Fetal Positions

At The End Of Pregnancy
Settling into position Babies are often quite active before birth — not just extending their arms and legs, but turning their entire bodies. By the time labor begins, most babies have settled into a position that allows them to be delivered headfirst through the birth canal. That doesn't always happen, though. Take this visual tour to see the most common fetal positions, including a few that may lead to a Caesarean (C-section) delivery.

Facing downward This baby is in the occiput anterior position, the most preferable — and common — fetal position. With the face down and turned slightly to the side, the smallest part of the baby's head leads the way through the birth canal. The back of the baby's head is ready to enter the pelvis.

Facing upward This baby is in the occiput posterior position, with the face up toward the mother's abdomen. In this position, a baby can't extend his or her head out from under the pubic bone — which makes delivery more difficult. Labor pain may be concentrated in the lower back. Most babies eventually turn on their own, if there's enough room. Sometimes, changing positions can help rotate the baby. Your health care provider may suggest getting on your hands and knees with your buttocks in the air. If that doesn't work, your health care provider may try to rotate the baby manually by reaching through your vagina and using his or her hand as a wedge. Sometimes, forceps can be used to help the baby rotate.

Buttocks first This baby is in the frank breech presentation — head facing the top of the uterus and buttocks facing the birth canal with both legs folded up over the body. Also known as the pike position, it's the most common type of breech presentation. C-section is usually the safest way to deliver these babies.

Feet first This baby is in a complete breech presentation — head facing the top of the uterus, legs crossed and feet facing the birth canal. It's also known as the cannonball position. Babies in this presentation are nearly always delivered by C-section due to potential problems with the umbilical cord.

Dangling feet This baby is in another breech position, a footling presentation. One or both feet dangle below the buttocks, leading into the birth canal. These babies are nearly always delivered by C-section.

Lying sideways This baby is in a transverse lie — positioned horizontally across the uterus, rather than vertically. If one of the baby's shoulders is pointing toward the birth canal, it's known as a shoulder presentation. Although many babies lie sideways early in pregnancy, few babies begin labor in this position. For the few who do, a C-section is needed. Less than 1 percent of babies begin labor in a sideways position. If the position lasts, the baby must be delivered through Caesarean section.

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