Breech: what it means when your baby is bottom first
In this article
Breech means your baby is lying bottom first or feet first in your womb instead of head down. It is very common earlier in pregnancy, and RCOG says most babies turn head first by 36 to 37 weeks. NUH says only 3 to 5% are still breech at term. If yours is one of them, you have more than one option for the birth.
| Breech position | Bottom first or feet first instead of head down |
|---|---|
| Still breech at term | 3 to 5% of babies (NUH) |
| When it matters | From about 36 weeks, when your team discusses options (RCOG) |
| Turning the baby (ECV) | Done at about 36 to 37 weeks; works for about 1 in 2 women |
| If baby stays breech | Planned caesarean, or a vaginal breech birth with a trained team |
The three breech positions on your scan report
RCOG names three:
- Frank or extended breech: bottom first, legs straight up with the feet by the ears. Most breech babies lie this way.
- Flexed breech: bottom first, knees bent, feet next to the bottom.
- Footling breech: one or both feet below the bottom.
The type matters for planning the birth. RCOG lists footling breech as one reason a team may advise against a vaginal birth.
Why some babies stay breech
Often it is just chance, RCOG says, and a breech baby does not usually mean anything is wrong with you or your baby. Some things make turning harder: a first pregnancy, a low-lying placenta (placenta praevia), too much or too little amniotic fluid, twins, or a womb with an unusual shape. NUH adds structural problems in the baby or the womb. Very rarely breech is a sign of a problem with the baby, and RCOG says that would usually show on the 20-week scan.
Turning a breech baby with ECV
In an external cephalic version (ECV), a doctor presses on your tummy with one or both hands to help your baby roll head down. NUH does it at around 36 to 37 weeks. RCOG says it works for about 1 in 2 women, more often if you have given birth vaginally before, and fewer than 5 in 100 turned babies flip back.
It can be uncomfortable or painful, and RCOG says the doctor will stop if you are in pain. Straight after an ECV there is a 1 in 200 chance of needing an emergency caesarean, so it should be done in a hospital that can do one. ECV is not done if you need a caesarean anyway, have had recent vaginal bleeding, your waters have broken or you are carrying twins.
What about positions and home remedies? RCOG says there is no scientific evidence that lying or sitting a certain way helps a baby turn. There is some evidence for moxibustion, burning the Chinese herb mugwort at 33 to 35 weeks, under a registered practitioner.
If your baby is still breech for the birth
NUH recommends a caesarean if ECV does not work or you would rather not try it. RCOG says a planned caesarean is safer for a breech baby. The risk of the baby dying is 1 in 2000 with a planned caesarean, 4 in 2000 with a planned vaginal breech birth, and 2 in 2000 for a head-first vaginal birth. A caesarean does raise the chance of problems in later pregnancies, such as placental problems.
If you choose a vaginal breech birth, RCOG says you need a team trained in breech births in a hospital that can do an emergency caesarean, and 4 in 10 women who plan one end up having a caesarean. Induction is not usually recommended.
Our full guide, breech baby in Singapore, sets the three choices side by side and lists where to go at each hospital.
Frequently asked questions
What does breech mean?
It means your baby is positioned bottom first or feet first in the womb rather than head first. RCOG says breech is very common early in pregnancy and less common by the end.
Is a breech baby a sign that something is wrong?
Usually not. RCOG says a baby who stays breech does not usually mean you or your baby have any problems. Very rarely it points to a problem with the baby, which the 20-week scan would normally have picked up.
Does ECV hurt?
It can. RCOG says ECV can be uncomfortable and sometimes painful, that it is different for everyone, and that the doctor will stop if you are in pain. A medicine to relax your womb is often given first and improves the chance of turning.
What happens if labour starts before my planned caesarean?
RCOG says your team will examine you to check whether it is still safe to go ahead. If your baby is close to being born, a vaginal breech birth may be the safer option. Go to your delivery hospital and tell the staff your baby is breech.
Related terms
- C-section (Caesarean Section): An operation to deliver your baby through a cut in your tummy and womb, planned ahead or done in labour.
- Placenta Praevia (Low-Lying Placenta): When the placenta sits low in the womb, near or over the cervix. Most low placentas move up as pregnancy goes on.
- Induction of Labour: Starting labour with medical help, such as a pessary, balloon or drip, instead of waiting for it to begin.
- VBAC (Vaginal Birth After Caesarean): Giving birth vaginally after a caesarean in an earlier pregnancy; possible for many women, with close monitoring.
- EDD (Estimated Due Date): The date your baby is expected: 40 weeks from the first day of your last period, checked by a dating scan.
