When you become pregnant, you want to know what to expect. This includes things that could complicate your pregnancy. One of those factors is a breech pregnancy.

A breech pregnancy means the baby is in a bottom-first or feet-first position in the uterus instead of headfirst. Babies can be breech early in pregnancy, but most flip back to headfirst by the time of delivery.

Dr. Rafael Unda Rivera, obstetrics and gynecology physician with Marshfield Clinic Health System, says it’s important to know that breech pregnancy doesn’t mean there is anything wrong with your child.

“Most breech pregnancies occur by chance,” he said.

Increased chances of breech pregnancy

Breech pregnancies are uncommon with only about 3% of births breech at full term. Many factors can contribute to having a breech pregnancy like a mother’s narrow bone structure, making the uterus not large enough for the baby to move. This also can occur when you are expecting twins or triplets. Often times when a mother or father was breech or had a breech child previously, breech pregnancies can happen again.

Other factors that may contribute to a breech pregnancy include:

For mom:

• First pregnancy
• Women over 35
• Thyroid problem
• Increased or low fluid
• Placenta abnormalities
• Abnormal uterus shape

For baby:

• Female baby
• Developmental abnormalities or neurological disease
• Short umbilical cord
• Pre-term babies

Although these factors can increase your chances for a breech baby, it does not mean it will occur. Talk to your women’s health provider about your health history to find out more.

Complications of breech delivery

Breech pregnancy is not dangerous until it’s time for the baby to be born. With breech deliveries, there is a higher risk for the baby to get stuck in the birth canal, and for the baby’s oxygen to get cut off through the umbilical cord.

In most cases, breech full-term babies will have to be delivered through caesarean section (C-section).

Options for a breech pregnancy

At around 35 to 37 weeks, your women’s health provider can check to see if your baby will be breech. Unda Rivera recommends waiting until after 35 weeks because if there are any complications, mom and baby will be safe for labor and delivery.

If your baby is breech after 35 weeks, your provider may suggest to schedule a C-section or try to re-position the baby with external cephalic version to achieve vaginal delivery. Unda Rivera said external cephalic version has a 50-60% success rate, but every patient is different.

“There are complications like not having enough fluid, when you won’t be able to do it,” he said. “Each pregnancy is going to be different. Your provider can talk with you to explain the risk factors and make recommendations.”

Unda Rivera strongly encourages not using alternative methods to move the baby without medical supervision.

“There’s really no evidence that any of those other methods work,” he said. “You can be putting yourself and your child at risk. If an emergency would arise, it’s best to have your doctor available or be in a labor and delivery facility.”

Healthy mom, healthy baby

Overall, Unda Rivera’s advice for all mothers is to keep yourself healthy pre-baby and during pregnancy to have the best overall birth for mom and baby.

“I always stress to my patients, ‘take care of yourself and you can avoid complications and achieve the best health for you and baby,’” he said.