When will my baby turn over?

The position of the foetus during pregnancy is important at the time of delivery. During pregnancy, generally during the first two trimesters, the foetus can assume various positions as long as its size allows. At a certain level, however, the baby no longer has enough room to move and will have to assume a definitive position which it will keep until the end of the pregnancy.

The position of the foetus during pregnancy is important at delivery. During pregnancy, generally during the first two trimesters, the foetus can assume various positions if its size allows. However, at a certain level, the baby no longer has sufficient room to move and must assume a definitive position, which they retain until the end of the pregnancy. Generally, the most common presentation and the most favourable for a vaginal delivery is the so-called cephalic presentation. However, the baby may present in other more complex positions that sometimes require external intervention.

When does the foetus usually turn over?

During the first two trimesters of pregnancy, your baby is constantly moving in the womb and assuming various positions because they still have sufficient room to move. However, in the last trimester of pregnancy, your baby must adopt a definitive position that they retain until delivery. Generally, most babies adopt the cephalic position before the beginning of the 35th week of amenorrhoea. It is difficult to determine the exact date when the baby should be in the correct position. However, it has been estimated that 20% of babies are breech at 28 weeks' gestation, and about 10%–15% are still breech at 33 weeks' gestation.

These estimates show that most babies are already in the cephalic or vertex position by the 8th-month examination, at the third ultrasound. However, if the doctor notices that the baby is still in a breech position during the ultrasound, this does not mean that they will not turn over in the following days.

What are the positions the baby can adopt?

The last few months of pregnancy are when the baby assumes their final position for delivery. The foetus can present in several positions, and the norm is the anterior or cephalic position.

The anterior cephalic position: This is the most favourable position for a vaginal delivery. It is the position in which most babies present at delivery (approximately 90% of cases, according to a recent study). The foetus has its head downwards, pressing on the cervix, and its back to the left.

The posterior cephalic position: The posterior position, also called the occipito-posterior position or "back-to-back", varies from 15% to 32%, according to studies. The foetus's head is slightly deflected and positioned downwards, and its back is pressed against the mother's spine. This is a more difficult position and may require forceps or vacuum extraction and sometimes a caesarean delivery.

Transverse position: The foetus is in a transverse position when its axis is perpendicular to that of the mother's pelvis. If the baby remains in this position until delivery, a caesarean section is required. This is because the shoulder presentation does not allow vaginal delivery.

Breech presentation: the breech position accounts for 4% to 5% of births. A breech baby has its head up and buttocks down. Different types of breech occur. With a full breech, the baby's legs are bent under the buttocks, and with a loose breech, the legs are stretched towards the chest. Several reasons exist for the breech position.

What to do when your baby is in a breech position

The breech position can be the source of several delivery complications. If you opt for a vaginal delivery, the risks of dystocia (difficult delivery) are increased. Therefore, it is preferable to undergo "repositioning" of the foetus during the pregnancy when the doctor notices it is in a breech position. Usually, when a breech is detected, the mother is recommended to use an external cephalic version (ECV).

ECV is a technique that aims to turn a breech or transverse position baby back to the normal position (anterior/cephalic position). The ideal time for an ECV is around the 36th or 37th week of amenorrhoea. It is always performed in a hospital and requires the subject to fast. Before starting the procedure, the midwife or gynaecologist checks the baby's position with an ultrasound to determine whether the procedure is necessary. If the baby has turned over spontaneously, the ECV is not required. Placing their hands on the mother's belly, the midwife rotates the baby in the womb by pushing their head. ECV is always performed under ultrasound control to observe the procedure and determine whether it is successful. It can be uncomfortable for the mother but is not painful. Virtually no risks are associated with performing this procedure. However, it may not be advisable in certain cases, including uterine malformation, uterine scarring and abnormal foetal well-being.

Some techniques to help the baby turn over

Apart from ECV, other techniques can help turn the foetus to the ideal position for a normal birth.