The position of the baby in the uterus at the time of childbirth is called the Cephalic Presentation of the fetus. The baby’s position during the last stages of pregnancy decides whether it is going to be a normal delivery or a Caesarean delivery.  Babies tend to rotate in the womb till the very last moments. It is difficult to predict what the final position would be on the due date of delivery. Read more about Cephalic Presentation Of The Baby - Best Position For Normal Delivery.

What is Cephalic Presentation at 36 weeks and what determines it?

The baby’s head is the largest part of the body;  so during delivery when the head comes out first , the rest of the body follows smoothly and the baby can cross the narrow delivery passage canal smoothly. The most favored situation for birth would be the baby positioned head-down, facing the mother’s back, with the chin tucked in to its chest and back of the head ready to enter the pelvis. This is called Cephalic Presentation. Most babies settle into this position during the 32^nd  – 36^th week of pregnancy; getting ready to enter this world.  Your health care provider will carefully assess the position of the baby throughout the last month of pregnancy to make sure that the baby is getting ready for a normal birth.

In some cases, the head may be facing upwards towards the mothers’s ribs instead of the pelvis. This is called as Cephalic Posterior position.  While we have understood that cephalic presentation is the best for a normal vaginal delivery, not all cases are the same. Every baby has a unique style of comfort while it stays in the womb itself!! Other Fetal Positions before Childbirth are mentioned below.

Common Positions For Birth

A fetus keeps on shifting its position inside the mother’s womb and just before the time of delivery, it usually aligns in a position with it’s head down and facing the mother’s back. This ideal position is known as Cephalic Presentation and it is the most natural position for childbirth which your doctor constantly monitors with ultrasound guidance during the last month of the pregnancy. Your baby will automatically move towards the birth canal and prepare for the descent. Most babies settle down in their position within the 32^nd – 36^th week of pregnancy.

The other common positions for Childbirth are:

Some fetal positions can be difficult to handle by your doctor and midwives during the labor period. While most of them could be handled comfortably by an experienced group of doctors and assistants, some fetal positions could prove to be fatal for both the mother and the baby. Your doctor might resort to a Cesarean delivery too in such cases.

Occiput Or Cephalic Posterior

Sometimes the baby is positioned head down but facing the abdomen, looks as if it is facing the ceiling. This is called Cephalic posterior position. It may result in painful and prolonged labor period and delivery.

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Frank Breech

In this presentation the baby’s buttocks are positioned in the pelvis. The hips are flexed, the knees extended and legs straight up in front of her body and feet near the head. This increases the chance of the umbilical cord forming the loop over the baby’s head and entering the birth canal before the head enters. This can cause injury to the baby if delivered vaginally.

Complete Breech

In this presentation, the buttocks are aimed towards the cervix; both the knees and hips are flexed. The legs are curled up and folded close to the knees and feet near the buttocks. The impact would be that the umbilical cord might coil up and form a loop over the baby’s head; thereby trying to push through the cervix even before the baby’s head. Thereby,  posing a threat to the baby’s safe delivery.

Transverse Lie

In this position, the baby lies in the crosswise position making it a high probability for the shoulder entering the pelvis first.  Your health care provider might consider the option of C – section delivery to ensure the safety of both the mother and the baby.

Footling Breech

This presentation of the fetus is considered to be quite dangerous as the baby’s one or both the feet are facing towards the cervix; thus will be shown first during delivery. The underlying risk factor is that the umbilical cord strangulates the baby and blood supply is cut off; so your doctor would never opt for a normal vaginal delivery in this case.

While we have understood the different presentations of the fetus before childbirth; it is also necessary for us to realize that the special shape of the uterus and the natural tendency of the fetus is to fall into the cephalic presentation on it’s own. It might take it’s own sweet time – usually between 32^nd – 36^th week of pregnancy. So you mums out there, there is no cause to worry as in many of the cases the  baby settles down into the head down position just before the birth process starts.

However, in cephalic presentation too the baby may lie in various positions, like the baby’s face, or the brow coming out first. This is an extremely dangerous probability; and might pose a life threat to both the mother and the baby. That is the reason why your doctor continuously monitors your pregnancy during the last month; to ensure the safe delivery of your baby and ensure your safety too.

What is External Cephalic Version (ECV)?

During the last stages of pregnancy, if your doctor discovers, through physical and ultrasound guidance, that the baby is not settled as yet in the head- down position, then external intervention might become essential. A breech baby could be turned around from the buttocks or feet first position to the head first position. This is called external cephalic presentation. The doctor will apply gentle force on your abdomen and turn the baby gently into the head – down position. This technique requires a lot of experience and under proper monitoring.

First time mums Vs Second time mums

Statistics say that a lot depends on whether this is your first time pregnancy or second. If you are a first time mum, then normally your baby will settle down into the cervix during the 32^nd – 37^th weeks of pregnancy. If your baby does not settle by then, then the chances of him/her settling later than that are highly unlikely.  Whereas, for the second time mums the baby might settle down even during the last minute. This is because the second time mums have already undergone pregnancy/pregnancies before. Due to which their uterus and tummy muscles have become weak; thus giving leverage to the child to take her/his own time to settle down into the head – down position. One more point to be noted is that ECV is generally successful in cases of second time mums when compared to the new mothers.

Statistics show that about 95-96% of the babies settle down into the ideal position, around 3% of them get into breech position.

On an average, the percentage of single babies in breech position is:

• Between 22 and 30, before 28 weeks
• About 20 at 28 weeks
• Around 15 to 18 by 32 weeks
• About 9 by 32 weeks
• 3-4 by 37 weeks, as most babies turn around naturally in the head down position by this time.

With advancements in technology and the expertise available; birth process is become lesser painful and more safer and smoother.

Disclaimer: The information provided above is based on the findings of experts in the related field. However, in every circumstance we advice you to take guidance and help of your doctor as there is no best substitute for professional medical help. Wishing you a safe delivery! Hope you now all that you need to about Cephalic Presentation Of The Baby - Best Position For Normal Delivery.

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