Checking your baby’s position: breech and head-down

Towards the end of pregnancy, your midwife will check which way up your baby is. Most babies end up head-down, and if yours isn’t, there are choices and plenty of time to talk them through.

How your midwife checks

The NHS says that from 36 weeks your midwife feels your bump to check your baby’s position. Before then, many babies lie sideways or in different positions and move around a lot. The NHS says most babies move into the head-down position before labour starts, though some don’t.

What does breech mean?

A breech baby is lying bottom first or feet first, rather than head-down. The RCOG says only 3 to 4 in every 100 babies are breech towards the end of pregnancy, and that ECV is successful for about 1 in 2 women. It’s checked for routinely, so it’s not an unusual find.

If your baby is still breech at 36 weeks

The NHS says if your baby is still breech at around 36 weeks, your obstetrician and midwife will talk through the options for a safe delivery.

External cephalic version (ECV). The NHS says ECV is usually offered if your baby is breech at around 36 weeks, and the RCOG says it is offered around 36 or 37 weeks. A healthcare professional, such as an obstetrician, applies pressure to your tummy to turn your baby head-down. The NHS says it can be a bit uncomfortable, but it is a safe procedure.
Vaginal breech birth or caesarean. If ECV doesn’t work, or you’d rather not have it, you’ll discuss vaginal birth or caesarean with your team. The RCOG advises against vaginal breech delivery in certain cases, such as a footling breech, an unusually large or small baby, a difficult head position, a low-lying placenta or pre-eclampsia.

If your baby is lying sideways

The NHS says that if your baby is lying sideways (a transverse position), you might need to be admitted to hospital because of the small risk of cord prolapse, which is a medical emergency. Manual turning may be offered. If your baby is still sideways near your due date or when labour begins, a caesarean is most likely to be advised.

When to get help

If your waters break, call your maternity unit straight away. Call them too if you have bleeding or you’re worried.

If your baby’s movements slow down, stop or change, call your midwife or maternity unit straight away, day or night. Don’t wait until the next day, and don’t use a home Doppler to check the heartbeat, because it isn’t reliable.

What you can do

Ask your midwife which position your baby is in at each appointment from 36 weeks, and what your options are. You can ask questions and take time to decide. For the signs that labour is starting, see signs of labour.

Questions people ask

Does a breech baby mean I’ll need a caesarean?

Not necessarily. ECV may turn your baby, and you can discuss a vaginal breech birth or caesarean with your team.

Can I turn my baby myself?

The NHS page describes ECV done by a healthcare professional. Ask your midwife before trying anything at home.

When do most babies turn?

The NHS says most babies move into the head-down position before labour starts, and many lie sideways earlier in pregnancy.

Is ECV painful?

The NHS says it can be a bit uncomfortable but is a safe procedure. Ask what pain relief is available.