what is c presentation in pregnancy

Appointments at Mayo Clinic

Pregnancy week by week
Fetal presentation before birth

The way a baby is positioned in the uterus just before birth can have a big effect on labor and delivery. This positioning is called fetal presentation.

Babies twist, stretch and tumble quite a bit during pregnancy. Before labor starts, however, they usually come to rest in a way that allows them to be delivered through the birth canal headfirst. This position is called cephalic presentation. But there are other ways a baby may settle just before labor begins.

Following are some of the possible ways a baby may be positioned at the end of pregnancy.

Head down, face down

When a baby is head down, face down, the medical term for it is the cephalic occiput anterior position. This the most common position for a baby to be born in. With the face down and turned slightly to the side, the smallest part of the baby's head leads the way through the birth canal. It is the easiest way for a baby to be born.

Head down, face up

When a baby is head down, face up, the medical term for it is the cephalic occiput posterior position. In this position, it might be harder for a baby's head to go under the pubic bone during delivery. That can make labor take longer.

Most babies who begin labor in this position eventually turn to be face down. If that doesn't happen, and the second stage of labor is taking a long time, a member of the health care team may reach through the vagina to help the baby turn. This is called manual rotation.

In some cases, a baby can be born in the head-down, face-up position. Use of forceps or a vacuum device to help with delivery is more common when a baby is in this position than in the head-down, face-down position. In some cases, a C-section delivery may be needed.

Illustration of the head-down, face-up position

Frank breech

When a baby's feet or buttocks are in place to come out first during birth, it's called a breech presentation. This happens in about 3% to 4% of babies close to the time of birth. The baby shown below is in a frank breech presentation. That's when the knees aren't bent, and the feet are close to the baby's head. This is the most common type of breech presentation.

If you are more than 36 weeks into your pregnancy and your baby is in a frank breech presentation, your health care professional may try to move the baby into a head-down position. This is done using a procedure called external cephalic version. It involves one or two members of the health care team putting pressure on your belly with their hands to get the baby to roll into a head-down position.

If the procedure isn't successful, or if the baby moves back into a breech position, talk with a member of your health care team about the choices you have for delivery. Most babies in a frank breech position are born by planned C-section.

Illustration of the frank breech position

Complete and incomplete breech

A complete breech presentation, as shown below, is when the baby has both knees bent and both legs pulled close to the body. In an incomplete breech, one or both of the legs are not pulled close to the body, and one or both of the feet or knees are below the baby's buttocks. If a baby is in either of these positions, you might feel kicking in the lower part of your belly.

If you are more than 36 weeks into your pregnancy and your baby is in a complete or incomplete breech presentation, your health care professional may try to move the baby into a head-down position. This is done using a procedure called external cephalic version. It involves one or two members of the health care team putting pressure on your belly with their hands to get the baby to roll into a head-down position.

If the procedure isn't successful, or if the baby moves back into a breech position, talk with a member of your health care team about the choices you have for delivery. Many babies in a complete or incomplete breech position are born by planned C-section.

Illustration of a complete breech presentation

When a baby is sideways — lying horizontal across the uterus, rather than vertical — it's called a transverse lie. In this position, the baby's back might be:

Down, with the back facing the birth canal.
Sideways, with one shoulder pointing toward the birth canal.
Up, with the hands and feet facing the birth canal.

Although many babies are sideways early in pregnancy, few stay this way when labor begins.

If your baby is in a transverse lie during week 37 of your pregnancy, your health care professional may try to move the baby into a head-down position. This is done using a procedure called external cephalic version. External cephalic version involves one or two members of your health care team putting pressure on your belly with their hands to get the baby to roll into a head-down position.

If the procedure isn't successful, or if the baby moves back into a transverse lie, talk with a member of your health care team about the choices you have for delivery. Many babies who are in a transverse lie are born by C-section.

If you're pregnant with twins and only the twin that's lower in the uterus is head down, as shown below, your health care provider may first deliver that baby vaginally.

Then, in some cases, your health care team may suggest delivering the second twin in the breech position. Or they may try to move the second twin into a head-down position. This is done using a procedure called external cephalic version. External cephalic version involves one or two members of the health care team putting pressure on your belly with their hands to get the baby to roll into a head-down position.

Your health care team may suggest delivery by C-section for the second twin if:

An attempt to deliver the baby in the breech position is not successful.
You do not want to try to have the baby delivered vaginally in the breech position.
An attempt to move the baby into a head-down position is not successful.
You do not want to try to move the baby to a head-down position.

In some cases, your health care team may advise that you have both twins delivered by C-section. That might happen if the lower twin is not head down, the second twin has low or high birth weight as compared to the first twin, or if preterm labor starts.

Landon MB, et al., eds. Normal labor and delivery. In: Gabbe's Obstetrics: Normal and Problem Pregnancies. 8th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed May 19, 2023.
Holcroft Argani C, et al. Occiput posterior position. https://www.updtodate.com/contents/search. Accessed May 19, 2023.
Frequently asked questions: If your baby is breech. American College of Obstetricians and Gynecologists https://www.acog.org/womens-health/faqs/if-your-baby-is-breech. Accessed May 22, 2023.
Hofmeyr GJ. Overview of breech presentation. https://www.updtodate.com/contents/search. Accessed May 22, 2023.
Strauss RA, et al. Transverse fetal lie. https://www.updtodate.com/contents/search. Accessed May 22, 2023.
Chasen ST, et al. Twin pregnancy: Labor and delivery. https://www.updtodate.com/contents/search. Accessed May 22, 2023.
Cohen R, et al. Is vaginal delivery of a breech second twin safe? A comparison between delivery of vertex and non-vertex second twins. The Journal of Maternal-Fetal & Neonatal Medicine. 2021; doi:10.1080/14767058.2021.2005569.
Marnach ML (expert opinion). Mayo Clinic. May 31, 2023.

Products and Services

A Book: Mayo Clinic Guide to a Healthy Pregnancy
3rd trimester pregnancy
Fetal development: The 3rd trimester
Overdue pregnancy
Pregnancy due date calculator
Prenatal care: 3rd trimester

Mayo Clinic does not endorse companies or products. Advertising revenue supports our not-for-profit mission.

Opportunities

Mayo Clinic Press

Check out these best-sellers and special offers on books and newsletters from Mayo Clinic Press .

