At one of your prenatal visits, your provider might tell you that your baby is in a breech position, which means that he's sitting upright, with his legs folded in the lower part of your uterus, instead of in the head-down position most babies assume before delivery. Don't let this worry you. Many babies are doing somersaults up until the 36th week of pregnancy. Your baby will probably turn around on his own before your due date.
Identifying a breech baby. If your baby is still breech a few weeks from now--a diagnosis usually made by feeling your baby through your abdomen and uterus--you may have an ultrasound to confirm the baby's position. Most babies flip between weeks 34 and 37. But a small percent--about three out of every 100 full-term babies--never get around to it. Your chances of having a breech baby are higher if you previously gave birth to twins or have too much or too little amniotic fluid, a uterine abnormality like multiple fibroids, a premature delivery, or placenta previa (placenta covering the cervix).
Possible complications. A breech presentation can raise the risk of injury to your baby, especially if you go into labor early. In most vaginal births, the baby is born headfirst, and because his head is the biggest part of him, it stretches the birth canal enough that the rest of his body can slip out easily. A breech baby is born feet- or buttocks-first, and because his skinny body slides out so quickly--especially if he's premature and hasn't accumulated much fat--the birth canal hasn't stretched to accommodate his head. The head may then have trouble delivering.
Another possible complication is umbilical cord prolapse when your water breaks. In this situation the cord might slide to the bottom of the uterus and become squeezed as the baby's butt and legs move downward. The pressure on the cord cuts off your baby's supply of blood and oxygen. Many hospitals require babies in the breech position to be delivered by cesarean.
Your best bet at this point is to wait to see if your baby flips in his own sweet time. If he still hasn't turned by your 37th week, discuss your options with your provider. You may need special exercises or manual manipulation (external version) to turn your baby before labor begins.
Originally published in You & Your Baby: Pregnancy.
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