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Why Is Cephalic Presentation Ideal For Childbirth?

5 Dec 2017 | 8 min Read

During labour, contractions stretch your birth canal so that your baby has adequate room to come through during birth. The cephalic presentation is the safest and easiest way for your baby to pass through the birth canal.

If your baby is in a non-cephalic position, delivery can become more challenging. Different fetal positions pose a range of difficulties and varying risks and may not be considered ideal birthing positions.

Two Kinds of Cephalic Positions

There are two kinds of cephalic positions:

Cephalic occiput anterior , where your baby’s head is down and is facing toward your back.
Cephalic occiput posterior , where your baby is positioned head down, but they are facing your abdomen instead of your back. This position is also nicknamed ‘sunny-side-up’ and can increase the chances of prolonged and painful delivery.

How to Know if Your Baby is In a Cephalic Position?

You can feel your baby’s position by rubbing your hand on your belly. If you feel your little one’s stomach in the upper stomach, then your baby is in a cephalic position. But if you feel their kicks in the lower stomach, then it could mean that your baby is in a breech position.

You can also determine whether your baby is in the anterior or posterior cephalic position. If your baby is in the anterior position, you may feel their movement underneath your ribs and your belly button could also pop out. If your baby is in the posterior position, then you may feel their kicks in their abdomen, and your stomach may appear rounded up instead of flat.

You can also determine your baby’s position through an ultrasound scan or a physical examination at your healthcare provider’s office.

Benefits of Cephalic Presentation in Pregnancy

Cephalic presentation is one of the most ideal birth positions, and has the following benefits:

It is the safest way to give birth as your baby’s position is head-down and prevents the risk of any injuries.
It can help your baby move through the delivery canal as safely and easily as possible.
It increases the chances of smooth labour and delivery.

Are There Any Risks Involved in Cephalic Position?

Conditions like a cephalic posterior position in addition to a narrow pelvis of the mother can increase the risk of pregnancy complications during delivery. Some babies in the head-first cephalic presentation might have their heads tilted backward. This may, in some rare cases, cause preterm delivery.

What are the Risks Associated with Other Birth Positions?

A small percentage of babies may settle into a non-cephalic position before their birth. This can pose risks to both your and your baby’s health, and also influence the way in which you deliver.

In the next section, we have discussed a few positions that your baby can settle in throughout pregnancy, as they move around the uterus. But as they grow old, there will be less space for them to tumble around, and they will settle into their final position. This is when non-cephalic positions can pose a risk.

Breech Position

There are three types of breech fetal positioning:

Frank breech : Your baby’s legs stick straight up along with their feet near their head.
Footling breech: One or both of your baby’s legs are lowered over your cervix.
Complete breech: Your baby is positioned bottom-first with their knees bent.

If your baby is in a breech position , vaginal delivery is considered complicated. When a baby is born in breech position, the largest part of their body, that is, their head is delivered last. This can lead to injury or even fetal distress. Moreover, the umbilical cord may also get damaged or get wrapped around your baby’s neck, cutting off their oxygen supply.

If your baby is in a breech position, your healthcare provider may recommend a c-section, or they may try ways to flip your baby’s position in a cephalic presentation.

Transverse Lie

In this position, your baby settles in sideways across the uterus rather than being in a vertical position. They may be:

Head-down, with their back facing the birth canal
One shoulder pointing toward the birth canal
Up with their hands and feet facing the birth canal

If your baby settles in this position, then your healthcare provider may suggest a c-section to reduce the risk of distress in your baby and other pregnancy complications.

Turning Your Baby Into A Cephalic Position

External cephalic version (ECV) is a common, and non-invasive procedure that helps turn your baby into a cephalic position while they are in the womb. However, your healthcare provider may only consider this procedure if they consider you have a stable health condition in the last trimester, and if your baby hasn’t changed their position by the 36th week.

You can also try some natural remedies to change your baby’s position, such as:

Lying in a bridge position: Movements like bridge position can sometimes help move your baby into a more suitable position. Lie on your back with your feet flat on the ground and your legs bent. Raise your pelvis and hips into a bridge position and hold for 5-10 minutes. Repeat several times daily.
Chiropractic care: A chiropractor can help with the adjustment of your baby’s position and also reduce stress in them.
Acupuncture: After your doctor’s go-ahead, you can also consider acupuncture to get your baby to settle into an ideal birthing position.

While most babies settle in a cephalic presentation by the 36th week of pregnancy, some may lie in a breech or transverse position before birth. Since the cephalic position is considered the safest, your doctor may recommend certain procedures to flip your baby’s position to make your labour and delivery smooth. You may also try the natural methods that we discussed above to get your baby into a safe birthing position and prevent risks or other pregnancy complications.

When Should A Baby Be In A Cephalic Position?

Your baby would likely naturally drop into a cephalic position between weeks 37 to 40 of your pregnancy .

Is Cephalic Position Safe?

Research shows that 95% of babies take the cephalic position a few weeks or days before their due date. It is considered to be the safest position. It ensures a smooth birthing process.

While most of the babies are in cephalic position at delivery, this is not always the case. If you have a breech baby, you can discuss the available options for delivery with your doctor.

Does cephalic presentation mean labour is near?

Head-down is the ideal position for your baby within your uterus during birth. This is known as the cephalic position. This posture allows your baby to pass through the delivery canal more easily and safely.

Can babies change from cephalic to breech?

The external cephalic version (ECV) is the most frequent procedure used for turning a breech infant.

How can I keep my baby in a cephalic position?

While your baby naturally gets into this position, you can try some exercises to ensure that they settle in cephalic presentation. Exercises such as breech tilt, forward-leaning position (spinning babies program), cat and camel pose can help.

Stitches after a normal delivery : How many stitches do you need after a vaginal delivery? Tap this post to know.

Vaginal birth after caesarean delivery : Learn all about the precautions to consider before having a vaginal delivery after a c-section procedure.

How many c-sections can you have : Tap this post to know the total number of c-sections that you can safely have.

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Fetal Presentation, Position, and Lie (Including Breech Presentation)

Variations in Fetal Position and Presentation |

During pregnancy, the fetus can be positioned in many different ways inside the mother's uterus. The fetus may be head up or down or facing the mother's back or front. At first, the fetus can move around easily or shift position as the mother moves. Toward the end of the pregnancy the fetus is larger, has less room to move, and stays in one position. How the fetus is positioned has an important effect on delivery and, for certain positions, a cesarean delivery is necessary. There are medical terms that describe precisely how the fetus is positioned, and identifying the fetal position helps doctors to anticipate potential difficulties during labor and delivery.

Presentation refers to the part of the fetus’s body that leads the way out through the birth canal (called the presenting part). Usually, the head leads the way, but sometimes the buttocks (breech presentation), shoulder, or face leads the way.

Position refers to whether the fetus is facing backward (occiput anterior) or forward (occiput posterior). The occiput is a bone at the back of the baby's head. Therefore, facing backward is called occiput anterior (facing the mother’s back and facing down when the mother lies on her back). Facing forward is called occiput posterior (facing toward the mother's pubic bone and facing up when the mother lies on her back).

Lie refers to the angle of the fetus in relation to the mother and the uterus. Up-and-down (with the baby's spine parallel to mother's spine, called longitudinal) is normal, but sometimes the lie is sideways (transverse) or at an angle (oblique).

For these aspects of fetal positioning, the combination that is the most common, safest, and easiest for the mother to deliver is the following:

Head first (called vertex or cephalic presentation)

Facing backward (occiput anterior position)

Spine parallel to mother's spine (longitudinal lie)

Neck bent forward with chin tucked

Arms folded across the chest

If the fetus is in a different position, lie, or presentation, labor may be more difficult, and a normal vaginal delivery may not be possible.

Variations in fetal presentation, position, or lie may occur when

The fetus is too large for the mother's pelvis (fetopelvic disproportion).

The uterus is abnormally shaped or contains growths such as fibroids .

The fetus has a birth defect .

There is more than one fetus (multiple gestation).

cephalic presentation means boy or girl in urdu

Position and Presentation of the Fetus

Toward the end of pregnancy, the fetus moves into position for delivery. Normally, the presentation is vertex (head first), and the position is occiput anterior (facing toward the pregnant person's spine) and with the face and body angled to one side and the neck flexed.

Variations in fetal presentations include face, brow, breech, and shoulder. Occiput posterior position (facing forward, toward the mother's pubic bone) is less common than occiput anterior position (facing backward, toward the mother's spine).

Variations in Fetal Position and Presentation

Some variations in position and presentation that make delivery difficult occur frequently.

Occiput posterior position

In occiput posterior position (sometimes called sunny-side up), the fetus is head first (vertex presentation) but is facing forward (toward the mother's pubic bone—that is, facing up when the mother lies on her back). This is a very common position that is not abnormal, but it makes delivery more difficult than when the fetus is in the occiput anterior position (facing toward the mother's spine—that is facing down when the mother lies on her back).

When a fetus faces up, the neck is often straightened rather than bent,which requires more room for the head to pass through the birth canal. Delivery assisted by a vacuum device or forceps or cesarean delivery may be necessary.

Breech presentation

In breech presentation, the baby's buttocks or sometimes the feet are positioned to deliver first (before the head).

When delivered vaginally, babies that present buttocks first are more at risk of injury or even death than those that present head first.

The reason for the risks to babies in breech presentation is that the baby's hips and buttocks are not as wide as the head. Therefore, when the hips and buttocks pass through the cervix first, the passageway may not be wide enough for the head to pass through. In addition, when the head follows the buttocks, the neck may be bent slightly backwards. The neck being bent backward increases the width required for delivery as compared to when the head is angled forward with the chin tucked, which is the position that is easiest for delivery. Thus, the baby’s body may be delivered and then the head may get caught and not be able to pass through the birth canal. When the baby’s head is caught, this puts pressure on the umbilical cord in the birth canal, so that very little oxygen can reach the baby. Brain damage due to lack of oxygen is more common among breech babies than among those presenting head first.