Mayo Clinic on Incontinence - Mayo Clinic Press Mayo Clinic on Incontinence
The Essential Diabetes Book - Mayo Clinic Press The Essential Diabetes Book
Mayo Clinic on Hearing and Balance - Mayo Clinic Press Mayo Clinic on Hearing and Balance
FREE Mayo Clinic Diet Assessment - Mayo Clinic Press FREE Mayo Clinic Diet Assessment
Mayo Clinic Health Letter - FREE book - Mayo Clinic Press Mayo Clinic Health Letter - FREE book
Healthy Lifestyle

Your gift holds great power – donate today!

Make your tax-deductible gift and be part of the cutting-edge research and care that's changing medicine.

Getting Pregnant
Registry Builder
Baby Products
Birth Clubs
See all in Community
Ovulation Calculator
How To Get Pregnant
How To Get Pregnant Fast
Ovulation Discharge
Implantation Bleeding
Ovulation Symptoms
Pregnancy Symptoms
Am I Pregnant?
Pregnancy Tests
See all in Getting Pregnant
Due Date Calculator
Pregnancy Week by Week
Pregnant Sex
Weight Gain Tracker
Signs of Labor
Morning Sickness
COVID Vaccine and Pregnancy
Fetal Weight Chart
Fetal Development
Pregnancy Discharge
Find Out Baby Gender
Chinese Gender Predictor
See all in Pregnancy
Baby Name Generator
Top Baby Names 2023
Top Baby Names 2024
How to Pick a Baby Name
Most Popular Baby Names
Baby Names by Letter
Gender Neutral Names
Unique Boy Names
Unique Girl Names
Top baby names by year
See all in Baby Names
Baby Development
Baby Feeding Guide
Newborn Sleep
When Babies Roll Over
First-Year Baby Costs Calculator
Postpartum Health
Baby Poop Chart
See all in Baby
Average Weight & Height
Autism Signs
Child Growth Chart
Night Terrors
Moving from Crib to Bed
Toddler Feeding Guide
Potty Training
Bathing and Grooming
See all in Toddler
Height Predictor
Potty Training: Boys
Potty training: Girls
How Much Sleep? (Ages 3+)
Ready for Preschool?
Thumb-Sucking
Gross Motor Skills
Napping (Ages 2 to 3)
See all in Child
Photos: Rashes & Skin Conditions
Symptom Checker
Vaccine Scheduler
Reducing a Fever
Acetaminophen Dosage Chart
Constipation in Babies
Ear Infection Symptoms
Head Lice 101
See all in Health
Second Pregnancy
Daycare Costs
Family Finance
Stay-At-Home Parents
Breastfeeding Positions
See all in Family
Baby Sleep Training
Preparing For Baby
My Custom Checklist
My Registries
Take the Quiz
Best Baby Products
Best Breast Pump
Best Convertible Car Seat
Best Infant Car Seat
Best Baby Bottle
Best Baby Monitor
Best Stroller
Best Diapers
Best Baby Carrier
Best Diaper Bag
Best Highchair
See all in Baby Products
Why Pregnant Belly Feels Tight
Early Signs of Twins
Teas During Pregnancy
Baby Head Circumference Chart
How Many Months Pregnant Am I
What is a Rainbow Baby
Braxton Hicks Contractions
HCG Levels By Week
When to Take a Pregnancy Test
Am I Pregnant
Why is Poop Green
Can Pregnant Women Eat Shrimp
Insemination
UTI During Pregnancy
Vitamin D Drops
Best Baby Forumla
Postpartum Depression
Low Progesterone During Pregnancy
Baby Shower
Baby Shower Games

Breech, posterior, transverse lie: What position is my baby in?

Fetal presentation, or how your baby is situated in your womb at birth, is determined by the body part that's positioned to come out first, and it can affect the way you deliver. At the time of delivery, 97 percent of babies are head-down (cephalic presentation). But there are several other possibilities, including feet or bottom first (breech) as well as sideways (transverse lie) and diagonal (oblique lie).

Fetal presentation and position

During the last trimester of your pregnancy, your provider will check your baby's presentation by feeling your belly to locate the head, bottom, and back. If it's unclear, your provider may do an ultrasound or an internal exam to feel what part of the baby is in your pelvis.

Fetal position refers to whether the baby is facing your spine (anterior position) or facing your belly (posterior position). Fetal position can change often: Your baby may be face up at the beginning of labor and face down at delivery.

Here are the many possibilities for fetal presentation and position in the womb.

Medical illustrations by Jonathan Dimes

Head down, facing down (anterior position)

A baby who is head down and facing your spine is in the anterior position. This is the most common fetal presentation and the easiest position for a vaginal delivery.

This position is also known as "occiput anterior" because the back of your baby's skull (occipital bone) is in the front (anterior) of your pelvis.

Head down, facing up (posterior position)

In the posterior position , your baby is head down and facing your belly. You may also hear it called "sunny-side up" because babies who stay in this position are born facing up. But many babies who are facing up during labor rotate to the easier face down (anterior) position before birth.

Posterior position is formally known as "occiput posterior" because the back of your baby's skull (occipital bone) is in the back (posterior) of your pelvis.

Frank breech

In the frank breech presentation, both the baby's legs are extended so that the feet are up near the face. This is the most common type of breech presentation. Breech babies are difficult to deliver vaginally, so most arrive by c-section .

Some providers will attempt to turn your baby manually to the head down position by applying pressure to your belly. This is called an external cephalic version , and it has a 58 percent success rate for turning breech babies. For more information, see our article on breech birth .

Complete breech

A complete breech is when your baby is bottom down with hips and knees bent in a tuck or cross-legged position. If your baby is in a complete breech, you may feel kicking in your lower abdomen.

Incomplete breech

In an incomplete breech, one of the baby's knees is bent so that the foot is tucked next to the bottom with the other leg extended, positioning that foot closer to the face.

Single footling breech

In the single footling breech presentation, one of the baby's feet is pointed toward your cervix.

Double footling breech

In the double footling breech presentation, both of the baby's feet are pointed toward your cervix.

Transverse lie

In a transverse lie, the baby is lying horizontally in your uterus and may be facing up toward your head or down toward your feet. Babies settle this way less than 1 percent of the time, but it happens more commonly if you're carrying multiples or deliver before your due date.

If your baby stays in a transverse lie until the end of your pregnancy, it can be dangerous for delivery. Your provider will likely schedule a c-section or attempt an external cephalic version , which is highly successful for turning babies in this position.

Oblique lie

In rare cases, your baby may lie diagonally in your uterus, with his rump facing the side of your body at an angle.

Like the transverse lie, this position is more common earlier in pregnancy, and it's likely your provider will intervene if your baby is still in the oblique lie at the end of your third trimester.

