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Congrats! If you’re reading this, chances are there’s a growing baby inside you — that much you’ve probably figured out. What you might still be wondering, though, is how this tenant is situated in their new digs (aka your uterus).

Are they chillin’ upside down like a pudgy little bat? Sitting crisscross applesauce? Lounging sideways?

Since there are several positions your baby can take during pregnancy, we put together this guide to help you figure out how they might be positioned and what that means for the two of you.

The position a baby takes in utero is called the fetal presentation. There are three main fetal presentations:

  • cephalic
  • breech
  • transverse

Here’s where things get fun: Within those three main presentations, there are six fetal positions babies commonly take.

Each fetal position will mean different things for your pregnancy and delivery. Babies commonly shift position throughout pregnancy, so their first trimester position may be different from the one they settle into for delivery day.

So what does each position mean, and what does each look like?

Cephalic: Occipito-anterior

The most common fetal position, and the ideal one for birthing, is called anterior or occipito-anterior. (“Occiput” is Latin for the back of the head or the skull.) This is when the baby is upside down facing your back with their chin tucked into their chest.

The anterior position is ideal for a vaginal birth, because the narrowest part of the baby’s head presses onto your cervix, helping it open for delivery. This is also the best position for the bones in baby’s head to mold so baby can travel smoothly down your birth canal.

The baby generally moves into this position by week 36 but can sometimes do so as early as weeks 18 to 20.

Cephalic: Occipito-posterior

A baby may also take the occipito-posterior position, sometimes called “sunny-side up” or “back-to-back.” Here the baby is upside down but facing forward, with their back against yours. Because the baby can’t tuck their chin down as easily when facing this way, the baby sometimes can’t travel down the pelvis as smoothly.

If a baby remains in the posterior position, your delivery may be longer and more painful and cause your back to ache. (Sorry to bring the bad news.) A baby in this position may require a cesarean delivery or delivery with help from forceps or a vacuum.

A healthcare provider may be able to manually rotate a baby during labor from a posterior position into a more optimal position for a vaginal birth.

Breech

In the breech position, your baby’s head is facing up, rather than down toward your pelvis.

There are three types of breech position:

  • Frank breech: Your baby’s butt is closest to the birth canal, and their legs are pointing up.
  • Complete breech: Your baby’s butt is closest to the birth canal, and their knees are bent (kind of like sitting cross-legged).
  • Footling breech: One or both of your baby’s feet are pointed down and closest to the birth canal.

Sometimes babies are in the breech position for most of the pregnancy but change position in the final weeks. But 3 to 4 percent of babies born at full-term stay in the breech position, which is not ideal for delivery.

Possible problems with the breech position include:

  • The cervix may not open widely enough for the baby to pass through easily.
  • The baby could become wedged against the bones of your pelvis.
  • The umbilical cord could form a loop and cut off blood supply or otherwise injure the baby during a vaginal birth.

If the baby doesn’t turn on their own and your healthcare provider can’t turn the baby manually, your provider may recommend a cesarean delivery.

Transverse

In this position, your baby is lying horizontally or sideways in your uterus, with their shoulder most likely positioned to come out first. Babies may lie this way at times, but it’s rare for them to stay in this position until the end of pregnancy.

If your baby stays in this position, your healthcare provider may try to reposition the baby manually. If that’s not possible, your provider will probably recommend a cesarean delivery.

Your healthcare provider can usually figure out your baby’s position by feeling your belly with their hands (this is called Leopold’s maneuver). If your provider is unsure, they’ll be able to see the position when you have an ultrasound.

But you may be able to figure out your baby’s position on your own.

Pay attention to the movements you feel, like firm pushes from elbows, knees, and feet or softer, tickle-y feelings from the baby’s hands. From these movements, you might get a sense of which way your baby is oriented.

If your abdomen feels firm, you might be feeling your baby’s back, which means the baby is in the anterior position. Another hint that your baby is anterior is if you feel kicks under your ribs. (Ouch.)

If your abdomen feels softer and your belly button is dipped in rather than poking out, your baby might be in the posterior position. You’ll feel kicks in the middle of your belly. You might even see them happening!

Remember, babies change position throughout pregnancy! Even if your baby is sitting breech, posterior, or transverse early on, they may settle into the anterior position before delivery.

Often, yes, you can change your baby’s position. The majority of babies will settle into the anterior position on their own by the 36th week of pregnancy. If your baby is posterior, they might also change position during labor (due to contractions).

If your baby is in the breech or transverse position, your healthcare provider may attempt an external cephalic version (ECV) after week 37, applying gentle pressure to your abdomen to encourage the baby to turn in the desired direction. Research suggests an ECV is effective about half the time.

While this method may sound simple, an ECV is not an at-home practice. It should be attempted only by trained medical professionals in a setting where a cesarean delivery can be done if complications arise.

It’s unlikely, but it’s possible that an ECV could put a baby in distress or damage the placenta. The fetal heart rate is monitored during ECVs, so your healthcare provider can watch out for emergency situations.

An ECV should be more uncomfortable than painful. However, one small study found that a pain reliever can help you if you’re experiencing pain during the procedure.

Of course, there’s lot of popular advice and folk wisdom floating around about how to turn your baby on your own by sitting or standing in various positions during pregnancy or labor. Unfortunately, there isn’t really any research to back up these ideas.

You may have heard that getting on your hands and knees during labor can help a baby turn from the posterior to the anterior position, but a 2016 study found that it didn’t make a significant difference. (However, many women say getting on your hands and knees reduces pain during labor, probably because it puts less pressure on your back.)

Some women with breech babies try other poses, like total-body inversions (lying upside down on a tilted board) or pelvic inversions (where you hold your knees up to your chest or wedge a cushion under your hips).

The little research that exists on this isn’t promising. A 2012 review of studies found that in most cases, a pregnant woman’s change in position didn’t change the baby’s position. But these methods aren’t likely to cause any adverse effects, so it wouldn’t hurt to try.

Some parents also try moxibustion, a traditional Chinese medicinal practice. This entails burning a plant called moxa (aka mugwort) over acupuncture points on the body that are said to affect the uterus. There isn’t much clinical research to support or refute its helpfulness.

It’s important to talk to your healthcare provider about any strategies you’re interested in trying during your pregnancy or delivery. They can give specific advice based on your body and condition to help you plan the safest, most comfortable birth possible.

tl;dr

  • There are four general positions babies take in the womb: anterior (head down, facing toward your back); posterior (head down, facing outward); breech (head up, legs may be in a variety of positions); and transverse (lying sideways).
  • The anterior position is ideal for giving birth safely and as comfortably as possible. The majority of babies will eventually settle into this position by the 36th week of pregnancy.
  • If your baby is not in the anterior position by week 36, your healthcare provider may attempt an ECV to gently push the baby into position from the outside.
  • Research does not support the effectiveness of any at-home methods of changing a baby’s position.
  • If your baby is still not in the anterior position when you go into labor — especially if it’s in the breech or transverse position — your healthcare provider may recommend a cesarean delivery to avoid possible complications from vaginal delivery.