In a first delivery, these problems may occur more frequently because a woman’s tissues have not been stretched by previous deliveries. Because of risk of injury or even death to the baby, cesarean delivery is preferred when the fetus is in breech presentation, unless the doctor is very experienced with and skilled at delivering breech babies or there is not an adequate facility or equipment to safely perform a cesarean delivery.

Breech presentation is more likely to occur in the following circumstances:

Labor starts too soon (preterm labor).

The uterus is abnormally shaped or contains abnormal growths such as fibroids .

How to get your baby in the best position for birth

Why does fetal position at birth matter?

What positions can a baby be in before delivery, what is the best position for my baby to be in for a normal delivery, why is the occipito-anterior position the best for giving birth, what does it mean if my baby is in a back-to-back (occipito-posterior) position, why are some babies in a posterior position at birth, how does an occipito-posterior position affect labour and delivery, how can i get my baby in the best position for birth, can a baby’s fetal positioning be changed once labour has started.

Throughout pregnancy, your developing baby will move into many different positions. You'll be used to him pushing, swirling, twisting, and even thumping or kicking as he moves his little limbs. Most babies settle into a head-down position by the end of pregnancy which is the ideal position for a normal delivery. But there are several other possibilities, including breech, transverse lie and oblique lie. Your baby's position in the womb at birth can affect the way you deliver. If his position isn't ideal for a vaginal delivery or if there are any complications, you'll need a c-section.

How your baby is situated in your womb at birth, is determined by the body part that's positioned to come out first, and it can affect the way you deliver. Knowing your baby's position is important as it helps your doctor plan for the kind of delivery you may need. It also helps to reduce the risk of complications during childbirth. In some cases, if your baby's position isn't ideal for a normal vaginal delivery. Some fetal positions may require you to deliver via c-section so that you and your baby stay safe. During the last trimester of your pregnancy, your doctor will check your baby's position by feeling your belly to locate the head, bottom, and back. If it's unclear, your doctor may do an ultrasound or an internal exam to feel what part of the baby is in your pelvis.

There are many ways your baby may be positioned come delivery time, such as:

Cephalic presentation (head-down) . Most babies rotate on their own and settle in a head-down position , at the time of delivery. A baby who is head-down and facing your spine is in the 'anterior position'. If your baby is head-down, and facing your belly it's known as a 'posterior position'.
Breech . A breech baby is bottom-down instead of head-down in the womb. Breech babies are difficult to deliver vaginally, so most arrive by c-section.
Transverse lie (sideways) . Transverse lie means that your baby is lying sideways across your tummy, rather than in a head-down position.
Oblique lie (diagonal) . An oblique means your baby is lying diagonally in your uterus, with his bottom facing the side of your body at an angle.

In rare cases, a baby may be in a brow presentation. Brow presentation happens when your baby's neck and head are slightly extended (deflexed), as if your baby is looking up. In such cases, the brow (forehead) or the largest part of the head will go through the pelvis first.

The best position for your baby to be in is head-down (cephalic presentation), with his face towards your spine and his back towards the front of your tummy (anterior position).

This is also known as the occipito-anterior or OA position. The occiput is the back of the head.

In the ideal head-down position, your baby fits snugly into the curve of your pelvis. During labour, your baby will curl his back over and tuck his chin into his chest. Your labour is more likely to progress smoothly if your baby is in this position, because:

The top of your baby's head puts rounded, even pressure on your cervix (the neck of your womb). During contractions , this pressure will help your cervix to widen, and your body produces the hormones you need for labour.
During the pushing stage , your baby moves through your pelvis at an angle, so that the smallest area of his head comes first. Try putting on a tight turtle neck top without tucking in your chin, and you'll understand how this works!
When your baby gets to the bottom of your pelvis, he turns his head slightly, so that the widest part of his head is in the widest part of your pelvis. The back of his head can then slip underneath your pubic bone. As he is born, his face sweeps across the area between your vagina and back passage (perineum).

All this has many benefits for you and your baby. If your baby is in an anterior position, you're more likely to:

Give birth without needing an induced labour or cesarean section .
Have a quicker and more straightforward labour and delivery.
Need less pain relief .

A back-to-back position is where your baby has his head down, with his back against your spine. This position is also known as "occipito-posterior or occiput posterior (OP) " because the back of your baby's skull (occipital bone) is in the back (posterior) of your pelvis.

Your baby may be posterior because of the type and shape of pelvis that you have. Some women have a pelvis that's narrow and oval (anthropoid pelvis) or wide and heart-shaped (an android pelvis), rather than round-shaped. If your pelvis is oval or heart-shaped, rather than round, your baby is more likely to settle in a back-to-back position at the widest part of your pelvis. This is because he can rest his head more easily in this position. How you move and sit may also play a part. When you relax on a comfortable armchair watching TV, or work at a computer for hours, your pelvis is tipped backwards. It is thought that this encourages the back of your baby's head and his spine (the heaviest part of him) to swing round to the back due to gravity. In this position, he'll end up lying against your spine. If you do a lot of upright activities, your baby is more likely to go down into your pelvis in an anterior position, because your pelvis is tipped forwards.

Most back-to-back babies are born vaginally. But this position can make labour more difficult for you, particularly if your baby's chin is pushed up, rather than tucked in. If your baby is occipito-posterior at the onset of labour:

You may have backache, as your baby's skull is pushing against your spine.
Your labour may be long and slow, with bouts of contractions starting and stopping.

Most posterior babies turn to an anterior position during labour. When your baby gets to the bottom of your pelvis, he'll need to turn through almost 180 degrees to get into the best position. This can take quite a while, or your baby may decide he's not going to turn at all, which means that he will be born with his face looking up at you as he emerges. You'll probably need an assisted birth with forceps or ventouse , to help him out.

Some experts believe that certain positions can help move your baby from a back-to-back position into an anterior position. This is known as optimal fetal positioning (OFP). Unfortunately, there isn't much evidence that OFP will help your baby to turn. Even so, many doctors and pregnant women feel it's still worth a try. Some positions can help provide relief from the back pain associated with back-to-back baby position in late pregnancy. If you're interested in OFP, these are some of the recommended positions:

Adopt a hands-and-knees position for 10 minutes, twice a day. Many women find the " cat stretch" yoga pose helpful.
Tilt your pelvis forward , rather than back, when you're sitting. Ensure your knees are always lower than your hips.
Check that your favourite chair, sofa or car seat doesn't make your bottom go down and your knees come up. If it does, sit on a cushion to lift up your bottom.
Move around if your job involves a lot of sitting, and take regular breaks.
Watch TV leaning forward over a birth ball , or sitting on the ball. If you are sitting, ensure that your hips are higher than your knees.

Learning about and trying upright labour positions and postures can also be useful. They can prepare you for labour and may help you feel more comfortable in later pregnancy. Also, getting used to doing them now will make it easier for you to find the same positions when labour starts. It's worth checking with your doctor in advance about her views on trying different birthing positions in labour. Also, find out about maternity hospital's policies and protocols about what's allowed in the labour and delivery ward. Don't worry about getting your baby into the right position when you lie down to sleep. The important thing is to focus on sleeping on your side (especially the left side) rather than your back. It is the best position for sleep in late pregnancy .

If your baby is in a posterior position when labour starts, you can still use postures and movements to try to help your baby to turn. Although there's not much evidence that it will turn your baby, it may help to relieve your pain . Posterior babies often change position during labour, and most get themselves into an anterior position by the pushing stage . Your doctor will be able to tell how your baby's lying by feeling your tummy at first.

Get plenty of rest at night .
Eat and drink regularly to keep your strength up and stay hydrated.
Try to stay relaxed and positive .

Throughout early and active labour, try to vary your positions and movements , and use whichever of the following is most comfortable for you as your labour progresses:

You may find that one of the best positions is on all fours. In this position, your baby drops away from your spine, helping to relieve backache.
Try adopting knees-to-chest positions, on your knees with your head, shoulders and upper chest on the floor or mattress and your bottom in the air.
Lean forwards during your contractions by using a birth ball, beanbag, your spouse, or the bed for support.
Rock your pelvis during contractions to help your baby turn as he passes through the pelvis. A birth ball is great for pelvic rocking.
Adopt lunge positions, either when standing on one foot, kneeling on one knee, or when you're lying on the bed. The side that is most comfortable to lunge is likely to be the side that gives your baby more room to turn.
If your hospital allows, try to walk or move every now and again. Avoid sitting in a chair, or on a bed in a leaning-back position, for too long.
Try not to have an epidural too early on in labour if you can, as epidurals may increase the chance of your baby being in a posterior position at birth. Epidurals also increase the likelihood of you having an assisted birth.

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Management of Labour and Delivery – Questions

Rekha Wuntakal, Madhavi Kalidindi, Tony Hollingworth in Get Through , 2014

For each clinical scenario below, choose the single most appropriate stage of labour from the above list of options. Each option may be used once, more than once or not at all. A 30-year-old para 3 woman was admitted at term with regular uterine activity at 5 cm cervical dilatation and 4 hours later she delivered a female neonate with APGARs 9, 10, 10 at 1, 5 and 10 minutes. Syntometrine injection was given immediately after delivery and placenta with membranes was delivered completely 20 minutes after the delivery of the baby by continuous cord traction.A 23-year-old para 3 woman was admitted after spontaneous rupture of membranes at 39 weeks’ gestation. She is contracting 4 in 10 minutes and pushing involuntarily. On vaginal examination the cervix was fully dilated, vertex was 2 cm below the spines in direct occipito-anterior position with minimal caput and moulding.A 30-year-old nulliparous woman was admitted at term with uterine contractions once in every 5 minutes. On examination, the fetus is in cephalic presentation with two fifths palpable per abdomen. The cervix is central, soft, fully effaced and 2 cm dilated with intact membranes.

