliver your baby’s head;
  • problems with the umbilical cord, resulting in less blood and oxygen getting to your baby;
  • breathing problems requiring oxygen or a breathing tube for your baby after birth; 
  • baby needing to be admitted to the Neonatal Intensive Care Unit (NICU); and
  • emergency c-section.

Benefits of delivering your breech baby vaginally compared to c-section including:

  • less blood loss;
  • less risk of injury and infection (for you);
  • no complications from surgery;
  • shorter hospital stay;
  • faster, less painful recovery;
  • increased chance of having a vaginal birth in the future.

Before labour begins, a c-section birth is recommended if:

  • Your baby is in a feet or legs first position;
  • You are pregnant with twins and the first baby is in a breech presentation;
  • You and/or your baby have other medical concerns (such as your baby being smaller or larger than usual, low amniotic fluid, baby is not full term, the placenta in front of the baby’s head). 

After labour begins, a c-section birth is recommended if:

  • The umbilical cord comes out before your baby.
  • Your labour is not progressing normally.
  • You and/or your baby develop complications during labour.

A caesarean section (c-section) is a surgical procedure where your baby is delivered through a cut made in your lower belly. You will receive medication so you don’t feel any pain. Once your baby is born, the cut is closed with dissolving stitches or removable staples.

The benefits and risks of a planned c-section birth for a breech baby are the same as with any planned c-section birth. A planned C-section is pre-booked and done in a hospital. If you care provider or local hospital does not offer c-section, they can refer you to BC Women’s. 

Talk to your care provider about the best option for you and your baby. 

Turning the baby

If your baby is breech and you are in, or past the 36th week of  your pregnancy, your care provider may suggest trying to turn your baby. Turning your baby so they are in a head-down position will increase your chance of giving birth vaginally. This is called an External Cephalic Version (ECV).

During an ECV, one or two obstetricians (pregnancy specialists) try to turn your baby to a head-down position in your uterus. This is the best position for your baby to be in for birth and increases your chance of having a vaginal birth. 

An ECV is done in hospital so you and your baby can be monitored throughout the procedure. You will have an ultrasound at the start of the procedure to check your baby’s size and position.

One or two obstetricians will push on your belly to encourage your baby to do a forward or backward roll into a head-down position in your uterus. It may make several attempts at lifting and pushing on your belly to try and get your baby to turn over. 

You will feel a lot of pressure during this procedure and it can be an uncomfortable or painful . You can ask them to stop the procedure at any time. Despite any discomfort you may feel, the ECV procedure is safe and does not hurt your baby.

Once the procedure is done, you will have another ultrasound to check your baby’s position. You and your baby will be monitored for a short while to make sure you are both well before you go home. 

If the ECV is successful, your baby will now be in a head-down position for birth. It is safer to attempt a vaginal delivery when the head of the baby is down compared to when the baby is in a breech position.  

The ECV procedure does not always work. Sometimes it is not possible to move your baby into a head-down position. Also there is a small chance that even after a successful ECV, your baby could roll back to a breech position.

Complications from an ECV include:

  • Early rupture of your membranes (water breaking) and/or early labour (preterm birth).
  • There may be a drop in your baby’s heart rate during the ECV. Most of the time your baby’s heart rate returns to normal when the ECV is stopped. In rare cases, the heart rate does not recover and you will need to have an emergency c-section. This is extremely rare.
  • Separation of your placenta from the wall of your uterus (placental abruption). This is extremely rare.

Our data shows that an ECV has a 10% to 20% success rate if this is your first baby and a 20-40% success rate if you have previously given birth (either vaginal or by c-section). Your chance of having a successful ECV are best when you have the procedure in the 36th – 37th week of pregnancy.

Some of the things that may affect the success of the ECV Procedure are:

  • Gestational age at the time of ECV
  • Amount of fluid around the baby
  • If you have had a past full-term pregnancy (36-40 weeks)

What if your baby doesn’t turn?

If the ECV is not successful in turning your baby to a head-down position, you may have other options to deliver your breech baby. Talk with your care provider about whether a vaginal breech birth or a planned c-section is the best choice for you and your baby.

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SOURCE: If Your Baby is Breech ( )
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