Turn Turn Turn: Options for Turning and Birthing Breech Babies

A breech presentation refers to the position of the baby in the uterus. It is normal, up to the seventh month of pregnancy, for the baby to be in a head-up, or breech, position. After the seventh month, any position other than vertex (head-down) may not only challenge the possibility of a vaginal birth, but put abnormal stressors on the developing baby.

The risk is small; research shows that approximately 4 percent of full-term (38-42 week) pregnancies are breech presentations. There are several causes of a breech presentation. A structurally altered pelvis is a likely possibility; this can be caused by rickets (severe vitamin D deficiency), poor bone and joint development, or structural or functional pelvic compromise. Additional causes of a breech presentation are uterine abnormalities, placenta previa, multiple births, excessive amniotic fluid, or fetal anomalies such as hydrocephaly and anencephaly.

There are three main types of breech presentations: frank, complete and footling. With a frank presentation, the baby’s legs are extended upward with feet near the head. This is the most common breech presentation, occurring 65 to 70 percent of the time. Complete presentation means the baby is “sitting” upright in the uterus, with legs crossed and feet near the buttocks. A footling presentation is when one or both of the baby’s feet are extended downward toward the cervix.