Biometric Measurements and Normal Growth Parameters in a Child

Nirmal Raj Gopinathan in Clinical Orthopedic Examination of a Child , 2021

In cephalic presentation, the intra-uterine fetal position is of universal flexion, which is carried by the child to the immediate post-partum period. The hips and knees are flexed. The lower legs are internally rotated. The feet are further internally rotated with respect to the lower legs. At times there is an external rotational contracture of the hip that tends to mask the true femoral rotational profile. The anatomy of the lower limbs changes significantly as the child grows. This is primarily in response to the development of motor abilities and the ability of the child to crawl, cruise, stand, walk, and finally run. These changes are seen right from the hip joints, the femoral neck, knees, and tibia to the feet.

DRCOG MCQs for Circuit A Questions

Una F. Coales in DRCOG: Practice MCQs and OSCEs: How to Pass First Time three Complete MCQ Practice Exams (180 MCQs) Three Complete OSCE Practice Papers (60 Questions) Detailed Answers and Tips , 2020

External cephalic version: Used to convert a breech presentation to cephalic presentation.Not contraindicated if there is a prior Caesarean section scar.Can cause premature labour.Contraindicated in hypertension.Can be performed after 33 weeks' gestation in a rhesus-negative mother.

Complex maternal congenital anomalies – a rare presentation and delivery through a supra-umbilical abdominal incision

Published in Journal of Obstetrics and Gynaecology , 2018

Samantha Bonner, Yara Mohammed

She had a spontaneous conception and booked at 9 weeks of gestation under consultant-led care. A scan confirmed the pregnancy was in the right uterus. She had no other significant medical history but did suffer from recurrent urinary tract infections and hence was on low-dose antibiotic prophylaxis. There was no sonographic evidence of hydronephrosis. Her body mass index (BMI) was 18 at the time of booking. Combined screening was low risk and she had a normal 20 week anomaly scan. She had serial growth scans which demonstrated a normal growth trajectory on a customised chart. The baby was consistently a cephalic presentation. She had multidisciplinary antenatal care, including specialist urologists, general surgeons, obstetricians and anaesthetists. An antenatal MRI scan had shown extensive adhesions over the lower segment of the uterus. She was extensively counselled regarding the mode of delivery and this was scheduled at 37 weeks of gestation to avoid the potential of spontaneous labour and an emergency Caesarean section.

Utilization of epidural volume extension technique for external cephalic version

Published in Baylor University Medical Center Proceedings , 2021

Hanna Hussey, James Damron, Mark F. Powell, Michelle Tubinis

Repeat ultrasound demonstrated breech presentation, normal amniotic fluid volume, and fetal head toward the maternal left abdomen. After 0.25 mg of intramuscular terbutaline injection, a forward roll was initiated by applying pressure from behind the fetal head toward the maternal left. Continuous progress was made and bedside ultrasound showed cephalic presentation. Immediately after successful ECV, the fetal heart rate was 70 beats/min but returned to baseline with conservative measures. Motor blockade regressed after approximately 1.5 hours. After 4 hours of fetal heart rate monitoring and tocometry, the patient was deemed stable for discharge. Follow-up discussion with the patient via phone call on postprocedure day 1 confirmed that she was not experiencing pain or concerning symptoms for neuraxial complications. She returned to the labor and delivery unit at 40 weeks’ gestation for elective induction of labor and had a successful vaginal delivery.

Antenatal scoring system in predicting the success of planned vaginal birth following one previous caesarean section

Aida Kalok, Shahril A. Zabil, Muhammad Abdul Jamil, Pei Shan Lim, Mohamad Nasir Shafiee, Nirmala Kampan, Shamsul Azhar Shah, Nor Azlin Mohamed Ismail

The inclusion criteria were pregnant women at 36 weeks of gestation or more with singleton foetus in cephalic presentation, who agreed for trial of vaginal delivery after one lower segment caesarean section. We excluded women with contraindication for vaginal birth, or who declined trial of vaginal delivery from this study. Previous antenatal history was noted and recorded during the 36-week assessment, including year and indication for previous caesarean section. Recurrent indications involved were cephalopelvic disproportion and obstructed labour. While non-recurrent indications were foetal distress and malpresentation. Past operative notes were checked for any operative complications such as extended uterine tear, organ injury and post-partum haemorrhage. Information regarding current pregnancy including pre-existing medical disorder was recorded. Estimated foetal weight based on ultrasound scan at 36 weeks of gestation was used in this study.

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Which Way Is Up? What Your Baby’s Position Means For Your Delivery

by Physicians & Midwives | Feb 11, 2022 | Pregnancy

“Will I be able to have a vaginal delivery?”, “Will labor pains be more in my pelvis or back?”, and “How long will labor and delivery last?” are all questions that have probably entered your head at some point. The answers to these questions, in large part, depend on the position of your baby within your uterus at the time you go into labor. Medical professionals call this the fetal presentation and position. Let’s break down different fetal presentations and what your baby’s position could mean for your delivery.

Cephalic presentation

Almost all (95-97%) babies are delivered by cephalic presentation, where they are head-down with legs and feet at the top of the uterus. Most babies move into the head-down position by the third trimester. Cephalic presentation is further broken down by the position of the head; in the vast majority of cephalic deliveries, the crown or top of the head (called the vertex), enters the birth canal first and is the first part of the baby to be delivered. This is what we mean when we say a baby is “crowning”.

In most cases of vertex presentation, the back of the baby’s head (called the occiput) is toward the front (anterior) of the mother’s pelvis. This presentation is called occiput anterior and is considered the best position for a vaginal delivery. This position is considered best because this position typically leads to the easiest navigation of the baby through the birth canal.

Around 5% of babies are delivered in the occiput posterior position, where the back of the baby’s head is toward the mother’s backbone and tailbone. This is popularly believed to be the cause of painful “back labor”, although the scientific support for this is somewhat lacking. What is known is that the occiput posterior presentation can significantly prolong labor, and is three times more likely than occiput anterior presentation to result in cesarean section. This comes down to less ease of passage through the birth canal. Occiput posterior presentation is more common in older and first-time mothers, as well as with larger or overdue babies. Surfing the internet will provide you with many different exercises which claim to prevent occiput posterior presentation, but none of these have been scientifically proven to be of benefit.

Rarely (around 1 in every 800 births), the baby will present face-first instead of with the top of the head. Around 70% of these babies can be delivered vaginally, although the labor may be mildly prolonged. The remainder tend to be delivered by cesarean section either because the labor is not progressing or because the doctor or midwife is concerned about the baby’s heart rate. Around 5% of babies are delivered in the occiput posterior position, where the back of the baby’s head is toward the mother’s backbone and tailbone. This is popularly believed to be the cause of painful “back labor”, although the scientific support for this is somewhat lacking. What is known is that the occiput posterior presentation can significantly prolong labor, and is three times more likely than occiput anterior presentation to result in cesarean section. This comes down to less ease of passage through the birth canal. Occiput posterior presentation is more common in older and first-time mothers, as well as with larger or overdue babies. Surfing the internet will provide you with many different exercises which claim to prevent occiput posterior presentation, but none of these have been scientifically proven to be of benefit.

Breech presentation

Shoulder presentation.

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What Is Cephalic Position?

The ideal fetal position for labor and delivery

Why It's Best

Risks of Other Positions

Determining Position
Turning a Fetus

The cephalic position is when a fetus is head down when it is ready to enter the birth canal. This is one of a few variations of how a fetus can rest in the womb and is considered the ideal one for labor and delivery.

About 96% of babies are born in the cephalic position. Most settle into it between the 32nd and 36th weeks of pregnancy . Your healthcare provider will monitor the fetus's position during the last weeks of gestation to ensure this has happened by week 36.

If the fetus is not in the cephalic position at that point, the provider may try to turn it. If this doesn't work, some—but not all—practitioners will attempt to deliver vaginally, while others will recommend a Cesarean (C-section).

Getty Images

Why Is the Cephalic Position Best?

During labor, contractions dilate the cervix so the fetus has adequate room to come through the birth canal. The cephalic position is the easiest and safest way for the baby to pass through the birth canal.

If the fetus is in a noncephalic position, delivery becomes more challenging. Different fetal positions have a range of difficulties and varying risks.

A small percentage of babies present in noncephalic positions. This can pose risks both to the fetus and the mother, and make labor and delivery more challenging. It can also influence the way in which someone can deliver.

A fetus may actually find itself in any of these positions throughout pregnancy, as the move about the uterus. But as they grow, there will be less room to tumble around and they will settle into a final position.

It is at this point that noncephalic positions can pose significant risks.

Cephalic Posterior

A fetus may also present in an occiput or cephalic posterior position. This means they are positioned head down, but they are facing the abdomen instead of the back.

This position is also nicknamed "sunny-side up."

Presenting this way increases the chance of a painful and prolonged delivery.

There are three different types of breech fetal positioning:

Frank breech: The legs are up with the feet near the head.
Footling breech: One or both legs is lowered over the cervix.
Complete breech: The fetus is bottom-first with knees bent.

A vaginal delivery is most times a safe way to deliver. But with breech positions, a vaginal delivery can be complicated.

When a baby is born in the breech position, the largest part—its head—is delivered last. This can result in them getting stuck in the birth canal (entrapped). This can cause injury or death.

The umbilical cord may also be damaged or slide down into the mouth of the womb, which can reduce or cut off the baby's oxygen supply.

Some providers are still comfortable performing a vaginal birth as long as the fetus is doing well. But breech is always a riskier delivery position compared with the cephalic position, and most cases require a C-section.

