A breech baby is positioned bottom or feet first instead of head down; it is common earlier in pregnancy, but only about 3% to 4% of babies are still breech at term.
Hearing that your baby is breech can be unsettling, especially late in the third trimester. Most babies turn on their own, and when they do not, there are well-studied options for turning the baby or planning a safe birth.
This guide covers the breech types, how common breech is week by week, causes, how it is diagnosed, external cephalic version, what the evidence says about moxibustion and exercises, birth options, what to do if labor starts, and when to call your provider.
Key Takeaways
Breech is common early: about 25% of babies at 28 weeks and 3% to 4% at term (StatPearls).
Most babies turn head down by 36 weeks; after about 37 weeks a baby usually does not turn on its own (Cleveland Clinic).
External cephalic version works in about 60% of attempts (StatPearls) and is offered around 36 to 38 weeks.
Most babies who stay breech are born by planned cesarean; ACOG says planned vaginal breech birth may be reasonable under hospital protocols.
If your water breaks or labor starts with a breech baby, call and go to the hospital right away.
Table of Contents
What Is a Breech Baby?
Quick Answer
A breech baby is positioned so the buttocks or feet would come out first instead of the head. StatPearls, an NIH clinical reference, puts breech at about 25% of babies at 28 weeks and 7% at 32 weeks, falling to 3% to 4% at term. If your baby is still breech near term, the main options are an external cephalic version (ECV) to try to turn the baby, a planned cesarean, or, for some pregnancies in some hospitals, a planned vaginal breech birth.
Cleveland Clinic calls the ideal head down position at delivery the vertex position, and notes breech usually does not affect the pregnancy itself; the risks mainly come at delivery. StatPearls defines breech as a longitudinal lie (the baby lined up with your body, not sideways) with the buttocks or lower legs entering the pelvis first.
Types of Breech Position: Frank, Complete and Footling
StatPearls uses three types: frank, complete and incomplete, with footling as a kind of incomplete breech. Cleveland Clinic lists frank, complete and footling. The descriptions match:
Type
What it looks like
Share of breech babies (one study, StatPearls)
Cord prolapse risk in a vaginal birth (StatPearls)
Frank breech
Bottom first, legs straight up in front of the body with the feet near the face (a “pike” position)
57%
About 0.5%
Complete breech
Bottom first, hips and knees bent, as if sitting cross-legged
19%
4% to 6%
Incomplete or footling breech
One or both hips straightened so one foot (footling) or both feet (double footling) would come first
18%
15% to 18%
Breech types. Sources: StatPearls, Breech Presentation (NCBI Bookshelf, NIH); Cleveland Clinic, Breech Baby. In the study StatPearls cites, 5% were of unknown type.
The type matters for birth planning. Cord prolapse, where the umbilical cord slips down ahead of the baby, is far more likely with footling breech, and StatPearls reports that footling breech was the one reason against planned vaginal breech birth shared by every national guideline in a review it cites. Cleveland Clinic also describes a transverse lie, where the baby lies sideways and a shoulder would come first; that is a different position from breech.
How Common Is Breech, and When Do Babies Turn?
Point in pregnancy
Babies in breech position
Source
28 weeks
About 25%
StatPearls (NIH)
32 weeks
About 7%
StatPearls (NIH)
36 weeks
Most babies have moved head down
Cleveland Clinic
Term (39 to 40 weeks)
About 3% to 4%
StatPearls (NIH); Cleveland Clinic
How common breech position is by stage of pregnancy.
A baby who is breech at your 33 week visit still has time to turn. Cleveland Clinic says breech is typically diagnosed around 37 weeks, and after that a baby usually does not turn on its own because there is little room left.
MedlinePlus says that if your baby is not head down after the 36th week, your provider will go over your options and their risks. Our 36 weeks pregnant guide covers what else happens at those visits.
Baby on the way? Get ahead on sleep.
Our free two-minute quiz builds a gentle, personalized sleep plan you can use from the first weeks at home.
Cleveland Clinic says breech often happens without a clear cause. Factors linked with it, per Cleveland Clinic and StatPearls:
Preterm birth: breech is simply more common earlier in pregnancy.
More than one baby: twins, triplets or more.
Amniotic fluid: too much (polyhydramnios) or too little (oligohydramnios).
The uterus: fibroids or an irregular shape, such as a uterine septum.
Placenta previa: a placenta that lies low and blocks the cervix.
Previous pregnancies: Cleveland Clinic lists a previous pregnancy; StatPearls reports about 10% recurrence in the next pregnancy after a term breech.
The baby: conditions affecting movement, including some muscular or skeletal differences (Cleveland Clinic), and congenital anomalies, chromosomal differences, growth restriction or a short cord (StatPearls).
