When do babies usually turn head down

When Does A Baby Turn Its Head Down?

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As you progress through pregnancy the baby’s position becomes a more important consideration. At about 30 weeks about 25% of babies are not in a “cephalic” (head down) position. It is normal for the baby to turn head down even by about 34 weeks. So don’t worry!

It is a concern if the baby is not head down at 36 weeks and beyond. This does not mean that spontaneous turning will not happen. Indeed occasionally a baby can turn even as late as the onset of labour.

Why are most babies head down?

A singleton baby’s position is related to the size of your baby and the size and shape of your uterus.

In early pregnancy, there is plenty of room for your baby in the uterus and so there is no reason why your baby should be head down. As the pregnancy becomes more advanced there is less room for your baby to move in your uterus and so your baby wants to adopt a more comfortable position. As the buttock area is greater, a more comfortable position is for the buttock area to be at the top (“fundus”) of the uterus and the head to be towards the pelvis.

If your uterus has been overstretched because of previous pregnancies, if you have excessive amniotic fluid (“liquor”) in your uterus or your baby is unusually small then your baby may be quite mobile in advanced pregnancy. We refer to this an “unstable lie”.

If you have an abnormality of the uterus such as a fibroid protruding into your uterine cavity or you have a uterine shape abnormality, or you have an unusual shape to your pelvis then your baby can be prevented for adopting a head down position. If you have twins often one is not head down and sometimes both.

What can be done about it?

There is no need for concern until more advanced pregnancy. The reasons need to be considered as to why your baby is not in a head down position. I will monitor you each visit with an ultrasound scan so we can monitor your baby’s position.

If your baby has been breech and turns to head down spontaneously, then this is a very encouraging sign. It usually then stays head down. If your baby remains breech toward the end of the pregnancy, then there is usually a good reason. A procedure (“external cephalic version“) to try to turn your baby around to head down can be done, but only after a careful ultrasound scan and giving you a medication to relax the uterus. External cephalic version will be done very carefully and with close monitoring on the labour ward/birth unit of your baby and you with the procedure. This is because studies have shown the external cephalic version procedure has risk to your baby’s wellbeing because it can cause an umbilical cord accident, placental separation and preterm labour. Also, it is generally considered that the babies who turn easily with external cephalic version procedures would have turned anyway and the so the procedure was not necessary.

If the lie is unstable and you go into labour or your waters go then you must attend the labour ward/birth unit immediately so your baby’s position and presentation can be checked and umbilical cord presentation/prolapse can be excluded. Sometimes with an unstable lie, a careful stabilising induction is a safer option than waiting for spontaneous labour onset.

Also see my video titled ‘When will my baby turn head down?‘

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Symptoms of Baby Turning Head Down

Your baby kicks, squirms, and flips all day (and night!). But what exactly are they doing in there?

Well, toward the end of your pregnancy, your baby will likely get into a head-down position so that they can begin their descent into the birth canal. The exact timing of when your baby hits this position is individual. And some babies prefer other positions, like breech (head up) or transverse (side lying).

Regardless, some signs can serve as clues about how baby’s relaxing in there. Here’s more about when your baby will move head down, what the options are if they stay head up or in another position, and what to feel for when trying to determine your baby’s position at home.

Related: What Sleeping Position Will Help Turn My Breech Baby?

Most babies tend to shimmy their way into a cephalic (head-first) presentation before birth.

Fast fact

At 28 weeks, around 25 percent of babies are breech (head up), but this number jumps down to just 3 or 4 percent at term.

Your baby may move all over the place in the first and second trimesters. Their position may change wildly early on in the third trimester as well.

However, if you’re between 32 and 36 weeks, you may notice your baby staying put in a head-down position. Your uterus grows to accommodate their size — but there’s only so much room. As time passes, your baby gets bigger and starts to run out of space to move into different positions.

Related: The Third Trimester of Pregnancy: Concerns and Tips

Being head down is just half of the equation when it comes to birth. There’s also the matter of which way your baby is facing.

Why does this make a difference? It comes down to geometry. Your baby’s head must fit through the pelvis on its way into the vaginal canal for delivery. Some positions make this journey easier than others, especially considering how different parts of your baby’s skull are wider and narrower than others.