Was this article helpful?

What to know if your baby is breech

What's a sunny-side up baby?

9 of the most jaw-dropping breech birth photos

baby with umbilical cord getting delivered

Raspberry leaf tea is popular during pregnancy – but possible benefits aren't proven

BabyCenter's editorial team is committed to providing the most helpful and trustworthy pregnancy and parenting information in the world. When creating and updating content, we rely on credible sources: respected health organizations, professional groups of doctors and other experts, and published studies in peer-reviewed journals. We believe you should always know the source of the information you're seeing. Learn more about our editorial and medical review policies .

Ahmad A et al. 2014. Association of fetal position at onset of labor and mode of delivery: A prospective cohort study. Ultrasound in obstetrics & gynecology 43(2):176-182. https://www.ncbi.nlm.nih.gov/pubmed/23929533 Opens a new window [Accessed September 2021]

Gray CJ and Shanahan MM. 2019. Breech presentation. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK448063/ Opens a new window [Accessed September 2021]

Hankins GD. 1990. Transverse lie. American Journal of Perinatology 7(1):66-70. https://www.ncbi.nlm.nih.gov/pubmed/2131781 Opens a new window [Accessed September 2021]

Medline Plus. 2020. Your baby in the birth canal. U.S. National Library of Medicine. https://medlineplus.gov/ency/article/002060.htm Opens a new window [Accessed September 2021]

Where to go next

Screening & Prevention
Sexual Health & Relationships
Birth Control
Preparing for Surgery Checklist
Healthy Teens
Getting Pregnant
During Pregnancy
Labor and Delivery
After Pregnancy
Pregnancy Book
Mental Health
Prenatal Testing
Menstrual Health
Heart Health
Special Procedures
Diseases and Conditions
Browse All Topics
View All Frequently Asked Questions

Read common questions on the coronavirus and ACOG’s evidence-based answers.

If Your Baby Is Breech

URL has been copied to the clipboard

Frequently Asked Questions Expand All

In the last weeks of pregnancy, a fetus usually moves so his or her head is positioned to come out of the vagina first during birth. This is called a vertex presentation . A breech presentation occurs when the fetus’s buttocks, feet, or both are in place to come out first during birth. This happens in 3–4% of full-term births.

It is not always known why a fetus is breech. Some factors that may contribute to a fetus being in a breech presentation include the following:

You have been pregnant before.

There is more than one fetus in the uterus (twins or more).

There is too much or too little amniotic fluid .

The uterus is not normal in shape or has abnormal growths such as fibroids .

The placenta covers all or part of the opening of the uterus ( placenta previa )

The fetus is preterm .

Occasionally fetuses with certain birth defects will not turn into the head-down position before birth. However, most fetuses in a breech presentation are otherwise normal.

Your health care professional may be able to tell which way your fetus is facing by placing his or her hands at certain points on your abdomen. By feeling where the fetus's head, back, and buttocks are, it may be possible to find out what part of the fetus is presenting first. An ultrasound exam or pelvic exam may be used to confirm it.

External cephalic version (ECV) is an attempt to turn the fetus so that he or she is head down. ECV can improve your chance of having a vaginal birth. If the fetus is breech and your pregnancy is greater than 36 weeks your health care professional may suggest ECV.

ECV will not be tried if:

You are carrying more than one fetus

There are concerns about the health of the fetus

You have certain abnormalities of the reproductive system

The placenta is in the wrong place

The placenta has come away from the wall of the uterus ( placental abruption )

ECV can be considered if you have had a previous cesarean delivery .

The health care professional performs ECV by placing his or her hands on your abdomen. Firm pressure is applied to the abdomen so that the fetus rolls into a head-down position. Two people may be needed to perform ECV. Ultrasound also may be used to help guide the turning.

The fetus's heart rate is checked with fetal monitoring before and after ECV. If any problems arise with you or the fetus, ECV will be stopped right away. ECV usually is done near a delivery room. If a problem occurs, a cesarean delivery can be performed quickly, if necessary.

Complications may include the following:

Prelabor rupture of membranes

Changes in the fetus's heart rate

Placental abruption

Preterm labor

More than one half of attempts at ECV succeed. However, some fetuses who are successfully turned with ECV move back into a breech presentation. If this happens, ECV may be tried again. ECV tends to be harder to do as the time for birth gets closer. As the fetus grows bigger, there is less room for him or her to move.

Most fetuses that are breech are born by planned cesarean delivery. A planned vaginal birth of a single breech fetus may be considered in some situations. Both vaginal birth and cesarean birth carry certain risks when a fetus is breech. However, the risk of complications is higher with a planned vaginal delivery than with a planned cesarean delivery.

In a breech presentation, the body comes out first, leaving the baby’s head to be delivered last. The baby’s body may not stretch the cervix enough to allow room for the baby’s head to come out easily. There is a risk that the baby’s head or shoulders may become wedged against the bones of the mother’s pelvis. Another problem that can happen during a vaginal breech birth is a prolapsed umbilical cord . It can slip into the vagina before the baby is delivered. If there is pressure put on the cord or it becomes pinched, it can decrease the flow of blood and oxygen through the cord to the baby.

Although a planned cesarean birth is the most common way that breech fetuses are born, there may be reasons to try to avoid a cesarean birth.

A cesarean delivery is major surgery. Complications may include infection, bleeding, or injury to internal organs.

The type of anesthesia used sometimes causes problems.

Having a cesarean delivery also can lead to serious problems in future pregnancies, such as rupture of the uterus and complications with the placenta.

With each cesarean delivery, these risks increase.

If you are thinking about having a vaginal birth and your fetus is breech, your health care professional will review the risks and benefits of vaginal birth and cesarean birth in detail. You usually need to meet certain guidelines specific to your hospital. The experience of your health care professional in delivering breech babies vaginally also is an important factor.

Amniotic Fluid : Fluid in the sac that holds the fetus.

Anesthesia : Relief of pain by loss of sensation.

Breech Presentation : A position in which the feet or buttocks of the fetus would appear first during birth.

Cervix : The lower, narrow end of the uterus at the top of the vagina.

Cesarean Delivery : Delivery of a fetus from the uterus through an incision made in the woman’s abdomen.

External Cephalic Version (ECV) : A technique, performed late in pregnancy, in which the doctor attempts to manually move a breech baby into the head-down position.

Fetus : The stage of human development beyond 8 completed weeks after fertilization.

