What it is: Most babies settle into the head-down position before birth. But some babies position themselves differently. A breech baby is one whose buttocks or feet, instead of the head, are the first to present into the birth canal. A baby who's positioned buttocks down is called a frank breech; a baby who puts one or both feet forward is called a footling breech.
How common is it? Fewer than five percent of babies present in a breech position.
Who is most at risk? Breech babies are more common when the fetus is smaller than average (as would be the case with a premature baby or multiples), if the uterus is unusually shaped or contains fibroids, if there is too much or too little amniotic fluid, or if there is placenta previa. If you've had a previous breech baby you do run a somewhat higher chance of subsequent babies turning breech as well.
What are the symptoms? During your regular prenatal visits, your practitioner will feel your abdomen and uterus with his or her hands to determine your baby's position. The baby's head — which feels round and firm — will be felt toward the top of your uterus if your baby is breech. The baby's bottom — which is softer and less round than the head — will be felt lower in the uterus. The location of your baby's heartbeat will also clue you in to his or her position: If presentation is breech, the heartbeat will usually be heard in the upper half of your abdomen.
Should you be concerned? Not really — especially if you still have a while to go in your pregnancy. Most breech babies turn head-down by the last few weeks of pregnancy. If your baby stubbornly remains a breech as delivery approaches, you and your practitioner will have a frank (breech) talk about possible ways to attempt to turn your baby head-down and the best method of delivery. While vaginal delivery of a breech baby is possible, most practitioners prefer to deliver via a cesarean section instead. (Recent studies seem to indicate that a C-section is the safest method of delivery for a breech baby.)
What you can do: There's nothing you can do to prevent a breech baby, but there are things you can try to get yours to turn around. Some women, for instance, say that simple exercises such as rocking on your hands and knees with your buttocks higher than your head will help persuade your baby to turn. Many midwives recommend doing pelvic tilts or suggest you kneel on the floor on your knees (keep them slightly apart), and then bend over so that your belly almost touches the floor; you could also assume that butt-up position (use pillows if you need to) on your bed. Try to stay in this position for 20 minutes three times a day, if you can. Others recommend moxibustion, a traditional Chinese treatment that combines acupuncture and burning herbs. Or your practitioner may suggest a procedure called an external cephalic version (ECV), in which he or she tries to manipulate your baby from the outside to get it into a head-down position. This is generally done only in normal, healthy pregnancies, in a hospital under ultrasound guidance, and after 37 weeks. It's not foolproof, but the chances of success are pretty high — about two-thirds of all ECV attempts are successful. Even so, some of the initially successful versions will eventually turn back around to the breech position.