Occiput anterior: This position is the most common. It means that your baby is head down with their back against your stomach and their chin tucked into their chest.
Occiput posterior: This position means that your baby is head down but facing the opposite direction. In this position, your baby’s back is at your back.

Anterior is the ideal position for an uncomplicated vaginal delivery. When your baby’s chin is tucked, it helps the narrowest part of their head go through the birth canal. Posterior presentation can mean a longer or potentially more difficult delivery, sometimes requiring a vacuum, forceps, or cesarean section.

If your baby is posterior even in early labor, they may still turn throughout the process as contractions move them around in the womb. Some babies completely spin to an anterior position during labor while others are born posterior.

Related: What Your Baby’s Position in the Womb Means

You may not experience any signs that your baby has flipped into a head-down position. There’s really no easy way to tell just by looking at your bump. You need to get in there and feel around. But how?

Fortunately, your doctor or midwife is trained to feel for your baby’s position using what are called Leopold’s maneuvers.

With this technique, your provider will feel for what part of your baby is presenting in the pelvis, then for your baby’s back, and then for what part of your baby is in your fundus (up high, near your rib cage). They’ll also feel around for your baby’s cephalic prominence, which simply means which way your baby is facing.

With a head-down presentation:

baby’s head would be in your pelvis
baby’s back position would depend on whether baby is anterior/posterior, but generally baby will have either their back to your belly (anterior) or your back (posterior)
baby’s bottom/legs would be in your fundus

All these findings can also be confirmed via ultrasound to give you the clearest picture.

But how can you figure out your baby’s position at home? Pay close attention to the shapes in your belly, as well as the different movements you feel.

Your baby may be head down if you can:

feel their head low down in your belly
feel their bottom or legs above your belly button
feel larger movements — bottom or legs — higher up toward your rib cage
feel smaller movements — hands or elbows — low down in your pelvis
feel hiccups on the lower part of your belly, meaning that their chest is likely lower than their legs
hear their heartbeat (using an at-home doppler or fetoscope) on the lower part of your belly, meaning that their chest is likely lower than their legs

Belly mapping

It can be difficult to read the different lumps and bumps you feel on your stomach. With practice, you may start to understand what you’re feeling. You might even try belly mapping — a process to estimate baby’s position. It was created by Gaily Tully, certified professional midwife and author of SpinningBabies.com.

To use this technique, wait until you are at least 30 weeks pregnant. You may even want to try belly mapping following a prenatal appointment so your doctor can give you some guidance on baby’s position.

Lie down in bed or on the couch. Using a washable marker or finger paint, gently mark where you feel your baby’s head (it feels like a small bowling ball). The arms and hands are likely near the head, and their tiny movements give them away.

Then feel for the back, butt, and legs, as well as larger movements. You may find it helpful to use a baby doll to play with different possible positions. You can then lightly draw or paint your baby on your stomach to help you visualize how they’re lying.

Related: Can You Give Birth with Baby in the Vertex Position?

If you’re in late pregnancy and have concerns about your baby’s positioning, ask your doctor about it at your next prenatal appointment. Chances are that your healthcare provider is making a note of your baby’s position as well.

If your baby is breech or in some other position besides head down, there are several options for delivery. Factors at play here include:

whether your baby stays in a certain position as you reach term
any other pregnancy complications you might have
when you end up going into labor naturally

Wait-and-see approach

Again, your baby’s position isn’t usually a big concern until you reach between 32 and 36 weeks in your pregnancy. Before that point, the fluid in the uterus gives your baby plenty of space to move around. As you get closer to delivery and your baby hasn’t settled head down, they start to run out of room to make the switch.

Your doctor can monitor your baby’s position at your prenatal appointments by feeling your belly for where their head, back, and buttocks are. To confirm, you may also have an ultrasound or pelvic exam.

External cephalic version (ECV)

External cephalic version (ECV) is a procedure during which your doctor tries to move your baby into a head-down position to increase the chance you’ll have a vaginal birth. This is done in a setting in which baby can be monitored and you can have an emergency cesarean section (C-section) if needed.

