At one time or another, you may have heard an unborn baby described as being in a "breech position." A breech presentation means the baby is not in a head-down position, and the legs or buttocks come into the birth canal first.
One of the main causes of breech presentation is prematurity of the baby. Near the end of the second trimester, it s more common for the baby to be in a breech position. As you progress through the third trimester, the baby usually turns into the head-down position for birth.
By the last 4 to 6 weeks, your baby should be in a head-down position. If your baby is breech when it is time to deliver, your doctor may try to turn the baby, or you may need a Cesarean delivery.
There are different breech presentations and other abnormal positions. They include:
 | Frank breech—lower legs are flexed at the hips and extended at the knees. Feet are up by the face or head. |
| Complete breech—one or both knees are flexed, not extended. |
| Incomplete breech—a foot or knee enters the birth canal ahead of the rest of the baby. |
| Face presentation—the baby's head is hyperextended so the face enters the birth canal first. |
| Transverse-lie presentation—the baby is lying almost as if in a cradle in the pelvis. The head is on one side of the mother's abdomen, and the bottom is on the other side. |
| Shoulder presentation—shoulder enters the birth canal first. |
There is some controversy about how to deliver a baby in the breech position. For a long time, breech deliveries were performed vaginally; then it was believed the safest method was by C-section. Many doctors still believe a Cesarean delivery is the safest way to deliver a baby in the breech position. However, some doctors believe a woman can deliver a breech baby without difficulty if the situation is right.
Sometimes the doctor will try to turn a baby in the breech position. Your physician may attempt to change its position by using external cephalic version (ECV). The doctor places his or her hands on your abdomen. Using gentle movements, he or she attempts to shift the baby manually into the head-down position. An ultrasound is usually done first so the doctor can see the position of the baby. It is used during the procedure to guide the doctor in changing the baby's position. Most physicians who use this method do so before labor begins or in the early stages of labor. ECV is successful in about 50% of the cases in which it is used.