Fibroids : Growths that form in the muscle of the uterus. Fibroids usually are noncancerous.

Oxygen : An element that we breathe in to sustain life.

Pelvic Exam : A physical examination of a woman’s pelvic organs.

Placenta : Tissue that provides nourishment to and takes waste away from the fetus.

Placenta Previa : A condition in which the placenta covers the opening of the uterus.

Placental Abruption : A condition in which the placenta has begun to separate from the uterus before the fetus is born.

Prelabor Rupture of Membranes : Rupture of the amniotic membranes that happens before labor begins. Also called premature rupture of membranes (PROM).

Preterm : Less than 37 weeks of pregnancy.

Ultrasound Exam : A test in which sound waves are used to examine inner parts of the body. During pregnancy, ultrasound can be used to check the fetus.

Umbilical Cord : A cord-like structure containing blood vessels. It connects the fetus to the placenta.

Uterus : A muscular organ in the female pelvis. During pregnancy, this organ holds and nourishes the fetus.

Vagina : A tube-like structure surrounded by muscles. The vagina leads from the uterus to the outside of the body.

Vertex Presentation : A presentation of the fetus where the head is positioned down.

Article continues below

If you have further questions, contact your ob-gyn.

Don't have an ob-gyn? Learn how to find a doctor near you .

Published: January 2019

Last reviewed: August 2022

Copyright 2024 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information . This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer .

Clinicians: Subscribe to Digital Pamphlets

Explore ACOG's library of patient education pamphlets.

A Guide to Pregnancy from Ob-Gyns

For trusted, in-depth advice from ob-gyns, turn to Your Pregnancy and Childbirth: Month to Month.

ACOG Explains

A quick and easy way to learn more about your health.

Fetal Positions for Labor and Birth

Knowing your baby's position can you help ease pain and speed up labor

In the last weeks of pregnancy , determining your baby's position can help you manage pain and discomfort. Knowing your baby's position during early labor can help you adjust your own position during labor and possibly even speed up the process.

Right or Left Occiput Anterior

Illustration by JR Bee, Verywell

Looking at where the baby's head is in the birth canal helps determine the fetal position.The front of a baby's head is referred to as the anterior portion and the back is the posterior portion. There are two different positions called occiput anterior (OA) positions that may occur.

The left occiput anterior (LOA) position is the most common in labor. In this position, the baby's head is slightly off-center in the pelvis with the back of the head toward the mother's left thigh.

The right occiput anterior (ROA) presentation is also common in labor. In this position, the back of the baby is slightly off-center in the pelvis with the back of the head toward the mother's right thigh.

In general, OA positions do not lead to problems or additional pain during labor or birth.

Right or Left Occiput Transverse

Illustration by JR Bee, Verywell

When facing out toward the mother's right thigh, the baby is said to be left occiput transverse (LOT). This position is halfway between a posterior and anterior position. If the baby was previously in a posterior position (in either direction), the LOT position indicates positive movement toward an anterior position.

When the baby is facing outward toward the mother's left thigh, the baby is said to be right occiput transverse (ROT). Like the previous presentation, ROT is halfway between a posterior and anterior position. If the baby was previously in a posterior position, ROT is a sign the baby is making a positive move toward an anterior position.

When a baby is in the left occiput transverse position (LOT) or right occiput transverse (ROT) position during labor, it may lead to more pain and a slower progression.

Tips to Reduce Discomfort

There are several labor positions a mother can try to alleviate pain and encourage the baby to continue rotating toward an anterior position, including:

Pelvic tilts
Standing and swaying

A doula , labor nurse, midwife , or doctor may have other suggestions for positions.

Right or Left Occiput Posterior

When facing forward, the baby is in the occiput posterior position. If the baby is facing forward and slightly to the left (looking toward the mother's right thigh) it is in the left occiput posterior (LOP) position. This presentation can lead to more back pain (sometimes referred to as " back labor ") and slow progression of labor.

In the right occiput posterior position (ROP), the baby is facing forward and slightly to the right (looking toward the mother's left thigh). This presentation may slow labor and cause more pain.

To help prevent or decrease pain during labor and encourage the baby to move into a better position for delivery, mothers can try a variety of positions, including:

Hands and knees
Pelvic rocking

Mothers may try other comfort measures, including:

Bathtub or shower (water)
Counter pressure
Movement (swaying, dancing, sitting on a birth ball )
Rice socks (heat packs)

How a Doctor Determines Baby's Position

Leopold's maneuvers are a series of hands-on examinations your doctor or midwife will use to help determine your baby's position. During the third trimester , the assessment will be done at most of your prenatal visits. Knowing the baby's position before labor begins can help you prepare for labor and delivery.

Once labor begins, a nurse, doctor, or midwife will be able to get a more accurate sense of your baby's position by performing a vaginal exam. When your cervix is dilated enough, the practitioner will insert their fingers into the vagina and feel for the suture lines of the baby's skull as it moves down in the birth canal. It's important to ensure the baby is head down and moving in the right direction.

Labor and delivery may be more complicated if the baby is not in a head-down position, such as in the case of a breech presentation.

How You Can Determine Baby's Position

While exams by health practitioners are an important part of your care, from the prenatal period through labor and delivery, often the best person to assess a baby's position in the pelvis is you. Mothers should pay close attention to how the baby moves and where different movements are felt.

A technique called belly mapping can help mothers ask questions of themselves to assess their baby's movement and get a sense of the position they are in as labor approaches.

For example, the position of your baby's legs can be determined by asking questions about the location and strength of the kicking you feel. The spots where you feel the strongest kicks are most likely where your baby's feet are.

Other landmarks you can feel for include a large, flat plane, which is most likely your baby's back. Sometimes you can feel the baby arching his or her back.

At the top or bottom of the flat plane, you may feel either a hard, round shape (most likely your baby's head) or a soft curve (most likely to be your baby's bottom).