Likelihood of a Breech Baby

You are more likely to have a breech baby if you:

Go into early labor before you're full term
Have an abnormally shaped uterus, fibroids , or too much amniotic fluid
Are pregnant with multiples
Have placenta previa (when the placenta covers the cervix)

Transverse Lie

In transverse lie position, the fetus is presenting sideways across the uterus rather than vertically. They may be:

Down, with the back facing the birth canal
With one shoulder pointing toward the birth canal
Up, with the hands and feet facing the birth canal

If a transverse lie is not corrected before labor, a C-section will be required. This is typically the case.

Determining Fetal Position

Your healthcare provider can determine if your baby is in cephalic presentation by performing a physical exam and ultrasound.

In the final weeks of pregnancy, your healthcare provider will feel your lower abdomen with their hands to assess the positioning of the baby. This includes where the head, back, and buttocks lie

If your healthcare provider senses that the fetus is in a breech position, they can use ultrasound to confirm their suspicion.

Turning a Fetus So They Are in Cephalic Position

External cephalic version (ECV) is a common, noninvasive procedure to turn a breech baby into cephalic position while it's still in the uterus.

This is only considered if a healthcare provider monitors presentation progress in the last trimester and notices that a fetus is maintaining a noncephalic position as your delivery date approaches.

External Cephalic Version (ECV)

ECV involves the healthcare provider applying pressure to your stomach to turn the fetus from the outside. They will attempt to rotate the head forward or backward and lift the buttocks in an upward position. Sometimes, they use ultrasound to help guide the process.

The best time to perform ECV is about 37 weeks of pregnancy. Afterward, the fetal heart rate will be monitored to make sure it’s within normal levels. You should be able to go home after having ECV done.

ECV has a 50% to 60% success rate. However, even if it does work, there is still a chance the fetus will return to the breech position before birth.

Natural Methods For Turning a Fetus

There are also natural methods that can help turn a fetus into cephalic position. There is no medical research that confirms their efficacy, however.

Changing your position: Sometimes a fetus will move when you get into certain positions. Two specific movements that your provider may recommend include: Getting on your hands and knees and gently rocking back and forth. Another you could try is pushing your hips up in the air while laying on your back with your knees bent and feet flat on the floor (bridge pose).
Playing stimulating sounds: Fetuses gravitate to sound. You may be successful at luring a fetus out of breech position by playing music or a recording of your voice near your lower abdomen.
Chiropractic care: A chiropractor can try the Webster technique. This is a specific chiropractic analysis and adjustment which enables chiropractors to establish balance in the pregnant person's pelvis and reduce undue stress to the uterus and supporting ligaments.
Acupuncture: This is a considerably safe way someone can try to turn a fetus. Some practitioners incorporate moxibustion—the burning of dried mugwort on certain areas of the body—because they believe it will enhance the chances of success.

A Word From Verywell

While most babies are born in cephalic position at delivery, this is not always the case. And while some fetuses can be turned, others may be more stubborn.

This may affect your labor and delivery wishes. Try to remember that having a healthy baby, and staying well yourself, are your ultimate priorities. That may mean diverting from your best laid plans.

Speaking to your healthcare provider about turning options and the safest route of delivery may help you adjust to this twist and feel better about how you will move ahead.

Glezerman M. Planned vaginal breech delivery: current status and the need to reconsider . Expert Rev Obstet Gynecol. 2012;7(2):159-166. doi:10.1586/eog.12.2

Cleveland Clinic. Fetal positions for birth .

MedlinePlus. Breech birth .

UT Southwestern Medical Center. Can you turn a breech baby around?

The American College of Obstetricians and Gynecologists. If your baby is breech .

Roecker CB. Breech repositioning unresponsive to Webster technique: coexistence of oligohydramnios . Journal of Chiropractic Medicine . 2013;12(2):74-78. doi:10.1016/j.jcm.2013.06.003

By Cherie Berkley, MS Berkley is a journalist with a certification in global health from Johns Hopkins University and a master's degree in journalism.

Vishal's account
Prenatal Care

Fetal Cephalic Presentation During Pregnancy

What Is Cephalic Position?

Types of cephalic position, benefits of cephalic presentation, risks of cephalic position, what are some other positions and their associated risks, when does a foetus get into the cephalic position, how do you know if baby is in cephalic position, how to turn a breech baby into cephalic position, natural ways to turn a baby into cephalic position.

If your baby is moving around in the womb, it’s a good sign as it tells you that your baby is developing just fine. A baby starts moving around in the belly at around 14 weeks. And their first movements are usually called ‘ quickening’ or ‘fluttering’.

A baby can settle into many different positions throughout the pregnancy, and it’s alright. But it is only when you have reached your third and final trimester that the position of your baby in your womb will matter the most. The position that your baby takes at the end of the gestation period will most likely be how your baby will make its appearance in the world. Out of all the different positions that your baby can settle into, the cephalic position at 36 weeks is considered the best position. Read on to learn more about fetal cephalic presentation.

When it comes to cephalic presentation meaning, the following can be considered. A baby is in the cephalic position when he is in a head-down position. This is the best position for them to come out in. In case of a ‘cephalic presentation’, the chances of a smooth delivery are higher. This position is where your baby’s head has positioned itself close to the birth canal, and the feet and bottom are up. This is the best position for your baby to be in for safe and healthy delivery.

Your doctor will begin to keep an eye on the position of your baby at around 34 weeks to 36 weeks . The closer you get to your due date, the more important it is that your baby takes the cephalic position. If your baby is not in this position, your doctor will try gentle nudges to get your baby in the right position.

Though it is pretty straightforward, the cephalic position actually has two types, which are explained below:

1. Cephalic Occiput Anterior

Most babies settle in this position. Out of all the babies who settle in the cephalic position, 95% of them will settle this way. This is when a baby is in the head-down position but is facing the mother’s back. This is the preferred position as the baby is able to slide out more easily than in any other position.

2. Cephalic Occiput Posterior

In this position, the baby is in the head-down position but the baby’s face is turned towards the mother’s belly. This type of cephalic presentation is not the best position for delivery as the baby’s head could get stuck owing to its wide position. Almost 5% of the babies in cephalic presentation settle into this position. Babies who come out in this position are said to come out ‘sunny side up’.

Cephalic presentation, where the baby’s head is positioned down towards the birth canal, is the most common and optimal fetal presentation for childbirth. This positioning facilitates a smoother delivery process for both the mother and the baby. Here are several benefits associated with cephalic presentation:

1. Reduced risk of complications

Cephalic presentation decreases the likelihood of complications during labor and delivery , such as umbilical cord prolapse or shoulder dystocia, which can occur with other presentations.

2. Easier vaginal delivery

With the baby’s head positioned first, vaginal delivery is generally easier and less complicated compared to other presentations, resulting in a smoother labor process for the mother.

3. Lower risk of birth injuries

Cephalic presentation reduces the risk of birth injuries to the baby, such as head trauma or brachial plexus injuries, which may occur with other presentations, particularly breech or transverse positions.

4. Faster progression of labor

Babies in cephalic presentation often help to stimulate labor progression more effectively through their positioning, potentially shortening the duration of labor and reducing the need for medical interventions.

5. Better fetal oxygenation

Cephalic presentation typically allows for optimal positioning of the baby’s head, which facilitates adequate blood flow and oxygenation, contributing to the baby’s well-being during labor and delivery.

Factors such as the cephalic posterior position of the baby and a narrow maternal pelvis can increase the likelihood of complications during childbirth. Occasionally, infants in the cephalic presentation may exhibit a backward tilt of their heads, potentially leading to preterm delivery in rare instances.

In addition to cephalic presentation, there are several other fetal positions that can occur during pregnancy and childbirth, each with its own associated risks. These positions can impact the delivery process and may require different management strategies. Here are two common fetal positions and their associated risks:

1. Breech Presentation

Babies in breech presentation, where the buttocks or feet are positioned to enter the birth canal first, are at higher risk of birth injuries such as hip dysplasia or brachial plexus injuries.
Breech presentation can lead to complications during labor and delivery, including umbilical cord prolapse, entrapment of the head, or difficulty delivering the shoulders, necessitating interventions such as cesarean section.

2. Transverse Lie Presentation

Transverse lie , where the baby is positioned sideways across the uterus, often leads to prolonged labor and increases the likelihood of cesarean section due to difficulties in the baby’s descent through the birth canal.
The transverse position of the baby may result in compression of the umbilical cord during labor, leading to decreased oxygen supply and potential fetal distress. This situation requires careful monitoring and intervention to ensure the baby’s well-being.

When a foetus is moving into the cephalic position, it is known as ‘head engagement’. The baby stars getting into this position in the third trimester, between the 32nd and the 36th weeks, to be precise. When the head engagement begins, the foetus starts moving down into the pelvic canal. At this stage, very little of the baby is felt in the abdomen, but more is felt moving downward into the pelvic canal in preparation for birth.

Fetal Cephalic Position During Pregnancy

You may think that in order to find out if your baby has a cephalic presentation, an ultrasound is your only option. This is not always the case. You can actually find out the position of your baby just by touching and feeling their movements.

By rubbing your hand on your belly, you might be able to feel their position. If your baby is in the cephalic position, you might feel their kicks in the upper stomach. Whereas, if the baby is in the breech position, you might feel their kicks in the lower stomach.

Even in the cephalic position, it may be possible to tell if your baby is in the anterior position or in the posterior position. When your baby is in the anterior position, they may be facing your back. You may be able to feel your baby move underneath your ribs. It is likely that your belly button will also pop out.

When your baby is in the posterior position, you will usually feel your baby start to kick you in your stomach. When your baby has its back pressed up against your back, your stomach may not look rounded out, but flat instead.

Mothers whose placentas have attached in the front, something known as anterior placenta , you may not be able to feel the movements of your baby as well as you might like to.

Breech babies can make things complicated. Both the mother and the baby will face some problems. A breech baby is positioned head-up and bottom down. In order to deliver the baby, the birth canal needs to open a lot wider than it has to in the cephalic position. Besides this, your baby can get an arm or leg entangled while coming out.

