Babies toss, turn and tumble in the womb. As they grow, space becomes a premium, and they may move around less often. Most babies finally settle into a head-first position in the last days of pregnancy — the easiest position for the birth process — but some babies don’t get the memo. This can affect the birth process, which is why it’s important to know exactly how the baby is positioned before you go into labor.
Babies start moving around in the womb by the time they are only 8 weeks old, according to Sutter Health. Because the baby is only a little over an inch long, the mother cannot feel these movements. It is not until the fifth month that most pregnant women start to feel the baby’s movements. Babies usually continue to be very active until the end of the eighth month, when rapid weight gain and tight living quarters start to interfere with the baby’s ability to shift position.
The most common (and safest) position is head down and facing the mother’s back. In this position, the baby’s head slides out first. Asynclitism means the baby is head down, but the head is to one side of the pelvis. Breech babies are flipped around — they present feet or buttocks first. There are three types of breech positions. The first is frank breech, where the buttocks are sitting on top of the birth canal, and the legs are sticking straight up, with the feet resting by the baby’s ears. The second is called a complete breech. Again, the buttocks are near the birth canal, but the legs are neatly folded. The final breech position is the footling breech, where one or both of the legs are pointing straight down. In this position, the feet are born first if a vaginal birth is attempted. Transverse babies lie horizontally in the womb.
Head-down births are the safest for the baby. Since the head is the largest part of the baby’s body, the rest of the body usually follows easily. In addition, if the baby is facing the mother’s back, the head can flex on the neck. If the baby is front-facing, the head cannot flex, and the mother must push harder to deliver the head. Breech positions can be dangerous for the baby because the head is delivered last. If the head gets stuck in the pelvis, the baby’s health can be compromised. In these cases, the body of the baby has already been delivered, and the cord might be compressed in the birth canal as well. This can cut off the blood supply to the baby. Transverse babies are simply lying the wrong way to slide out of the birth canal. Most transverse babies that do not turn head-down before labor cannot be delivered vaginally, according to WebMD.
In some cases, it is possible to turn the turn baby to the correct position. This can be done through external manipulation by a trained specialist. Turning the baby through external manipulation works best if it is done well before the due date, when there is enough room and amniotic fluid for the baby to easily move. In some cases, however, the baby will just move right back to the undesirable position. Other methods to turn a baby involve exercises done by the pregnant mother and “luring” the baby to turn with light or music.
While it is possible to deliver a breech baby vaginally, it is not usually recommended, according to Dr. Gerard M. DiLeo of BabyZone. If it is attempted, the baby should be in a frank breech position, and the mother’s pelvic space should be wide. The baby’s heartbeat should be monitored at all times, and an anesthesiologist should be available in the event an emergency cesarean is needed.