Guittier M, Othenin-Girard V, de Gasquet B, Irion O, Boulvain M. Maternal positioning to correct occiput posterior fetal position during the first stage of labour: a randomised controlled trial . BJOG: An International Journal of Obstetrics & Gynaecology . 2016;123(13):2199-2207. doi:10.1111/1471-0528.13855

Gizzo S, Di Gangi S, Noventa M, Bacile V, Zambon A, Nardelli G. Women’s Choice of Positions during Labour: Return to the Past or a Modern Way to Give Birth? A Cohort Study in Italy . Biomed Res Int . 2014;2014:1-7. doi:10.1155/2014/638093

Ahmad A, Webb S, Early B, Sitch A, Khan K, MacArthur C. Association between fetal position at onset of labor and mode of delivery: a prospective cohort study . Ultrasound in Obstetrics & Gynecology . 2014;43(2):176-182. doi:10.1002/uog.13189

Nishikawa M, Sakakibara H. Effect of nursing intervention program using abdominal palpation of Leopold’s maneuvers on maternal-fetal attachment . Reprod Health . 2013;10(1). doi:10.1186/1742-4755-10-12

Choi S, Park Y, Lee D, Ko H, Park I, Shin J. Sonographic assessment of fetal occiput position during labor for the prediction of labor dystocia and perinatal outcomes . The Journal of Maternal-Fetal & Neonatal Medicine . 2016;29(24):3988-3992. doi:10.3109/14767058.2016.1152250

Bamberg C, Deprest J, Sindhwani N et al. Evaluating fetal head dimension changes during labor using open magnetic resonance imaging . J Perinat Med . 2017;45(3). doi:10.1515/jpm-2016-0005

Gabbe S, Niebyl J, Simpson J et al. Obstetrics . Philadelphia, Pa.: Elsevier; 2012.

By Robin Elise Weiss, PhD, MPH Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor.

Breech Position: What It Means if Your Baby Is Breech

Medically reviewed for accuracy.

What does it mean if a baby is breech?

What are the different types of breech positions, what causes a baby to be breech, recommended reading, how can you tell if your baby is in a breech position, what does it mean to turn a breech baby, how can you turn a breech baby, how does labor usually start with a breech baby.

If your cervix dilates too slowly, if your baby doesn’t move down the birth canal steadily or if other problems arise, you’ll likely have a C-section. Talk your options over with your practitioner now to be prepared. Remember that though you may feel disappointed things didn’t turn out exactly as you envisioned, these feelings will melt away once your bundle of joy safely enters the world.

Pregnancy Classes

Breech Births

In the last weeks of pregnancy, a baby usually moves so his or her head is positioned to come out of the vagina first during birth. This is called a vertex presentation. A breech presentation occurs when the baby’s buttocks, feet, or both are positioned to come out first during birth. This happens in 3–4% of full-term births.

What are the different types of breech birth presentations?

Complete breech: Here, the buttocks are pointing downward with the legs folded at the knees and feet near the buttocks.
Frank breech: In this position, the baby’s buttocks are aimed at the birth canal with its legs sticking straight up in front of his or her body and the feet near the head.
Footling breech: In this position, one or both of the baby’s feet point downward and will deliver before the rest of the body.

What causes a breech presentation?

The causes of breech presentations are not fully understood. However, the data show that breech birth is more common when:

You have been pregnant before
In pregnancies of multiples
When there is a history of premature delivery
When the uterus has too much or too little amniotic fluid
When there is an abnormally shaped uterus or a uterus with abnormal growths, such as fibroids
The placenta covers all or part of the opening of the uterus placenta previa

How is a breech presentation diagnosed?

A few weeks prior to the due date, the health care provider will place her hands on the mother’s lower abdomen to locate the baby’s head, back, and buttocks. If it appears that the baby might be in a breech position, they can use ultrasound or pelvic exam to confirm the position. Special x-rays can also be used to determine the baby’s position and the size of the pelvis to determine if a vaginal delivery of a breech baby can be safely attempted.

Can a breech presentation mean something is wrong?

Even though most breech babies are born healthy, there is a slightly elevated risk for certain problems. Birth defects are slightly more common in breech babies and the defect might be the reason that the baby failed to move into the right position prior to delivery.

Can a breech presentation be changed?

It is preferable to try to turn a breech baby between the 32nd and 37th weeks of pregnancy . The methods of turning a baby will vary and the success rate for each method can also vary. It is best to discuss the options with the health care provider to see which method she recommends.

Medical Techniques

External Cephalic Version (EVC) is a non-surgical technique to move the baby in the uterus. In this procedure, a medication is given to help relax the uterus. There might also be the use of an ultrasound to determine the position of the baby, the location of the placenta and the amount of amniotic fluid in the uterus.

Gentle pushing on the lower abdomen can turn the baby into the head-down position. Throughout the external version the baby’s heartbeat will be closely monitored so that if a problem develops, the health care provider will immediately stop the procedure. ECV usually is done near a delivery room so if a problem occurs, a cesarean delivery can be performed quickly. The external version has a high success rate and can be considered if you have had a previous cesarean delivery.

ECV will not be tried if:

You are carrying more than one fetus
There are concerns about the health of the fetus
You have certain abnormalities of the reproductive system
The placenta is in the wrong place
The placenta has come away from the wall of the uterus ( placental abruption )

Complications of EVC include:

Prelabor rupture of membranes
Changes in the fetus’s heart rate
Placental abruption
Preterm labor

Vaginal delivery versus cesarean for breech birth?

Most health care providers do not believe in attempting a vaginal delivery for a breech position. However, some will delay making a final decision until the woman is in labor. The following conditions are considered necessary in order to attempt a vaginal birth:

The baby is full-term and in the frank breech presentation
The baby does not show signs of distress while its heart rate is closely monitored.
The process of labor is smooth and steady with the cervix widening as the baby descends.
The health care provider estimates that the baby is not too big or the mother’s pelvis too narrow for the baby to pass safely through the birth canal.
Anesthesia is available and a cesarean delivery possible on short notice

What are the risks and complications of a vaginal delivery?

In a breech birth, the baby’s head is the last part of its body to emerge making it more difficult to ease it through the birth canal. Sometimes forceps are used to guide the baby’s head out of the birth canal. Another potential problem is cord prolapse . In this situation the umbilical cord is squeezed as the baby moves toward the birth canal, thus slowing the baby’s supply of oxygen and blood. In a vaginal breech delivery, electronic fetal monitoring will be used to monitor the baby’s heartbeat throughout the course of labor. Cesarean delivery may be an option if signs develop that the baby may be in distress.

When is a cesarean delivery used with a breech presentation?

Most health care providers recommend a cesarean delivery for all babies in a breech position, especially babies that are premature. Since premature babies are small and more fragile, and because the head of a premature baby is relatively larger in proportion to its body, the baby is unlikely to stretch the cervix as much as a full-term baby. This means that there might be less room for the head to emerge.

Want to Know More?

Creating Your Birth Plan
Labor & Birth Terms to Know
Cesarean Birth After Care

Compiled using information from the following sources:

ACOG: If Your Baby is Breech
William’s Obstetrics Twenty-Second Ed. Cunningham, F. Gary, et al, Ch. 24.
Danforth’s Obstetrics and Gynecology Ninth Ed. Scott, James R., et al, Ch. 21.