If your baby is in the breech position, there are some things that you can do to encourage the baby to get into the cephalic position. There are a few exercises that could help such as pelvic tilts , swimming , spending a bit of time upside down, and belly dancing are a few ways you can try yourself to get your baby into the head-down position .

If this is not working either, your doctor will try an ECV (External Cephalic Version) . Here, your doctor will be hands-on, applying some gentle, but firm pressure to your tummy. In order to reach a cephalic position, the baby will need to be rolled into a bottom’s up position. This technique is successful around 50% of the time. When this happens, you will be able to have a normal vaginal delivery.

Though it sounds simple enough to get the fetal presentation into cephalic, there are some risks involved with ECV. If your doctor notices your baby’s heart rate starts to become problematic, the doctor will stop the procedure right away.

Encouraging a baby to move into the cephalic position, where the head is down towards the birth canal, is often desirable for smoother labor and delivery. While medical interventions may be necessary in some cases, there are natural methods that pregnant individuals can try to help facilitate this positioning. Here are several techniques that may help turn a baby into the cephalic position:

1. Optimal Maternal Positioning

Maintaining positions such as kneeling, hands and knees, or pelvic tilts may encourage the baby to move into the cephalic position by utilizing gravity and reducing pressure on the pelvis.

2. Spinning Babies Techniques

Specific exercises and positions recommended by the Spinning Babies organization, such as Forward-Leaning Inversion or the Sidelying Release, aim to promote optimal fetal positioning and may help encourage the baby to turn cephalic.

3. Chiropractic Care or Acupuncture

Some individuals find that chiropractic adjustments or acupuncture sessions with qualified practitioners can help address pelvic misalignment or relax tight muscles, potentially creating more space for the baby to maneuver into the cephalic position.

4. Prenatal Yoga and Swimming

Engaging in gentle exercises like prenatal yoga or swimming may help promote relaxation, reduce stress on the uterine ligaments, and encourage the baby to move into the cephalic position naturally. These activities also support overall physical and mental well-being during pregnancy.

1. What factors influence whether my baby will be in cephalic presentation?

Several factors can influence your baby’s position during pregnancy, including the shape and size of your uterus, the strength of your abdominal muscles, the amount of amniotic fluid, and the position of the placenta . Additionally, your baby’s own movements and preferences play a role.

2. Is it necessary for my baby to be in cephalic presentation for a vaginal delivery?

While cephalic presentation is considered the optimal position for vaginal delivery, some babies born in non-cephalic presentations can still be safely delivered vaginally with the guidance of a skilled healthcare provider. However, certain non-cephalic presentations may increase the likelihood of needing a cesarean section.

3. What can I do to encourage my baby to stay in the cephalic presentation?

Maintaining good posture, avoiding positions that encourage the baby to settle into a breech or transverse lie, staying active with gentle exercises, and avoiding excessive reclining can all help encourage your baby to remain in the cephalic presentation. Additionally, discussing any concerns with your healthcare provider and following their recommendations can be beneficial.

This was all about fetus with cephalic presentation. Most babies get into the cephalic position on their own. This is the most ideal situation as there will be little to no complications during normal vaginal labour. There are different cephalic positions, but these should not cause a lot of issues. If your baby is in any position other than cephalic in pregnancy, you may need C-Section . Keep yourself updated on the smallest of progress during your pregnancy so that you are aware of everything that is going on. Go for regular check-ups as your doctor will be able to help you if a complication arises during acephalic presentation at 20, 28 and 30 weeks.

References/Resources:

1. Glezerman. M; Planned vaginal breech delivery: current status and the need to reconsider (Expert Review of Obstetrics & Gynecology); Taylor & Francis Online; https://www.tandfonline.com/doi/full/10.1586/eog.12.2 ; January 2014

2. Feeling your baby move during pregnancy; UT Southwestern Medical Center; https://utswmed.org/medblog/fetal-movements/

3. Fetal presentation before birth; Mayo Clinic; https://www.mayoclinic.org/healthy-lifestyle/pregnancy-week-by-week/in-depth/fetal-positions/art-20546850

4. Fetal Positions; Cleveland Clinic; https://my.clevelandclinic.org/health/articles/9677-fetal-positions-for-birth

5. FAQs: If Your Baby Is Breech; American College of Obstetricians and Gynecologists; https://www.acog.org/womens-health/faqs/if-your-baby-is-breech

6. Roecker. C; Breech repositioning unresponsive to Webster technique: coexistence of oligohydramnios (Journal of Chiropractic Medicine); Science Direct; https://www.sciencedirect.com/science/article/abs/pii/S1556370713000588 ; June 2013

7. Presentation and position of baby through pregnancy and at birth; Pregnancy, Birth & Baby; https://www.pregnancybirthbaby.org.au/presentation-and-position-of-baby-through-pregnancy-and-at-birth

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What Is a Posterior Placenta?

Posterior placenta is one position of the placenta. Here’s everything you need to know about how it impacts pregnancy and delivery.

What Does Posterior Placenta Mean?

How does posterior placenta affect delivery, how do i know i have a posterior placenta, can there be posterior placenta complications, what are posterior placenta benefits, can a posterior placenta indicate the baby’s sex, when to seek medical help.

Jose Luis Pelaez Inc/Getty Images

The placenta is considered the baby’s lifeline, so it’s little wonder close medical attention is paid to this vital organ. During pregnancy, the placenta provides nutrients and oxygen from your body to your fetus via the umbilical cord.

But did you know the position of the placenta can reveal critical insights into the health of your pregnancy? Many pregnant people will be told they have a posterior placenta, but what does this mean for you and your fetus?

Posterior placentas are common, but given the importance of placement, it’s helpful to know how this may affect your pregnancy. Experts weigh in on all you need to know.

Shortly after conception, the placenta attaches itself within the uterus in one of four main positions. One of the locations is posterior, which simply means the placenta has implanted on the back of your uterus, closest to your spine. Generally speaking, a posterior placenta won’t negatively impact your pregnancy and it’s unlikely to complicate labor or delivery.

“Posterior placenta is for the most part a normal variation and of little to no clinical consequence,” explains Robert M. Silver , MD, a professor of obstetrics and gynecology at the University of Utah Health Sciences Center.

Other placental positions include:

Anterior: at the front of your uterus, closest to your abdomen
Fundal: at the top of your uterus
Lateral: on the left or right side of your uterus
Low-lying: located toward the bottom of your uterus, potentially obstructing the cervix

What To Know About the Placenta

The placenta is a temporary organ created to support your fetus during pregnancy. Along with providing nutrients and oxygen to your little one, the placenta removes waste and carbon dioxide while producing the necessary hormones to help your fetus grow.

A posterior placenta is normal and both vaginal and C-section births are usually considered safe in this scenario.

There are no major medical concerns or risks with a posterior placenta by itself, explains Karin A. Fox , MD, MEd, FACOG, FAIUM, an associate professor, fellowship director, and clinical director of Baylor College of Medicine's Maternal-Fetal Medicine Division.

“We get more concerned if the placenta is low-lying or ‘previa,’ where the placenta covers the inner portion of the cervix," she says. If you have placenta previa , a C-section is usually recommended–whether posterior or otherwise. However, the edge of the placenta can move safely away from the cervix later in pregnancy and reduce any risks.

Your sonographer will be able to tell you the location of your placenta at your anatomy scan , usually between 18-22 weeks. For many, this might be the only time you hear about the position of your placenta, unless it’s combined with other factors.

While having a posterior placenta is unlikely to pose any risks to you or the fetus itself, there are some conditions where knowing the exact location of your placenta will be crucial. This is why sonographers carefully study the position of the placenta when you get your routine scans.

One serious medical condition that may affect the placenta wherever it’s implanted is placenta accreta spectrum, an area Dr. Fox is well versed in as the lead of Baylor College of Medicine’s placenta accreta spectrum care team. When this happens, the placenta doesn’t spontaneously detach after the baby is delivered and, in severe cases, can lead to life-threatening bleeding. Although it is most common when the placenta is low, anterior, and in the region of a uterine scar from a prior surgical procedure, those with posterior placentas can also be affected.

“When a placenta is posterior and placenta accreta is present, it can be more difficult to identify on ultrasound because it is more difficult to see the entire placenta with the baby in front of it,” explains Dr. Fox. “For this reason, anyone who has risk factors for placenta accreta spectrum should have their sonogram performed by experts and may require delivery in a referral center with a specialized team.”

Dr. Silver agrees that occasionally a posterior placenta can make prenatal diagnosis of placental problems slightly more challenging. But he says most of these conditions can still be reliably diagnosed using transvaginal ultrasound, if necessary.

Pregnant people with posterior placentas may enjoy some benefits that others with placentas in different positions won’t.

“Some people report that they are more able to feel baby's movements and kicks when the placenta is posterior because there is just a bit less between baby and mom's abdomen when the placenta is behind the baby,” says Dr. Fox.

Posterior placenta can also make it easier to perform an external cephalic version, or a procedure to turn the baby from breech to ‘head down’ to allow for a vaginal delivery.

Plus, posterior placenta may slightly increase the success and decrease the risk of certain procedures, explains Dr. Silver. “In cases of placenta previa or low-lying placenta, the cesarean delivery is slightly easier and prone to less blood loss if the placenta is posterior. However, these benefits are minor and uncommon,” he says.

While one study shows posterior placentas could be associated with preterm labor, others suggest that it’s less risky overall compared to other placental positions. For example, a study found posterior placentas result in less adverse pregnancy, delivery, and infant outcomes than fundal and lateral locations. Meanwhile another study investigating prenatal hemorrhage in patients with placenta previa cited anterior positions–not posterior–as a notable risk factor.

Some studies have tried to find evidence between the location of the placenta and sex. Generally, these reports are disputed with one study suggesting there is no correlation at all. The best way to discover the sex of your baby is by ultrasound.