Your provider uses their hands to manually turn the baby head down. If you’ve reached 36 weeks and your baby still isn’t head down, your doctor may suggest an ECV.

The success rate of this procedure is around 58 percent. While that’s not a super impressive statistic, ECV may be worth a try if delivering vaginally is important to you.

It’s also worth noting that some babies that are flipped return to a breech position. You can have a repeat ECV, but space runs out the closer you get to birth, so it may be more difficult the second time.

Cesarean delivery (C-section)

A C-section is another option for delivering babies who aren’t head down. It involves major surgery that you may schedule ahead of time (if you know your baby isn’t head down) or that can be performed in the event you go into labor naturally.

Around 85 percent of breech babies are born via C-section. While this surgery is routine, it involves some risks, including:

infection
postpartum hemorrhage
blood clots
issues with future pregnancies, like a risk of placenta previa or uterine rupture

Vaginal birth

The American College of Obstetricians and Gynecologists explains that some women may be candidates for a vaginal birth even if their babies are breech. This possibility is determined on a case-by-case basis and involves a review of your medical history and weighing the benefits of vaginal delivery versus the risks of C-section.

If you choose to go this route, you’ll need to follow any specific guidelines set up by your hospital or birth center.

Related: Midwives Are Growing in Popularity: Here’s What You Need to Know

Your baby moves a lot throughout your pregnancy. As you get closer to your due date, they’ll likely settle into a head-down position as they get ready for birth.

If you have concerns about your baby’s position, don’t hesitate to bring them up at your next prenatal appointment. Your healthcare provider is also keeping tabs on whether baby is head down and can help guide you with options for repositioning or an alternate birth plan, if necessary. You’ve got this, mama!

Breech presentation - how to turn the baby

Vatagina Maria Alexandrovna

Obstetrician-gynecologist, Oncogynecologist

Clinical Hospital Lapino-1 "Mother and Child", Clinic "Mother and Child" Mytishchi

Do not worry and worry if a child under 36 weeks is "ass forward": this is completely normal and the baby still has time to roll over. By the way, it happens that the baby turns upside down and immediately before the birth, and even in the birth itself

Try to get the baby to turn into the desired position. Tell everything in detail: why he should turn around, what it will give both mother and child in childbirth. You can talk out loud, or you can talk to yourself, the main thing is to talk to the baby about it all the time

In the water, the mother’s body relaxes, which means that the muscles of the uterus relax, its volume increases somewhat, and as a result, the child has a little more space “for maneuvers ".

Talk to him

There is always a connection between a child and a mother. And mother is the first person whom the baby believes and obeys. Therefore, try to persuade the baby to turn into the desired position. Tell everything in detail: why he should turn around, what it will give both mother and child in childbirth. You can talk out loud, or you can talk to yourself, the main thing is to talk to your baby about it all the time. Be gentle and at the same time persistent. Be sure to connect the future dad to the conversation, children obey men even more. When you persuade the baby, additionally stroke the stomach, as if instructing the child how to turn around. Great option: dad talks and strokes his stomach with you.

Imagine

Visualization is a way in which a person imagines a picture he needs. So the expectant mother just needs to imagine the baby in the right position. If you don't know what it looks like or you just can't imagine a baby in your belly - find a beautiful photo from a magazine, book, Internet. Some kind of anatomical accuracy is not important here, just a pleasant and understandable picture is enough: the baby lies upside down inside the mother's belly. Look at the illustration more often and imagine that inside you the baby is also in the correct position. But you must not only look at someone else's photo, but imagine yourself and your child.

Lure him

Another way is to lure the baby. Children, especially small ones, are very curious, so make the baby turn around by showing him something interesting. But the baby is still in the stomach, how can he see something? We do not know exactly how the baby reacts to the world outside the mother's stomach, but it is believed that he, for example, can hear sounds. Place headphones with pleasant music in the lower abdomen, this can also encourage the child to turn towards the sound. Music should be calm, melodic and not loud so that the baby is not scared.

You can also turn on the flashlight and put it against the mother's stomach in the place where the baby's head is, and then, while talking, slowly move the flashlight to the side and down, dragging the baby along with you.

