The ideal position for a baby during birth is the cephalic presentation, where the head is positioned downward. The occiput anterior position—head down, facing the mother’s back with the chin tucked—offers the smoothest passage through the birth canal. Most babies naturally settle into this orientation by the third trimester. If they do not, they are considered to be in a malposition, such as breech or transverse lie. Encouraging this optimal, head-down position is a common focus for expectant parents nearing the end of pregnancy.
Understanding Fetal Position and Timing
Fetal positioning is typically discussed with healthcare providers between 32 and 36 weeks of pregnancy. Before this time, the baby has ample space and may spontaneously change position many times. By 36 weeks, the baby has grown large enough that its final orientation for birth is usually established.
A baby who is not head-down is in a malposition, most commonly a breech presentation. The three main types of breech are frank (legs straight up near the head), complete (sitting cross-legged), and footling (one or both feet positioned to deliver first). Less common is a transverse lie, where the baby is positioned horizontally across the abdomen.
Healthcare providers confirm the baby’s position using external palpation of the abdomen, known as Leopold’s maneuvers, or with an ultrasound. Leopold’s maneuvers systematically examine the abdomen to determine the baby’s orientation, including which part is in the upper uterus and which part is presenting closest to the pelvis. Confirming the position is the first step before attempting any turning techniques.
Positional and Movement Techniques
Non-invasive, mother-led techniques can encourage the baby to turn head-down by optimizing the space and alignment of the pelvis. These approaches use gravity and movement to coax the baby into a favorable position. The goal is to create a balanced environment in the uterus, allowing the baby to move freely.
The Forward-Leaning Inversion (FLI) is a technique performed by kneeling on a couch and slowly lowering onto the forearms on the floor, keeping the hips elevated. This position, held for 30 to 45 seconds, is thought to release tension in the uterine ligaments and create space for the baby to somersault. Always have a helper present, and avoid this exercise if conditions like high blood pressure or certain placental issues exist.
The breech tilt is a gravity-assisted method involving lying on the back with the hips elevated 9 to 12 inches above the head, often using pillows or a propped ironing board. This position is typically held for 10 to 15 minutes, three times per day, ideally when the baby is active and on an empty stomach. The elevation lifts the baby’s bottom out of the pelvis, giving it room to flip.
Simple movements for optimal positioning include daily pelvic tilts, performed on hands and knees to gently arch and round the back. This helps to loosen the lower back and keep the pelvic joints mobile. Other activities that maintain an open, balanced pelvis include spending time on a birthing ball, performing hip rotations, and avoiding deeply reclined sitting positions. Engaging in activities like swimming may also use the buoyancy of water to provide the baby with a greater ability to move and reposition itself.
Professional Strategies for Turning a Baby
If self-administered techniques are unsuccessful in the later stages of the third trimester, healthcare providers may recommend professional interventions. The most common medical procedure is the External Cephalic Version (ECV), typically performed around 37 weeks of pregnancy. During an ECV, an obstetrician applies firm pressure to the mother’s abdomen to manually guide the baby into a head-down position.
This procedure is usually done in a hospital setting with ultrasound monitoring and accessible emergency services. There is a small risk of complications, such as placental abruption or temporary changes in the baby’s heart rate. The success rate of ECV is approximately 58% on average, but it is often higher when medication is used to relax the uterine muscles. A successful ECV increases the likelihood of a vaginal birth.
Complementary therapies, such as moxibustion, may also be utilized. This traditional Chinese medicine technique involves burning dried mugwort herb near a specific acupuncture point on the little toe (Bladder 67) to stimulate the uterus. Evidence suggests moxibustion, especially when combined with postural techniques, may reduce the chance of a baby being breech at birth. It is generally attempted earlier, around 33 to 35 weeks.
The Webster Technique is a specific chiropractic adjustment focusing on aligning the pelvis and sacrum. A certified chiropractor uses gentle adjustments and soft tissue work to reduce tension in the ligaments supporting the uterus, thereby removing constraints that may be preventing the baby from moving. The technique does not physically turn the baby, but creates an optimal environment for the baby to turn on its own.