Physical symptoms are unlikely to indicate where your placenta is located and whether there is anything wrong. Instead, any symptoms relating to your placenta are likely to be more general, such as vaginal bleeding or pain, and these should always be investigated.

“Vaginal bleeding may be associated with placental problems–regardless of whether it is posterior, anterior, fundal, or lateral–and should prompt contact with a medical provider,” advises Dr. Silver.

The Bottom Line

Without any physical symptoms or suspicions on an ultrasound, it’s safe to assume that your posterior placenta is a variation of normal and unlikely to cause you any trouble. But if you have any concerns regarding fetal movement or if any abdominal pain, bleeding, or severe back pain is present, contact your health care provider.

Placental location and pregnancy outcome . J Turk Ger Gynecol Assoc. 2013

Placental location and pregnancy outcomes in nulliparous women: A population-based cohort study . AOGS . 2019

Maternal and Neonatal Outcomes Resulting from Antepartum Hemorrhage in Women with Placenta Previa and Its Associated Risk Factors: A Single-Center Retrospective Study . Ther Clin Risk Manag . 2021

Fetal gender screening based on placental location by 2-dimentional ul-trasonography . TUMJ . 2014

The role of placental location assessment in the prediction of fetal gender . Ultrasound in Obstetrics & Gynecology . 2010

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Geburtshilfe Frauenheilkd
v.76(3); 2016 Mar

Language: English | German

Foetal Gender and Obstetric Outcome

Fetales geschlecht und geburtshilfliches outcome, b. schildberger.

1 FH Gesundheitsberufe OÖ, Linz, Österreich

2 Institut für klinische Epidemiologie der Tirol Kliniken, Innsbruck, Österreich

Associated Data

Introduction: Data on specific characteristics based on the gender of the unborn baby and their significance for obstetrics are limited. The aim of this study is to analyse selected parameters of obstetric relevance in the phases pregnancy, birth and postpartum period in dependence on the gender of the foetus. Materials and Methods: The selected study method comprised a retrospective data acquisition and evaluation from the Austrian birth register of the Department of Clinical Epidemiology of Tyrolean State Hospitals. For the analysis all inpatient singleton deliveries in Austria during the period from 2008 to 2013 were taken into account (live and stillbirths n = 444 685). The gender of the baby was correlated with previously defined, obstetrically relevant parameters. Results: In proportions, significantly more premature births and sub partu medical interventions (vaginal and abdominal surgical deliveries. episiotomies) were observed for male foetuses (p < 0.001). The neonatal outcome (5-min Apgar score, umbilical pH value less than 7.1, transfer to a neonatal special unit) is significantly poorer for boys (p < 0.001). Discussion: In view of the vulnerability of male foetuses and infants, further research is needed in order to be able to react appropriately to the differing gender-specific requirements in obstetrics.

Zusammenfassung

Einleitung: Die Studienlage über die vom Geschlecht des ungeborenen Kindes ausgehenden Spezifika und deren Bedeutung in der Geburtshilfe ist limitiert. Ziel der Arbeit ist, anhand ausgewählter, geburtshilflich relevanter Parameter die Phasen Schwangerschaft, Geburt und Wochenbett in Abhängigkeit zum fetalen Geschlecht zu analysieren. Material und Methoden: Als Methode wurde eine retrospektive Datenerhebung und -auswertung aus dem Geburtenregister Österreich des Instituts für klinische Epidemiologie der Tirol Kliniken gewählt. Zur Analyse wurden alle stationären Einlingsgeburten in Österreich im Zeitraum von 2008–2013 (Lebend- und Totgeburten n = 444 685) herangezogen. Das Geschlecht des Kindes wurde mit vorab definierten, geburtshilflich relevanten Variablen in Beziehung gesetzt. Ergebnisse: Im Verhältnis sind bei männlichen Feten signifikant mehr Frühgeburten und medizinische Interventionen sub partu (vaginal und abdominal operativer Entbindungsmodus, Episiotomie) zu verzeichnen (p < 0,001). Das neonatale Outcome (5-min-Apgar-Wert, Na-pH-Wert unter 7,1, Verlegung auf neonatologische Abteilung) ist bei Knaben signifikant schlechter (p < 0,001). Diskussion: Im Hinblick auf die Vulnerabilität von männlichen Feten und Neugeborenen ist weitere Forschung notwendig, um in der Geburtshilfe den geschlechtsspezifisch unterschiedlichen Bedarfen entsprechend agieren zu können.

Introduction

The available studies on foetal gender as a specific influencing variable during pregnancy and birth are limited. In comparison our knowledge on the progress of infantile growth is relatively certain. In 280 days the unborn baby achieves a length of ca. 50 centimetres, whereby infant boys have on average a body length 1 centimetre and a head circumference of ca. 5 millimetres more than infant girls. At all times during pregnancy female foetuses have larger length-weight and head circumference-weight ratios than males. Already in the second trimester girls exhibit a shorter femur length and a smaller biparietal head diameter. Although girls show a lower intrauterine growth in comparison to boys they exhibit an accelerated maturation of about 4–6 weeks 1 .

Various studies have shown that placental dysfunctions, especially severe pre-eclampsia and intrauterine growth retardation, occur significantly more frequently in pregnancies involving a male foetus. The placentas of male foetuses exhibit significantly higher rates of deciduitis and velamentous navel insertions as well as a significantly lower incidence of placental infarction than the placenta of female foetuses 2 , 3 , 4 , 5 , 6 .

In the mothers of male infants, in comparison to the mothers of female babies, higher incidences of premature rupture of membranes and premature births can be observed 7 . The rates of gestational diabetes mellitus, macrosomia, protracted opening and expulsion phases, umbilical cord prolapses, umbilical cord looping and genuine umbilical cord knots are significantly elevated. Furthermore, male babies are more frequently delivered by Caesarean section than female babies 7 , 8 , 9 .

Also, the rates of vaginal surgical deliveries are higher, and the indication for birth completion is more frequently given with the diagnosis of “threatening intrauterine asphyxia” in the case of male babies. The rate of sonographically diagnosed growth retardation, however, is higher for female infants 10 .

Several studies have recognised male gender as being a risk factor during pregnancy and birth. The biological mechanisms of this gender-specific difference are, however, still virtually unknown even though various theories discuss the influence of hormonal, physiological or genetic factors 8 , 11 , 12 , 13 , 14 .

Although new management strategies have led to better and better therapeutic results for very preterm infants, boys still exhibit higher mortality and morbidity than girls. For boys in the group of very preterm infants significant differences can be seen in the criteria higher birth weight, oxygen dependency, hospital stay, pulmonary bleeding, treatment with steroids, skull anomalies and mortality. These differences also remain significant in the subsequent course. The authors conclude that male gender per se represents a risk factor for the poor general condition of very premature babies as well as for their poorer developmental course 15 , 16 , 17 .

The accelerated maturation for girls is well known and, in the neonatal period and infancy, results in girls having a markedly greater ability to form a primary relationship, being emotional stable, easier to calm down and being less restless. The perception of social and other interactions starts earlier in girls. In boys, on the other hand, the early ability to form relationships and coping strategies, for example, in cases of pain and discomfort are influenced by the greater restlessness, the delayed development of sleep rhythm and the vulnerability. “In unfavourable circumstances this leads to a higher degree of psychophysical stress in the male child” 18 .

The consideration of gender-specific components already in the perinatal phase should, in the sense of the aims of gender medicine, help to optimise the preventative, diagnostic, therapeutic and rehabilitation processes of general and health care from the very beginning “to act as an important step and bridge towards personalised medicine” 19 .

The aim of this study is to consider with the help of selected obstetrically relevant parameters the phases pregnancy, birth and postpartum period in relation to foetal gender. On the basis of the above-mentioned considerations, we posed the following guiding question for our research: what influence does foetal gender have on selected obstetric parameters?

Materials and Methods

For this publication we have obtained a positive vote from the Ethics Commission of Upper Austria and permission for the data analysis from the board of the Austrian birth register at the Department of Clinical Epidemiology of Tyrolean State Hospitals in Innsbruck.

We have decided upon a retrospective data acquisition and evaluation from the Austrian birth register as method for this study. The Austrian birth register contains the results of all births occurring in hospitals in Austria since 2008 in an epidemiological data base.

Samples and variables

For the analysis, all inpatient singleton births in Austria in the period from 2008 to 2013 (n = 444 685 live births) were included. The gender of the baby was correlated with the following, previously defined and obstetrically relevant variables: parity, duration of pregnancy, birth weight, tocolysis, position of the baby at birth, drug-induced labour, micro blood gas analysis sub partu, peridural or spinal anaesthesia, delivery mode, delivery position, duration of delivery, performance of episiotomy, perineal trauma, 5-min Apgar score, umbilical cord pH, disorder of placenta separation, transfer of the infant post partum to neonatal department, perinatal mortality.

The parameters duration of delivery, episiotomy, 5-min Apgar score, umbilical cord pH under 7.1 and transfer of the baby to a neonatal department were additionally analysed with the specific sample “live birth at term” (gestational weeks 36 + 6–42 + 0) (n = 411 380), in order to enable a differentiated presentation of the results.

Statistical evaluation

The χ2 test was used for the statistical evaluation and presentation of the results. As a consequence of the large sample size statistically significant results are possible already for small differences and have to be considered for their clinical relevance.

Among the total number of all inpatient live births from singleton pregnancies in Austria in the period 2008–2013 (n = 444 685) 51.5 % were boys and 48.5 % were girls ( Table 1 ).

Table 1 Representation of the proportions of boys and girls arranged according to the obstetric parameters. The influence of the foetal gender on selected obstetric parameters.