Share this post:

Episiotomy: Advantages & Complications

Retained Placenta

What is Dilation in Pregnancy?

Track your baby’s development, subscribe to our week-by-week pregnancy newsletter.

The Bumpy Truth Blog
Fertility Products Resource Guide

Pregnancy Tools

Ovulation Calendar
Baby Names Directory
Pregnancy Due Date Calculator
Pregnancy Quiz

Pregnancy Journeys

Partner With Us
Corporate Sponsors

If your baby is in a breech presentation, their feet or bottom will be closest to your birth canal. The 3 most common types of breech presentation are:

frank or extended breech — where your baby’s legs are straight up in front of their body, with their feet up near their face
complete or flexed breech — where your baby is in a sitting position with their legs crossed in front of their body and their feet near their bottom
footling breech — where one or both of your baby’s feet are hanging below their bottom, so the foot or feet are coming first

What are the different positions my baby could be in during pregnancy and birth?

If your baby is headfirst, the 3 main types of presentation are:

anterior – when the back of your baby’s head is at the front of your belly
lateral – when the back of your baby’s head is facing your side
posterior – when the back of your baby’s head is towards your back

Anterior, lateral and posterior fetal presentations

How will I know what presentation and position my baby is in?

Your doctor or midwife can usually work out your baby’s presentation by feeling your abdomen. They may also double check it with a portable ultrasound. Your baby’s presentation is usually checked around 36 weeks .

Your doctor or midwife will also confirm your baby’s head position in labour by examining your belly and using an ultrasound , and they may also do a vaginal examination . During the vaginal examination they are feeling for certain ridges on your baby’s head called sutures and fontanelles that help them work out which way your baby is positioned.

What is the ideal presentation and position for baby to be in for a vaginal birth?

For a vaginal birth, your baby will ideally be headfirst with the back of their head at the front of your belly, also known as being in the anterior position. This position is best for labour and birth since it means that the smallest part of your baby’s head goes down the birth canal first.

Vertex presentation, showing the narrow part of the baby’s head.

When does a baby usually get in the ideal presentation and position for birth?

Your baby will usually be in a headfirst position by 37 weeks of pregnancy. Around 3 in every 100 babies will be in breech presentation after 37 weeks.

Your baby’s position can change with your contractions during labour as they move down the birth canal, so their exact position can change during labour.

What are my options if baby isn't in the ideal presentation or position for a vaginal birth?

If your baby is in a breech presentation, your doctor may recommend a technique called an external cephalic version (ECV) to try and move your baby while they are still in the uterus . An ECV involves your doctor using their hands to apply pressure on your belly and help turn your baby to a headfirst position. It has a 1 in 2 chance of success and is a safe option in most pregnancies.

There is no evidence to show that alternative therapies, such as exercises, acupuncture or chiropractic treatments, help your baby change from a breech presentation to headfirst.

If your baby remains breech, your doctor may discuss having a breech vaginal birth. Not all doctors and hospitals offer this option. They may also suggest you birth your baby with a planned caesarean section .

If your baby’s presentation is headfirst but the position of your baby’s head is not ideal for labour, it can lead to a longer labour, and potential complications . The position of your baby’s head will often change as your labour progresses. If it doesn’t, sometimes you can still give birth without assistance, or you may need your doctor to help turn your baby’s head or help your birth with a vacuum or forceps .

Any procedure or decision for a type of birth will only go ahead with your consent . You will be able to discuss all the options with your doctor, and based on your preferences for yourself and your baby’s safety, make a decision together .

Resources and support

The Royal Australian and New Zealand College of Obstetrics and Gynaecology has a factsheet about the options available to you if your baby is in a breech presentation at the end of your pregnancy .

Mercy Perinatal has information on external cephalic version (ECV) safety and benefits if your baby is in a breech presentation at the end of your pregnancy.

The Women’s Hospital has information about the different presentations and positions your baby could be in, and how it can affect your birthing experience.

Speak to a maternal child health nurse

Call Pregnancy, Birth and Baby to speak to a maternal child health nurse on 1800 882 436 or video call . Available 7am to midnight (AET), 7 days a week.

Learn more here about the development and quality assurance of healthdirect content .

Last reviewed: October 2023

External cephalic version (ecv), malpresentation, breech pregnancy, search our site for.

Foetal Version
Breech Presentation

Need more information?

Breech presentation and turning the baby

In preparation for a safe birth, your health team will need to turn your baby if it is in a bottom first ‘breech’ position.

Breech Presentation at the End of your Pregnancy

Breech presentation occurs when your baby is lying bottom first or feet first in the uterus (womb) rather than the usual head first position. In early pregnancy, a breech position is very common.

Read more on RANZCOG - Royal Australian and New Zealand College of Obstetricians and Gynaecologists website

External Cephalic Version for Breech Presentation - Pregnancy and the first five years

This information brochure provides information about an External Cephalic Version (ECV) for breech presentation

Labour complications

Even if you’re healthy and well prepared for childbirth, there’s always a chance of unexpected problems. Learn more about labour complications.

ECV is a procedure to try to move your baby from a breech position to a head-down position. This is performed by a trained doctor.

Having a baby

The articles in this section relate to having a baby – what to consider before becoming pregnant, pregnancy and birth, and after your baby is born.

Anatomy of pregnancy and birth - pelvis

Your pelvis helps to carry your growing baby and is tailored for vaginal births. Learn more about the structure and function of the female pelvis.

Planned or elective caesarean

There are important things to consider if you are having a planned or elective caesarean such as what happens during and after the procedure.

Pregnancy, Birth and Baby is not responsible for the content and advertising on the external website you are now entering.

Call us and speak to a Maternal Child Health Nurse for personal advice and guidance.

Need further advice or guidance from our maternal child health nurses?

1800 882 436

Government Accredited with over 140 information partners

We are a government-funded service, providing quality, approved health information and advice

Healthdirect Australia acknowledges the Traditional Owners of Country throughout Australia and their continuing connection to land, sea and community. We pay our respects to the Traditional Owners and to Elders both past and present.

This information is for your general information and use only and is not intended to be used as medical advice and should not be used to diagnose, treat, cure or prevent any medical condition, nor should it be used for therapeutic purposes.

The information is not a substitute for independent professional advice and should not be used as an alternative to professional health care. If you have a particular medical problem, please consult a healthcare professional.