How Do You Know if Your Baby Is Breech?
Cleveland Clinic says some people feel kicks low in the pelvis instead of under the ribs, or a hard lump near the ribs that can be the head. Those clues are not reliable alone. In the third trimester, providers check position by pressing on your abdomen to find the head, back and bottom (StatPearls calls these Leopold maneuvers), and an ultrasound confirms it.
StatPearls says the scan should record the breech type, whether the head is bent forward or tilted back, estimated weight, amniotic fluid, placenta location and the baby’s anatomy. Ask what yours showed.
External Cephalic Version (ECV)
ECV is the most common medical way to turn a breech baby, according to Cleveland Clinic. A provider presses firmly on your abdomen to rotate the baby head down. MedlinePlus says ultrasound guides the turn, the baby’s heartbeat is monitored, it may be uncomfortable, and you may get a medicine to relax the uterus. ACOG says providers should offer ECV to eligible patients as an alternative to planned cesarean, and only where cesarean services are readily available.
Question
What the sources say
When?
StatPearls: as early as 36 weeks 0 days, though many wait until 37 weeks 0 days. Cleveland Clinic: 37 to 38 weeks. MedlinePlus: success is higher at about 36 to 37 weeks, when there is usually more fluid.
Success rate?
StatPearls: about 60% of attempts. Higher if you have given birth before, lower in a first pregnancy.
Risks?
StatPearls: complications in 1% to 2% of attempts; brief heart rate dips in the baby in 4.7% to 20%, usually passing; severe complications (water breaking, cord prolapse, bleeding, placental abruption, emergency cesarean) in under 1%.
Afterward?
StatPearls: heart rate monitoring for 30 to 60 minutes, and anti-D immune globulin if you are Rh negative.
In labor?
MedlinePlus: not once active labor has started.
External cephalic version at a glance.
What helps it work. StatPearls lists a previous birth, a complete breech, a baby not yet settled into the pelvis, enough fluid and a placenta on the back wall as favorable; a first birth, a front wall placenta, low fluid, frank breech, obesity and ruptured membranes as less favorable.
Who should not have it. StatPearls says anything that rules out vaginal birth rules out ECV, including placenta previa, vasa previa, active genital herpes and a previous classical (vertical) cesarean, and it is not used before labor in a multiple pregnancy. Success is less likely and risk higher with very low fluid, concerning fetal monitoring, a head tilted far back, a significant fetal or uterine anomaly, growth restriction or maternal high blood pressure. A previous low transverse cesarean is not an automatic no: StatPearls reports success of 50% to 84%.
Afterward. A baby can turn back to breech; StatPearls mentions this without a rate. If ECV works, a vaginal birth becomes possible (Cleveland Clinic), and StatPearls says about 80% of people with a successful ECV deliver vaginally. Only 20% to 30% of eligible candidates are offered ECV, it notes, so ask whether you qualify.
Moxibustion, Exercises and Other Turning Methods
Positions and exercises: Cleveland Clinic lists bridge pose, child’s pose, all fours, music low on the belly and cold at the top with warmth at the bottom, and says there is no scientific evidence these home methods work. A Cochrane review of postural management (6 studies, 417 women) found insufficient evidence to support it: breech births and cesarean rates were similar with or without it.
Moxibustion: Cochrane describes burning a herb (Artemisia) close to the skin at an acupuncture point on the little toe. Its 2023 review (13 studies, 2,181 women) found it probably reduces the chance of a baby who is not head first at birth (moderate certainty) but probably makes little or no difference to cesarean rates. Side effects were poorly reported; in one trial, 27 of 65 women using it reported effects such as contractions, nausea, headache and burns, versus none of 57 controls.
Webster technique and acupuncture: Cleveland Clinic says these must be done by a professional your provider recommends. The sources we read gave no evidence of effectiveness.
Do not try inversions or forceful positions on your own, and check with your provider before any method. None replaces a medical plan for birth.
Breech Birth Options: Planned Cesarean vs Vaginal Breech Birth
If your baby stays breech, ACOG says the mode of delivery should consider your wishes and your provider’s experience, and that planned vaginal delivery of a single term breech baby may be reasonable under hospital-specific protocols.