Obstetric parameter	Gender of the infant
	male	female	total

	229 014 (51.5 %)	215 671 (48.5 %)	444 685 (100.0 %)

	112 365 (51.6 %)	105 603 (48.4 %)	217 968 (100.0 %)
	78 316 (51.4 %)	73 994 (48.6 %)	152 310 (100.0 %)
	26 793 (51.4 %)	25 300 (48.6 %)	52 093 (100.0 %)
	7 766 (51.7 %)	7 255 (48.3 %)	15 021 (100.0 %)
	2 422 (51.8 %)	2 253 (48.2 %)	4 675 (100.0 %)
	786 (50.1 %)	782 (49.9 %)	1 568 (100.0 %)
	311 (56.0 %)	244 (44.0 %)	555 (100.0 %)
Pearson χ (6) = 6.8979 Pr = 0.330

	789 (55.1 %)	644 (44.9 %)	1 433 (100.0 %)
	1 413 (56.3 %)	1 099 (43.8 %)	2 512 (100.0 %)
	13 766 (55.2 %)	11 153 (44.8 %)	24 919 (100.0 %)
	210 710 (51.2 %)	200 670 (48.8 %)	411 380 (100.0 %)
	1 546 (53.4 %)	1 347 (46.6 %)	2 893 (100.0 %)
Pearson χ (4) = 186.9733 Pr = 0.000

	120 (47.1 %)	135 (52.9 %)	255 (100.0 %)
	281 (50.5 %)	275 (49.5 %)	556 (100.0 %)
	394 (55.3 %)	318 (44.7 %)	712 (100.0 %)
	999 (52.6 %)	900 (47.4 %)	1 899 (100.0 %)
	8 789 (46.5 %)	10 098 (53.5 %)	18 887 (100.0 %)
	192 315 (50.2 %)	190 619 (49.8 %)	382 934 (100.0 %)
	25 822 (66.4 %)	13 084 (33.6 %)	38 906 (100.0 %)
Pearson χ (6) = 3.9e + 03 Pr = 0,000

	2 550 (55.4 %)	2 051 (44.6 %)	4 601 (100.0 %)
Pearson χ (1) = 38.5233 Pr = 0.000

	205 194 (51.7 %)	191 581 (48.3 %)	396 775 (100.0 %)
	12 697 (52.7 %)	11 383 (47.3 %)	24 080 (100.0 %)
	9 389 (45.6 %)	11 194 (54.4 %)	20 583 (100.0 %)
	701 (53.8 %)	603 (46.2 %)	1 304 (100.0 %)
Pearson χ (3) = 309.9401 Pr = 0.000

	27 051 (50.7 %)	26 269 (49.3 %)	53 320 (100.0 %)
Pearson χ (1) = 0.5884 Pr = 0.443

	3 638 (55.0 %)	2 972 (45.0 %)	6 610 (100.0 %)
Pearson χ (1) = 47.4789 Pr = 0.000

	51 735 (52.9 %)	45 981 (47.1 %)	97 716 (100.0 %)
Pearson χ (1) = 14.6536 Pr = 0.000

	147 106 (50.3 %)	145 490 (49.7 %)	292 596 (100.0 %)
	16 076 (56.8 %)	12 215 (43.2 %)	28 291 (100.0 %)
	352 (62.4 %)	212 (37.6 %)	564 (100.0 %)
	283 (38.2 %)	457 (61.8 %)	740 (100.0 %)
	2 (40.0 %)	3 (60.0 %)	5 (100.0 %)
	31 382 (50.8 %)	30 387 (49.2 %)	61 769 (100.0 %)
	33 456 (55.7 %)	26 614 (44.3 %)	60 070 (100.0 %)
Pearson χ (6) = 1.0e + 03 Pr = 0.000

	140 636 (51.1 %)	134 551 (48.9 %)	275 187 (100.0 %)
	6 772 (50.1 %)	6 747 (49.9 %)	13 519 (100.0 %)
	5 827 (48.6 %)	6 153 (51.4 %)	11 980 (100.0 %)
	6 454 (49.0 %)	6 729 (51.0 %)	13 183 (100.0 %)
Pearson χ (3) = 52.5296 Pr = 0.000

	142 783 (50.8 %)	138 441 (49.2 %)	281 224 (100.0 %)
	12 689 (51.9 %)	11 748 (48.1 %)	24 437 (100.0 %)
	1 055 (49.5 %)	1 078 (50.5 %)	2 133 (100.0 %)
Pearson χ (2) = 13.6362 Pr = 0.001

	134 109 (50.5 %)	131 658 (49.5 %)	265 767 (100.0 %)
	12 181 (51.7 %)	11 372 (48.3 %)	23 553 (100.0 %)
	983 (48,8 %)	1 033 (51,2 %)	2 016 (100,0 %)
Pearson χ (2) = 16.2652 Pr = 0.000

	33 037 (54.6 %)	27 447 (45.4 %)	60 484 (100.0 %)
Pearson χ (1) = 421.8449 Pr = 0.000
	31 128 (54.4 %)	26 050 (45.6 %)	57 178 (100.0 %)
Pearson χ (1) = 423.8031 Pr = 0.000

	110 497 (50.5 %)	108 510 (49.5 %)	219 007 (100.0 %)
	30 344 (50.3 %)	30 000 (49.7 %)	60 344 (100.0 %)
	20 081 (53.0 %)	17 780 (47.0 %)	37 861 (100.0 %)
	2 764 (58.3 %)	1 976 (41.7 %)	4 740 (100.0 %)
	133 (54.5 %)	111 (45.5 %)	244 (100.0 %)
Pearson χ (4) = 200.9563 Pr = 0.000

	5 719 (47.2 %)	6 387 (52.8 %)	12 106 (100.0 %)
Pearson χ (2) = 65.6443 Pr = 0.000

	498 (54.1 %)	422 (45.9 %)	920 (100.0 %)
	272 (56.5 %)	209 (43.5 %)	481 (100.0 %)
	1 311 (59.6 %)	889 (40.4 %)	2 200 (100.0 %)
	9 212 (56.8 %)	7 018 (43.2 %)	16 230 (100.0 %)
	216 767 (51.2 %)	206 247 (48.8 %)	423 014 (100.0 %)
Pearson χ (4) = 255.9797 Pr = 0.000

	253 (52.0 %)	234 (48.0 %)	487 (100.0 %)
	162 (54.0 %)	138 (46.0 %)	300 (100.0 %)
	870 (61.4 %)	548 (38.6 %)	1 418 (100.0 %)
	6 633 (56.6 %)	5 082 (43.4 %)	11 715 (100.0 %)
	202 051 (51.0 %)	193 949 (49.0 %)	396 000 (100.0 %)
Pearson χ (4) = 202.1802 Pr = 0.000

	4 865 (53.9 %)	4 154 (46.1 %)	9 019 (100.0 %)
Pearson χ (1) = 20.5651 Pr = 0.000
	4 458 (53.6 %)	3 863 (46.4 %)	8 321 (100.0 %)
Pearson χ (1) = 17.7195 Pr = 0.000

	7 888 (57.5 %)	5 829 (42.5 %)	13 717 (100.0 %)
	4 500 (56.5 %)	3 459 (43.5 %)	7 959 (100.0 %)
	1 071 (57.0 %)	807 (43.0 %)	1 878 (100.0 %)
Pearson χ (3) = 322.8287 Pr = 0.000

	4 296 (57.8 %)	3 141 (42.2 %)	7 437 (100.0 %)
	3 740 (56.4 %)	2 886 (43.6 %)	6 626 (100.0 %)
	474 (58.6 %)	335 (41.4 %)	809 (100.0 %)
Pearson χ (3) = 227.7274 Pr = 0.000

	730 (51.0 %)	702 (49.0 %)	1 432 (100.0 %)
	81 (63.3 %)	47 (36.7 %)	128 (100.0 %)
	371 (56.7 %)	283 (43.3 %)	654 (100.0 %)
Pearson χ (3) = 14.4344 Pr = 0.002

On analysis of the parity and its relationship to the gender of the baby, at first, no significant differences can be determined. Only after the motherʼs 7th delivery does a difference become visible: the relationship for boys of 56 % is significantly higher than that for girls with 44 %.

Duration of pregnancy and birth weight

The proportion of male infants is markedly higher than that for female infants not only for the extremely preterm births (weeks of gestation < 27 + 6) and the very preterm births (weeks of gestation 28 + 0–31 + 6) but also for the late preterm births (weeks of gestation 32 + 0–36 + 6) (55.1 : 44.9 %; 56.3 : 43.8 %; 55.2 : 44.8 %). For term births, the ratio of girls to boys is balanced. Significantly more boys (53.4 %) than girls (46.6 %) are born after completion of the 42nd week of pregnancy (p < 0.001).

For the birth weights of the babies, it is seen that in the category under 500 g the ratio of male infants with 47.1 % is markedly lower than that of female infants with 52.9 %. In the category between 500 g and 750 g the ratio of boys to girls is balanced. The ratio of male to female infants is significantly higher in the categories 750–999 g (55.3 % boys and 44.7 % girls) and 1000–1499 g (52.6 % boys and 47.4 % girls) (p < 0.001). In the category 1500–2499 g the ratio is reversed (46.5 % boys and 53.5 % girls), in the category 2500–3999 g it is balanced and in the category 4000–6500 g again markedly elevated in favour of boys (66.4 % boys and 33.6 % girls).

The proportion of pregnancies and births in which tocolysis was applied is markedly higher for male foetuses with 55.4 % as compared to females with 44.6 %.

Sub partu interventions and delivery mode

For the parameters position of the baby at delivery, the ratio of boys to girls is relatively balanced for the proper cephalic position. On the other hand, there are marked differences with higher proportions for boys in cases with anomalous cephalic presentation (52.7 % boys, 47.3 % girls) and transverse presentation (53.8 % boys, 46.2 % girls) and there are significantly more girls with breech presentations at birth (45.6 % boys, 54.4 % girls) (p < 0.001).

With regard to drug-induced labour and foetal gender no differences could be found.

Micro blood gas analyses during birth for evaluation of the general condition of the infant were employed significantly more often for boys (55 %) than for girls (45 %) (p < 0.001).

