Presentation and position of baby through pregnancy and at birth

Presentation refers to the part of your baby's body that is facing downwards in the direction of the birth canal.

Position refers to where your baby's occiput (the bottom part of the back of their head) is in relation to your body.

If your baby is in a breech presentation, then position refers to where your baby's sacrum (lower back) is in relation to your body.

People — including medical professionals — sometimes use these terms incorrectly. Sometimes when speaking about babies in breech presentation, the word 'position' will be used to refer to their presentation. For example, you may read information or hear people say 'breech position' instead of 'breech presentation'.

Most babies present headfirst, also known as cephalic presentation. Most babies that are headfirst will be vertex presentation. This means that the crown of their head sits at the opening of your birth canal.

In rare cases, your baby can be headfirst but in face or brow presentation, which may not be suitable for vaginal birth.

If your baby is headfirst, the 3 main types of presentation are:

• anterior – when the back of your baby's head is at the front of your belly
• lateral – when the back of your baby's head is facing your side
• posterior – when the back of your baby's head is towards your back

Your doctor or midwife can usually work out your baby's presentation by feeling your abdomen. They may also double check it with a portable ultrasound. Your baby's presentation is usually checked around 36 weeks.

Your doctor or midwife will also confirm your baby's head position in labour by examining your belly and using an ultrasound, and they may also do a vaginal examination. During the vaginal examination they are feeling for certain ridges on your baby's head called sutures and fontanelles that help them work out which way your baby is positioned.

Your baby will usually be in a headfirst position by 37 weeks of pregnancy. Around 3 in every 100 babies will be in breech presentation after 37 weeks.

Your baby's position can change with your contractions during labour as they move down the birth canal, so their exact position can change during labour.

If your baby is in a breech presentation, your doctor may recommend a technique called an external cephalic version (ECV) to try and move your baby while they are still in the uterus. An ECV involves your doctor using their hands to apply pressure on your belly and help turn your baby to a headfirst position. It has a 1 in 2 chance of success and is a safe option in most pregnancies.

There is no evidence to show that alternative therapies, such as exercises, acupuncture or chiropractic treatments, help your baby change from a breech presentation to headfirst.

If your baby remains breech, your doctor may discuss having a breech vaginal birth. Not all doctors and hospitals offer this option. They may also suggest you birth your baby with a planned caesarean section.

If your baby's presentation is headfirst but the position of your baby's head is not ideal for labour, it can lead to a longer labour, and potential complications. The position of your baby's head will often change as your labour progresses. If it doesn't, sometimes you can still give birth without assistance, or you may need your doctor to help turn your baby's head or help your birth with a vacuum or forceps.

Any procedure or decision for a type of birth will only go ahead with your consent. You will be able to discuss all the options with your doctor, and based on your preferences for yourself and your baby's safety, make a decision together.

The Royal Australian and New Zealand College of Obstetrics and Gynaecology has a factsheet about the options available to you if your baby is in a breech presentation at the end of your pregnancy.

Mercy Perinatal has information on external cephalic version (ECV) safety and benefits if your baby is in a breech presentation at the end of your pregnancy.

The Women's Hospital has information about the different presentations and positions your baby could be in, and how it can affect your birthing experience.