Swim and relax

Swimming also helps your baby get into head presentation. In the water, the mother’s body relaxes, which means that the muscles of the uterus also relax, its volume increases somewhat, and as a result, the child has a little more space “for maneuvers”. But swimming should be pleasant for mom, if a woman is afraid of water or she is not warm enough, then there will be no relaxation. Therefore, you must want to swim, plus the water must be at a comfortable temperature.

Do the exercises

There are very simple exercises , that will help the baby to fit correctly. But first, check with your doctor if you can do such exercises. Gymnastics to turn the baby into head presentation is not carried out if there is gestosis, the threat of termination of pregnancy, a scar on the uterus after a previous cesarean section, placenta previa.

Turns. Lying on the couch, turn from side to side 3-4 times in 10 minutes. Perform 3 times a day. The turn usually occurs within the first week.

Force of attraction. Lie on your back with a large pillow under your lower back and a small one under your head. Bend your knees, placing your feet on the floor. Lie like this for 10 minutes.

Knee-elbow position. Stand on your knees and elbows, at this time the pelvis is located above the head. Stay in this position for 15 minutes several times a day.

Consult a specialist

If exercises and psychological methods do not work, there is another way – prophylactic external rotation performed by an experienced obstetrician-gynecologist in the maternity hospital. First, the mother is injected with drugs that relax the uterus, then the doctor tries to turn the child with certain hand movements, acting on his head and pelvis through the belly of the expectant mother. All this takes place under the control of ultrasound, and usually a woman does not experience any discomfort during this manipulation.

True, external rotation is now rarely performed: firstly, not all obstetricians and gynecologists can do it, and not all doctors believe that it is needed; secondly, not every woman is psychologically tuned in to him, and, besides, there are not always indications for him.

Psychological methods may seem questionable, but they often help. And if you add gymnastics and swimming, then the likelihood that the baby will turn into the correct position only increases. So if you don’t want to do a cesarean section with a breech presentation or give birth “ass first”, then you should try all the methods that are suitable and allowed for you.

Make an appointment

to the doctor - Vatagina Maria Aleksandrovna

Clinical Hospital Lapino-1 "Mother and Child" Clinic "Mother and Child" Mytishchi

GynecologyOperative gynecology

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At what week should the baby turn head down?

Between 27 and 40 weeks, the doctor performs an examination to determine the position of the fetus in the uterus. It is then that his previa will be revealed. From the presentation - that is, the position of the child depends on how the birth will proceed. Much fewer surprises await a woman if the child occupies a classic position in the uterus - upside down. The head position of the fetus is the most favorable for childbirth, since in this case the risk of complications for the baby is minimal. However, do not be afraid if the position in the uterus of your baby is different: pelvic or transverse. Such a doctor's verdict is also not critical, it's just that your birth will be different. And they will pass under the close attention of doctors.

Head position of the fetus (fetus head down): detected at 7 months of pregnancy when the doctor palpates the abdomen of the expectant mother. This will also be confirmed by the results of examination through the vagina and ultrasound.

Breech presentation of the fetus (the child either “sits” on the bottom, lifting the legs up, or “squats”, lowering them down, or pulls the legs under him) is recognized from the 32nd week of pregnancy: in the upper part of the uterus, the doctor gropes the firm head of the child, and at the bottom - the soft ass.

Transverse presentation of the fetus (the fetus lies across) is determined from the 20th week of pregnancy. Having probed the belly of the expectant mother, the doctor will “discover” the head and buttocks of the child on the sides.

There is no particular week or day in which women can expect their child to be in the required position. In some cases, the baby turns over already at the onset of labor or a few hours before the onset. For other women, this happens a few days or weeks before the onset of labor.

A cephalic reversal closer to the day of delivery usually occurs in women who already have children. This is because their body is already familiar with labor, so it may take less time for the pelvis to adjust to the process.

Women who are pregnant for the first time may find that the baby rolls over a few days or weeks before delivery. This may be because their pelvic muscles take longer to adjust for childbirth.