Except as permitted under the Copyright Act 1968, this publication or any part of it may not be reproduced, altered, adapted, stored and/or distributed in any form or by any means without the prior written permission of Healthdirect Australia.

Support this browser is being discontinued for Pregnancy, Birth and Baby

Support for this browser is being discontinued for this site

Internet Explorer 11 and lower

We currently support Microsoft Edge, Chrome, Firefox and Safari. For more information, please visit the links below:

Chrome by Google
Firefox by Mozilla
Microsoft Edge
Safari by Apple

You are welcome to continue browsing this site with this browser. Some features, tools or interaction may not work correctly.

Warning: The NCBI web site requires JavaScript to function. more...

An official website of the United States government

The .gov means it's official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Publications
Account settings
Browse Titles

NCBI Bookshelf. A service of the National Library of Medicine, National Institutes of Health.

StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

StatPearls [Internet].

Breech presentation.

Caron J. Gray ; Meaghan M. Shanahan .

Affiliations

Last Update: November 6, 2022 .

Continuing Education Activity

Breech presentation refers to the fetus in the longitudinal lie with the buttocks or lower extremity entering the pelvis first. The three types of breech presentation include frank breech, complete breech, and incomplete breech. In a frank breech, the fetus has flexion of both hips, and the legs are straight with the feet near the fetal face, in a pike position. This activity reviews the cause and pathophysiology of breech presentation and highlights the role of the interprofessional team in its management.

Describe the pathophysiology of breech presentation.
Review the physical exam of a patient with a breech presentation.
Summarize the treatment options for breech presentation.
Explain the importance of improving care coordination among interprofessional team members to improve outcomes for patients affected by breech presentation.
Introduction

Breech presentation refers to the fetus in the longitudinal lie with the buttocks or lower extremity entering the pelvis first. The three types of breech presentation include frank breech, complete breech, and incomplete breech. In a frank breech, the fetus has flexion of both hips, and the legs are straight with the feet near the fetal face, in a pike position. The complete breech has the fetus sitting with flexion of both hips and both legs in a tuck position. Finally, the incomplete breech can have any combination of one or both hips extended, also known as footling (one leg extended) breech, or double footling breech (both legs extended). [1] [2] [3]

Clinical conditions associated with breech presentation include those that may increase or decrease fetal motility, or affect the vertical polarity of the uterine cavity. Prematurity, multiple gestations, aneuploidies, congenital anomalies, Mullerian anomalies, uterine leiomyoma, and placental polarity as in placenta previa are most commonly associated with a breech presentation. Also, a previous history of breech presentation at term increases the risk of repeat breech presentation at term in subsequent pregnancies. [4] [5] These are discussed in more detail in the pathophysiology section.

Epidemiology

Breech presentation occurs in 3% to 4% of all term pregnancies. A higher percentage of breech presentations occurs with less advanced gestational age. At 32 weeks, 7% of fetuses are breech, and 28 weeks or less, 25% are breech.

Specifically, following one breech delivery, the recurrence rate for the second pregnancy was nearly 10%, and for a subsequent third pregnancy, it was 27%. Prior cesarean delivery has also been described by some to increase the incidence of breech presentation two-fold.

Pathophysiology

As mentioned previously, the most common clinical conditions or disease processes that result in the breech presentation are those that affect fetal motility or the vertical polarity of the uterine cavity. [6] [7]

Conditions that change the vertical polarity or the uterine cavity, or affect the ease or ability of the fetus to turn into the vertex presentation in the third trimester include:

Mullerian anomalies: Septate uterus, bicornuate uterus, and didelphys uterus
Placentation: Placenta previa as the placenta is occupying the inferior portion of the uterine cavity. Therefore, the presenting part cannot engage
Uterine leiomyoma: Mainly larger myomas located in the lower uterine segment, often intramural or submucosal, that prevent engagement of the presenting part.
Prematurity
Aneuploidies and fetal neuromuscular disorders commonly cause hypotonia of the fetus, inability to move effectively
Congenital anomalies: Fetal sacrococcygeal teratoma, fetal thyroid goiter
Polyhydramnios: Fetus is often in unstable lie, unable to engage
Oligohydramnios: Fetus is unable to turn to vertex due to lack of fluid
Laxity of the maternal abdominal wall: Uterus falls forward, the fetus is unable to engage in the pelvis.

The risk of cord prolapse varies depending on the type of breech. Incomplete or footling breech carries the highest risk of cord prolapse at 15% to 18%, while complete breech is lower at 4% to 6%, and frank breech is uncommon at 0.5%.

History and Physical

During the physical exam, using the Leopold maneuvers, palpation of a hard, round, mobile structure at the fundus and the inability to palpate a presenting part in the lower abdomen superior to the pubic bone or the engaged breech in the same area, should raise suspicion of a breech presentation.

During a cervical exam, findings may include the lack of a palpable presenting part, palpation of a lower extremity, usually a foot, or for the engaged breech, palpation of the soft tissue of the fetal buttocks may be noted. If the patient has been laboring, caution is warranted as the soft tissue of the fetal buttocks may be interpreted as caput of the fetal vertex.

Any of these findings should raise suspicion and ultrasound should be performed.

Diagnosis of a breech presentation can be accomplished through abdominal exam using the Leopold maneuvers in combination with the cervical exam. Ultrasound should confirm the diagnosis.

On ultrasound, the fetal lie and presenting part should be visualized and documented. If breech presentation is diagnosed, specific information including the specific type of breech, the degree of flexion of the fetal head, estimated fetal weight, amniotic fluid volume, placental location, and fetal anatomy review (if not already done previously) should be documented.

Treatment / Management

Expertise in the delivery of the vaginal breech baby is becoming less common due to fewer vaginal breech deliveries being offered throughout the United States and in most industrialized countries. The Term Breech Trial (TBT), a well-designed, multicenter, international, randomized controlled trial published in 2000 compared planned vaginal delivery to planned cesarean delivery for the term breech infant. The investigators reported that delivery by planned cesarean resulted in significantly lower perinatal mortality, neonatal mortality, and serious neonatal morbidity. Also, there was no significant difference in maternal morbidity or mortality between the two groups. Since that time, the rate of term breech infants delivered by planned cesarean has increased dramatically. Follow-up studies to the TBT have been published looking at maternal morbidity and outcomes of the children at two years. Although these reports did not show any significant difference in the risk of death and neurodevelopmental, these studies were felt to be underpowered. [8] [9] [10] [11]

Since the TBT, many authors since have argued that there are still some specific situations that vaginal breech delivery is a potential, safe alternative to planned cesarean. Many smaller retrospective studies have reported no difference in neonatal morbidity or mortality using these specific criteria.

