During pregnancy, as the fetus develops it moves into several positions. The one that matters the most is the position of the fetus when the labor approaches. The ideal position just before labor is the anterior position, the one in which the fetus faces the female’s back with the head pointed downward i.e towards the ground. Most fetuses settle into this position by the end of the pregnancy. This anterior position is also known as the vertex, cephalic, or occiput anterior position. There are lesser chances of complications during pregnancy with this position.
What Do Different Baby Positions in the Womb Mean?
The following are the positions a fetus might present.
- Left Occiput Anterior: This is head down and fetus facing towards the back of the pregnant female.
- Right Occiput Anterior: This position is the same as the left occiput anterior with the fetus in the womb’s right side.
- Posterior: It is a head down position with the back in line with the pregnant female’s back.
- Transverse Lie: In this, the fetus lies horizontally on the back.
- Breech: In this position, the feet point down.
The position changes throughout the pregnancy, but at the end of pregnancy, most of the fetus comes in the occiput anterior position (1).
Anterior Position
The is the best fetus position before delivery. Most fetuses get into this position before the labor begins. The fetus is in the head-down position, facing a person’s back. The fetus then tucks the head in pressing down the uterus. This encourages the cervix to open during labor. Depending on the position of the fetus in the womb, it is described as left occiput anterior or right occiput anterior.
Posterior Position
This is also known as back to back position, with the back of the fetus towards the pregnant female’s back. When in this position the fetus’s head can get difficult to tuck in, making it very difficult for the fetus through the smallest part of the pelvis.
It is known that a fetus may end up in this position when the pregnant female is mostly sitting or laying down.
As the fetus’s body is heavier than the front, a person can encourage the fetus to come to the ideal position by leaning in the direction, in which they want the fetus to move.
Transverse Lie Position
In this position, the fetus is lying horizontally in the womb. Most fetuses do not remain in this position as the time nears labor.
This position can lead to a medical emergency known as umbilical cord prolapse, which involves the umbilical cord entering the birth canal before the baby.
Breech Position
This is the feet down position, in which the fetus rests with the head up in the pregnant female’s pelvis. The breech position is of different types:
- Frank Breech: In this type, the legs of the fetus are straight up in a way that the feet are near the face
- Footling Breech: In this, position both feet of the fetus hang below the bottom. In the vaginal birth, one or both feet come out first.
- Complete Breech: In this, the fetus’s legs are crossed in a war and the feet are near the buttock.
3-4 percent of fetuses are known to be in breech position at the time of delivery. (2)
A fetus can be in a breech position due to the following reasons:
- Excess amniotic fluid
- Multiple fetuses
- Uterine fibroids
- The irregular shape of the uterus
Sometimes in the case of twin delivery, one fetus is in the anterior position while the other is in the breech position.
How is the Position of the Baby Determined?
To find the position of the baby it is best to speak with the doctor or the midwife. During the appointment, they check the abdomen of the female to look for the position of the fetus.
In the 35 or 36 weeks appointment, the doctor checks whether the fetus has reached the anterior or posterior position. If doubtful of the location, an ultrasound scan is requested.
A person can also tell, which position the fetus is developing. If the fetus is in a back-to-back or posterior position, the pregnancy bump may feel squishy. The kicks may be felt in the middle of the belly and there would be indentation around the belly button.
Anterior position fetus kicks would be felt below the ribs and the belly button may pop out.
How is the Position of the Fetus Changed?
Mostly the fetuses adopt the head-down position by the time of delivery. If at 36 weeks the position is breech the midwife or the doctor may suggest an external cephalic version. It is a procedure in which the doctor or midwife tries to turn the fetus manually. The female is given a drug that relaxes the uterus. Then by placing the hands on the outside of the belly the fetus is gently manipulated from breech to the transverse lie position and then to the anterior head position. The external cephalic version is effective in 58% of cases. (2)
There is also some anecdotal evidence for exercise and some herbal medication to be playing a role in helping change the position of the fetus.
A fetus moves through various positions during pregnancy and most of them move into the anterior position before the time of labor. If the fetus is still in the transverse or breech position before delivery, the doctor or the midwife takes suitable measures for safe delivery.
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