If a woman thinks her baby has turned upside down, she should talk to her doctor. The doctor can check the position of the baby, which will help him predict when labor will begin.

WHAT IS IT LIKE?

Some women may feel the rollover as a sudden, palpable movement. Others may not feel anything at all and miss this moment.

Some women may notice that their stomach seems to become lighter after the baby rolls over. Perhaps this is due to the fact that the child has moved into the pelvic area, leaving more free space in the abdomen. This feeling of free space in the stomach is the reason why turning over is also called relief. However, for some, this relief can be frightening. Sometimes, as the baby moves down, women feel like they have a bowling ball between their legs. Every woman has her own unique experience of turning a baby.

NINE SIGNS THAT THE BABY HAS TURNED HEAD DOWN

The following signs indicate that the baby is most likely head down:

Abdominal prolapse. When the baby rolls over, the abdomen may look like it has dropped a little.
Pressing pain in the pelvic region. As the baby moves into the pelvis, the pressure in this area may increase. This can cause a woman to feel like she is rocking from side to side while walking.
Flashes of pelvic pain. When a baby rolls over, some women may experience flare-ups of pelvic pain. This may be due to the fact that the baby's head is pressed against the ligaments in the pelvis.
Easier breathing. When the baby rolls over and lowers into the pelvis, there is less pressure on the diaphragm. This can make breathing easier.
Hemorrhoids. After the baby is in the prenatal position, the head may put pressure on the nerves in the pelvis and rectum. This pressure can cause hemorrhoids.
More allocations. Moving the baby towards the pelvis increases pressure on the cervix. This causes her to secrete mucus that sits at the top of her cervix for the rest of her pregnancy. This is to ensure that bacteria do not enter the uterus. After the baby rolls over, mucus may come out of the vagina as a jelly-like discharge.
Frequent need to urinate. As the baby moves down into the pelvis, the head may put pressure on the bladder. This can cause a woman to urinate frequently.
Back pain. The baby's cephalic position can put extra pressure on the muscles in the lower back. This can cause back pain.
Feeling of hunger. Proper prenatal positioning of the baby can relieve pressure on the stomach. It can relieve heartburn and increase hunger.

THE ROLE OF FETAL POSITION IN LABOR

If a woman thinks her baby has turned upside down, she should see a doctor. The doctor can determine what position the child is in using a special scale. Some doctors use a three-point scale, while others use a five-point scale.

The five-point scale is more traditional and more widely used. A 2015 scientific article describes it as a system that divides the pelvis above and below the ischial spines into five segments. The ischial spines are located on the pelvis. When the baby is ready to be born, his head is level with them.

The five-point scale is measured from -5 to +5. Each step forward on the scale means the baby is one centimeter closer to birth. Before the baby rolls over, the woman can be at point -5. As the baby rolls over (and moves deeper into the pelvis), the woman may be at zero point. When the baby descends into the vagina, the woman may be at +5.

According to a 2014 study, 95 percent of women are at or below zero during full dilation. To assess what stage a woman is in, the doctor examines the woman's vagina and tries to feel for the baby's head.

If the due date is close at hand and the baby has not yet rolled over, the woman can try certain things to get the baby into position.

These include:

Hiking
Birth Ball Sitting
Squats
Pelvic Tilts

These activities help open the hips and stretch the pelvic muscles. This may encourage the baby to move into the pelvis.

WHEN SHOULD YOU SEE A DOCTOR?

It is normal to feel pain in the pelvic area after the baby is in the prenatal position. However, some types of pelvic pain may need to be evaluated. Talk to your doctor if pelvic pain is constant or regular. Or if it's accompanied by:

Bleeding
Fluid loss
Fever

Turning the baby usually occurs towards the end of pregnancy. This can happen both immediately at the onset of labor, and a few hours, and sometimes weeks before that. In women who are pregnant with their first child, this process is likely to occur a few weeks before delivery. This maneuver may feel like a sudden, abrupt movement, however, some women do not even notice when it occurs. The head presentation of the baby can make breathing easier and increase appetite. This happens because there is space in the abdomen and pressure on the organs is reduced. When the baby rolls over and goes down, the pressure on the pelvis can cause some pain.