Planned cesarean
Planned vaginal breech birth
Timing
No earlier than 39 weeks, with an ultrasound just before to confirm position (MedlinePlus)
Labor starts on its own, under a hospital protocol with an experienced provider (ACOG)
Who it fits
Most people whose baby stays breech; Cleveland Clinic says most providers recommend it
Selected pregnancies; guidelines commonly exclude footling breech, a head tilted far back, an estimated weight under 2 kilograms or over 3.8 to 4 kilograms (StatPearls)
Evidence
Term Breech Trial: about one third the risk of perinatal death, newborn death or serious newborn illness, with no significant difference for mothers (StatPearls)
ACOG: newborn death or serious short-term illness may be higher, and this must be part of informed consent
The research is nuanced. StatPearls reports the Term Breech Trial’s two year follow-up found no significant difference in death or neurodevelopmental delay. A 2022 meta-analysis of about 94,000 term births found higher perinatal death and injury with planned vaginal birth, but less severe maternal illness.
Why the caution? MedlinePlus explains that the head is the baby’s largest part, so when the hips come first the head can get stuck, and the cord can be squeezed, reducing oxygen. Cleveland Clinic adds that a breech cesarean can be slightly harder and sometimes needs a wider incision. It also says most children who were breech are healthy long term, and that pediatricians examine the hips after birth and recommend follow-up if needed. For recovery, see our postpartum essentials list.
With a breech baby, do not wait for a pattern. MedlinePlus says to contact your provider right away and go to the hospital, because when the water breaks the cord is more likely to slip out ahead of a breech baby, which can be very dangerous. If you are unsure whether fluid is leaking, see signs of leaking amniotic fluid and call.
Most babies who stay breech are born by cesarean (MedlinePlus). StatPearls reports ECV is sometimes tried in early labor, succeeding in 65% of early labor admissions in one national analysis, but MedlinePlus says it cannot be done once active labor starts.
Call your provider or labor and delivery any time you are unsure. With a breech baby, call right away and go to the hospital if:
Your water breaks or fluid leaks: a gush or a trickle (MedlinePlus, Cleveland Clinic).
You have contractions or severe pelvic cramping: (Cleveland Clinic), especially before your planned cesarean date.
You have vaginal bleeding: (Cleveland Clinic, CDC).
Your baby’s movement stops or slows: an urgent maternal warning sign (CDC).
The CDC’s Hear Her campaign says to seek medical care immediately for these urgent maternal warning signs, during pregnancy or in the year after birth: a headache that will not go away or gets worse; dizziness or fainting; vision changes; a fever of 100.4 F (38 C) or higher; extreme swelling of your hands or face; trouble breathing; chest pain or a fast-beating heart; severe nausea and throwing up; severe belly pain that does not go away; severe swelling, redness or pain in a leg or arm; overwhelming tiredness; or thoughts of harming yourself or your baby.
If you cannot reach your provider quickly, or a sign feels life threatening, call 911 or go to the nearest emergency room and say you are pregnant. This article is general education, not medical advice.
Frequently Asked Questions
What causes a breech baby?
Often there is no clear cause, according to Cleveland Clinic. Linked factors include preterm birth, twins or more, too much or too little amniotic fluid, fibroids or an irregularly shaped uterus, placenta previa and a previous breech birth. StatPearls also lists some conditions affecting the baby, such as growth restriction or congenital anomalies.
Can a breech baby turn on its own?
Yes, often. StatPearls reports about 25% of babies are breech at 28 weeks but only 3% to 4% at term, so most turn by themselves. Cleveland Clinic says most babies are head down by 36 weeks, and that after about 37 weeks a baby usually does not turn on its own because space is limited.
How successful is external cephalic version?
StatPearls puts the success rate at about 60% of attempts. It works more often in people who have given birth before, with enough amniotic fluid and a baby not yet settled deep in the pelvis. Overall complications occur in 1% to 2% of attempts, and the baby can sometimes turn back to breech.
Can you deliver a breech baby vaginally?
Sometimes. ACOG says planned vaginal delivery of a single term breech baby may be reasonable under hospital-specific protocols, with an experienced provider and detailed informed consent, because newborn risks may be higher than with planned cesarean. Footling breech is commonly excluded. Most babies who stay breech are delivered by planned cesarean.
How can I tell if my baby is breech?
Cleveland Clinic says you may feel kicks low in your pelvis instead of under your ribs, or a hard lump near your ribs that could be the head. These clues are not reliable alone. Your provider checks position by feeling your belly in the third trimester, and an ultrasound confirms it.
Do exercises or moxibustion turn a breech baby?
A Cochrane review found insufficient evidence that positions or exercises help, and Cleveland Clinic says home methods have no scientific evidence. A 2023 Cochrane review found moxibustion probably reduces breech at birth somewhat but probably does not change cesarean rates, and side effects were poorly reported. Ask your provider before trying anything.
Calmer days, better nights.
Betteroo builds a personalized sleep plan for your baby. Take the free two-minute quiz and have it ready before the newborn weeks.
