Your Baby’s Fetal Position and What it Can Mean for Her Birth

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As you draw near the end of the third trimester, your baby’s position will begin to take root—and possibly reshape your delivery plans.

Over the past few months you’ve felt your acrobatic bundle twist, flip and tumble inside you, but around 32-36 weeks of pregnancy, she’ll settle into a position to get ready for her grand entrance. Usually, your babe will be head down—but not always! Here are the phrases that your doctor might use to describe baby’s fetal presentation in the womb. Knowing her position will help you be better prepared for labor day possibilities.

Vertex (or cephalic) presentation

What it means: Baby’s head is going to be pushed out first, but there are more specific terms depending on which way she’s facing. The vertex presentations are further classified according to the position of the occiput (the back of baby’s head or skull), including right, left, transverse, anterior or posterior.

Occiput anterior (AKA facing downward)

What it means: Baby is headfirst and the back of her head is against your belly. Usually baby’s head will be turned slightly, so your medical care provider might add a “left” or “right” to the phrase: left occiput-anterior position (LOA); right occiput-anterior position (ROA). This may also be referred to as cephalic presentation, and is the most common and preferred position for a vaginal birth.

Occiput Posterior (AKA facing upward)

What it means: Baby is headfirst and the back of her head is closest to your back. This is another instance where your doctor can specify “left” or “right” in describing whether baby’s face is turned: left occiput-posterior position (LOP); right occiput-posterior position (ROP).

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Occiput Transverse (AKA facing sideways)

What it means: Baby is headfirst and facing toward either side of the mother’s side, halfway between a posterior and anterior position. If facing the left thigh, baby is said to be in the right occiput-transverse position (ROT); when facing the right thigh, baby is in the left occiput-transverse position (LOT).

Breech

What it means: Your babe’s head is near the top of the uterus, her rear end is facing the birth canal, and her tiny toes are pointing skyward. A breech baby will often change position and turn head-down by 36 weeks. It’s possible to birth vaginally, but a cesarean delivery is usually recommended.

Complete Breech Presentation

What it means: This presentation is the same as standard breech, except baby’s legs will be bent at the knees with her feet tucked down near her bottom.

Frank Breech

What it means: Baby’s legs are folded flat up against her head, and her rear is closest to the birth canal. This is the most common type of breech position.

Transverse Lie

What it means: Your wee one is lying sideways, horizontally across your uterus. Her back or her hands and feet will be nearest to the birth canal depending on which way she’s facing. This position (referred to as a “malposition”) is uncommon and may be caused by a number of factors, including an atypically shaped uterus or pelvis, the position of the placenta, low amniotic fluid, and a twin or multiples pregnancy.

A baby in the transverse lie position will not fit into the vaginal canal, making a safe vaginal delivery unlikely, if not impossible. Additional complications, such as umbilical cord prolapse, may also arise.

Thankfully, most babies will turn themselves to the correct position for labor. If not, your doctor might suggest an external cephalic version to help manually rotate baby from the outside using strategic pressure on baby’s head and bottom. It sounds scary, but complications are rare. If your bambino is still transverse as her birth day approaches, a C-section may be needed.

By Chantel Newton

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