Use of peridural or, respectively, spinal anaesthesia as pain therapy during birth was requested similarly independent of the gender of the unborn baby.

With regard to the mode of delivery, there were no significant differences between the genders of the babies in the categories “spontaneous birth” and “primary Caesarean section”. The proportion of boys is markedly higher than that of girls in the vaginal surgical delivery modes (vacuum: 56.8 % boys, 43.2 % girls; forceps: 62.4 % boys, 37.6 % girls) and also in the category “secondary Caesarean section” (55.7 % boys, 44.3 % girls).

For the parameter position of the baby in vaginal deliveries, the Austrian birth register records the categories “delivery room bed”, “stool delivery”, “water birth” and “others”. In the context of these categories no relevant differences between the foetal genders could be demonstrated.

For the duration of delivery, no relationships with foetal gender could be derived. In the case of duration of delivery in excess of 24 hours, the proportion of girls is slightly elevated as compared to boys, and this is also the case in the sample of term births.

With 54.6 %, episiotomies are performed significantly more frequently in the births of boys than in the births of girls (p < 0.001). If we consider only the sample of term births (weeks of gestation 36 + 6 to 42 + 0), the result is very similar. In this subgroup the ratio is 54.4 % for the boys and 45.6 % for the girls.

Similarly, perineal traumata, especially severe perineal traumata are more frequent in the course of birth of boys than during the birth of girls.

Disorders of placental separation are significantly less frequent with 47.2 % in the placentas of male foetuses than in the placentas of female foetuses with 52.8 %.

Perinatal outcome

In the case of the 5-min Apgar score as instrument to evaluate the clinically identifiable general condition of the new born baby we find a significantly higher proportion especially of low scores for the boys. For all new born infants exhibiting an Apgar score of 9–10 after 5 minutes, the ratio between boys and girls is balanced.

This tendency can also be seen when the reduced sample of live births at term is used in the analysis (weeks of gestation 36 + 6–42 + 0).

The proportion of boys with an umbilical cord pH value of less than 7.1 is 53.9 % which is significantly higher than that for the girls with 46.1 %. Also in the sample of live births at term, boys show a significantly higher proportion of 53.6 % than girls with 46.4 % (p < 0.001).

Transfer of the new born baby to a neonatal department between birth and the 7th day after birth in all categories is significantly more frequently necessary for boys than for girls. The same result is found on evaluating the sample of live births at term.

The obstetric parameter mortality prior to birth (n = 2214) does not exhibit any differences with regard to the gender of the foetus. During delivery the relative proportion of male foetuses with 63.3 % as compared to 36.7 % for the female foetuses is markedly elevated as it is also after birth with 63.3 % for the boys and 36.7 % for the girls.

An analysis of selected, obstetrically relevant parameters in relation to the gender of the foetus provides a contribution to the gender-oriented optimisation of general and health-care management. Our results are, in principle, in accord with the results of studies by Di Renzo et al. (2007), Aibar et al. (2012) and Khalil (2013) and demonstrate that male foetuses have a higher vulnerability in the perinatal phase and a high obstetric risk 7 , 10 , 11 .

The high tendency towards premature births or, respectively, the higher rate of preterm births for boys revealed by these data confirms the results of previous studies 2 , 3 , 6 , 7 . Di Renzo et al. assumed that the higher incidences of premature rupture of membranes and preterm births among boys can be attributed to their relatively higher weights and lower gestational ages 7 . However, this assumption contradicts the results of Challis et al. (2013), who demonstrated in their study that chorionic trophoblast cells from pregnancies with a male foetus possess the potential to generate a pro-inflammatory environment by which the significantly higher rate of male preterm births than female preterm births can be explained 20 . This further substantiates the results of Zeitlin et al. (2004) that the tendency for preterm births among boys is significantly more frequently due to the spontaneous onset of contractions and less often due to a medically indicated and drug-induced completion of the pregnancy 21 . This generally high rate of preterm births requires more research initiatives on the pathophysiological processes. For this there is a need to acquire basic knowledge about the intrinsic and extrinsic triggers of the threatening preterm birth as a complex event under consideration of gender-specific characteristics.

We can also confirm the high rates of interventions among males foetuses sub partu (vaginal surgical conclusion of the birth process, Caesarean section) demonstrated in the studies of Di Renzo et al., Sheiner et al. and Dunn et al. 7 , 8 , 14 . The relatively higher rate of micro blood gas analyses (MBA) employed during the birth of boys allows the conclusion of a higher rate of at least suspected hypoxia in the foetal metabolism. In this context it is still not clear whether the physiological characteristics of boys lead more often to stress phases during birth or if the interpretation of findings (above all of CTG and MBA) require a gender-specific differentiation. In order to more exactly evaluate the foetal condition sub partu, we need a further specialisation of the possible monitoring and diagnostic options as well as their adaptation to gender-specific peculiarities.

The higher birth weight of boys may be a factor to help explain the higher rates of vaginal surgical deliveries and Caesarean sections. However, it has not been possible to confirm a relationship between higher birth weight and longer duration of birth. At duration of birth in excess of 24 hours the proportion of girls is even higher than that of boys.

As can be seen from the parameters 5-min Apgar score, umbilical pH value and transfer of the infant post partum, the higher intervention rate sub partu does not lead to a better neonatal outcome for boys in comparison to girls. Dunn et al. reported similar results where, in spite of a higher rate of interventions, lower Apgar scores, more reanimation procedures and a higher rate of respiratory distress were demonstrated for male babies 14 . Also in this context the question must be posed as to how reliable are the instruments used during birth to monitor the foetus and how valid is the interpretation of the so obtained data.

One limitation of this study is the lacking analysis of multifactorial events. This would have been suitable to more precisely describe indications, interventions and neonatal outcome in relation to foetal gender.

According to these results male foetuses and babies exhibit a vulnerable constitution not only in the prepartal phase but also sub partu and post partum. On the basis of this finding, it is essential to generate further basic knowledge about the physiological and pathophysiological processes during pregnancy and birth in dependence on the gender of the foetus.

Then it would be possible to derive preventative, diagnostic and therapeutic measures according to the foetal gender and to apply them accordingly. This knowledge could contribute to an optimisation of obstetric management, especially with regard to a reduction in the rates of preterm births and preterm interventions.

Conflict of Interest None.

Supporting Information

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Posterior placenta can also make it easier to perform an external cephalic version, or a procedure to turn the baby from breech to 'head down' to allow for a vaginal delivery. Plus, posterior ...
Foetal Gender and Obstetric Outcome
The .gov means it's official. ... On the other hand, there are marked differences with higher proportions for boys in cases with anomalous cephalic presentation (52.7 % boys, 47.3 % girls) and transverse presentation (53.8 % boys, 46.2 % girls) and there are significantly more girls with breech presentations at birth (45.6 % boys, 54.4 % ...
What to know about baby's position at birth
An incomplete breech presentation is where just one of the baby's knees is bent up. Their other foot and bottom are closest to the birth canal. In a footling breech presentation, one or both feet may be delivered first. Complete breech. A complete breech presentation is less common, occurring in 5 to 10 percent of breech births.
ultrasound report says cephalic presentation can any one help me
Head down: "cephalic presentation" just means that your baby's head is down in the pelvis, as opposed to a "breech presentation" when the baby's buttocks or feet are in the pelvis. Dr Brown agreed. Answered . 6/12/20145.9k. views. Thank. Related Questions. A member asked: F 66 years. Kidney ultrasound report says 2.5 cm stone in lower calyx and ...
Flexi answers
Flexi Says: Cephalic presentation is the position of the baby's head pointing downwards, facing your back. Discuss further with Flexi. Ask your own question!
cephalic presentation
presentation [prez″en-ta´shun] that part of the fetus lying over the pelvic inlet; the presenting body part of the fetus. See also position and lie. breech presentation presentation of the fetal buttocks, knees, or feet in labor; the feet may be alongside the buttocks (complete breech presentation); the legs may be extended against the trunk and the ...
Is cephalic presentation normal at 21 weeks?
I would prefer head down over breeches anytime. My 1st and 2nd were always head down early. This one is any way she feels lol, normally curled up into a ball with her feet on my bladder! My daughter was head down at our anatomy scan but then at our follow up two weeks later was Breech.

Why Is Cephalic Presentation Ideal For Childbirth?

Two Kinds of Cephalic Positions

How to Know if Your Baby is In a Cephalic Position?

Benefits of Cephalic Presentation in Pregnancy

Are There Any Risks Involved in Cephalic Position?

What are the Risks Associated with Other Birth Positions?

Breech Position

Transverse Lie

Turning Your Baby Into A Cephalic Position

When Should A Baby Be In A Cephalic Position?

Is Cephalic Position Safe?

Does cephalic presentation mean labour is near?

Can babies change from cephalic to breech?

How can I keep my baby in a cephalic position?

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Cephalic presentation

Breech presentation

What Is Cephalic Position?

Risks of Other Positions

Why Is the Cephalic Position Best?

Cephalic Posterior

Likelihood of a Breech Baby

Transverse Lie

Determining Fetal Position

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Fetal Cephalic Presentation During Pregnancy

What Is Cephalic Position?

1. Cephalic Occiput Anterior

2. Cephalic Occiput Posterior

1. Reduced risk of complications

2. Easier vaginal delivery

3. Lower risk of birth injuries

4. Faster progression of labor

5. Better fetal oxygenation

1. Breech Presentation

2. Transverse Lie Presentation

1. Optimal Maternal Positioning

2. Spinning Babies Techniques

3. Chiropractic Care or Acupuncture

4. Prenatal Yoga and Swimming

1. What factors influence whether my baby will be in cephalic presentation?

2. Is it necessary for my baby to be in cephalic presentation for a vaginal delivery?

3. What can I do to encourage my baby to stay in the cephalic presentation?

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