The initial criteria used in these reports were similar: gestational age greater than 37 weeks, frank or complete breech presentation, no fetal anomalies on ultrasound examination, adequate maternal pelvis, and estimated fetal weight between 2500 g and 4000 g. In addition, the protocol presented by one report required documentation of fetal head flexion and adequate amniotic fluid volume, defined as a 3-cm vertical pocket. Oxytocin induction or augmentation was not offered, and strict criteria were established for normal labor progress. CT pelvimetry did determine an adequate maternal pelvis.

Despite debate on both sides, the current recommendation for the breech presentation at term includes offering external cephalic version (ECV) to those patients that meet criteria, and for those whom are not candidates or decline external cephalic version, a planned cesarean section for delivery sometime after 39 weeks.

Regarding the premature breech, gestational age will determine the mode of delivery. Before 26 weeks, there is a lack of quality clinical evidence to guide mode of delivery. One large retrospective cohort study recently concluded that from 28 to 31 6/7 weeks, there is a significant decrease in perinatal morbidity and mortality in a planned cesarean delivery versus intended vaginal delivery, while there is no difference in perinatal morbidity and mortality in gestational age 32 to 36 weeks. Of note, due to lack of recruitment, no prospective clinical trials are examining this issue.

Differential Diagnosis
Face and brow presentation
Fetal anomalies
Fetal death
Grand multiparity
Multiple pregnancies
Oligohydramnios
Pelvis Anatomy
Preterm labor
Primigravida
Uterine anomalies
Pearls and Other Issues

In light of the decrease in planned vaginal breech deliveries, thus the decrease in expertise in managing this clinical scenario, it is prudent that policies requiring simulation and instruction in the delivery technique for vaginal breech birth are established to care for the emergency breech vaginal delivery.

Enhancing Healthcare Team Outcomes

A breech delivery is usually managed by an obstetrician, labor and delivery nurse, anesthesiologist and a neonatologist. The ultimate decison rests on the obstetrician. To prevent complications, today cesarean sections are performed and experienced with vaginal deliveries of breech presentation is limited. For healthcare workers including the midwife who has no experience with a breech delivery, it is vital to communicate with an obstetrician, otherwise one risks litigation if complications arise during delivery. [12] [13] [14]

Review Questions
Access free multiple choice questions on this topic.
Comment on this article.

Disclosure: Caron Gray declares no relevant financial relationships with ineligible companies.

Disclosure: Meaghan Shanahan declares no relevant financial relationships with ineligible companies.

This book is distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ), which permits others to distribute the work, provided that the article is not altered or used commercially. You are not required to obtain permission to distribute this article, provided that you credit the author and journal.

Cite this Page Gray CJ, Shanahan MM. Breech Presentation. [Updated 2022 Nov 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.

In this Page

Bulk download.

Bulk download StatPearls data from FTP

Related information

PMC PubMed Central citations
PubMed Links to PubMed

Recent Activity

Breech Presentation - StatPearls Breech Presentation - StatPearls

Your browsing activity is empty.

Activity recording is turned off.

Turn recording back on

Connect with NLM

National Library of Medicine 8600 Rockville Pike Bethesda, MD 20894

Web Policies FOIA HHS Vulnerability Disclosure

Help Accessibility Careers

Search Please fill out this field.
Newsletters
Sweepstakes
Labor & Delivery

All You Need To Know About Having a C-Section

Whether your C-section is planned or unexpected, here's what you can expect. Plus, tips to help in the recovery process.

What Is a C-Section?

When do you need a c-section, preparing for a c-section, the c-section procedure: what to expect, how long does a c-section take, what happens after a c-section, c-section recovery timeline, c-section side effects.

Future Pregnancies After a C-Section

Even if you have an idea of the birth you want, things may not always fit your plan. If you wanted a vaginal birth, for example, there's a chance you may need to have a Cesarean section or C-section.

But whether your C-section is planned or unexpected, there's no reason it has to be a negative experience, says Dana Sullivan, a three-time C-section veteran and co-author of The Essential C-Section Guide .

Knowing how to prepare for and "personalize" a C-section can make the surgery less traumatic and help speed recovery. Here's everything you need to know about the C-section procedure.

A Cesarean delivery or C-section is a surgical procedure that involves delivering a baby through abdominal and uterine incisions. There are more than a million babies in the United States born via C-sections, according to the Centers for Disease Control and Prevention (CDC).

There are various reasons why a vaginal delivery may not be possible. A C-section may be planned in advance or be a last minute decision when it's deemed beneficial for parent and baby.

Scheduled C-Section

C-sections are sometimes scheduled in advance for various pregnancy complications, including breech presentation or the pregnant person having high blood pressure. According to Michele Hakakha, MD, a board-certified OB-GYN in Los Angeles, scheduled C-sections are typically booked to be performed one week before the due date. "This is done to try to prevent a woman from going into labor prior to her C-section date," she says. Some other reasons for scheduled C-sections include:

Pregnancy with multiples
Sexually transmitted infections like herpes
Medical conditions like heart disease or kidney disease
Suspected issues with the placenta such as placenta previa
You've had a prior C-section and are at risk for complications

Emergency C-Section

On the other hand, emergency C-sections aren't scheduled before labor begins, and they occur as a lifesaving measure for the pregnant person and/or baby. They're often necessary if:

The baby is in distress
Labor isn't progressing normally
There’s a placenta emergency such as placenta abruption

If you're having a C-section, the first order of business—after consent forms are signed—is anesthesia. If you already have an epidural in place , the anesthesiologist will increase the dosage. If not, your obstetrician and the anesthesiologist will most likely choose an intrathecal (spinal). Both involve an injection in your back, and both numb you from the rib cage down.

Next, you'll take some chalky antacid like Bicitra to neutralize your stomach acids, and you'll be given a catheter and IV. Then it's on to the operating room, where any support person with you suits up in scrubs and a mask.

A curtain will usually be pulled across your midsection so you can't see the procedure. With so many of your senses out of commission, you may find yourself listening hard to what's going on behind the curtain. You're likely to hear a fair amount of activity: the surgeon, a scrub nurse, another nurse or two, the anesthesiologist, and perhaps a hospital pediatrician. In a teaching hospital, an extra doctor may be observing.

Typically, medical staff will have to shave just enough of your pubic hair to clear the way for the incision, which is usually about 4 to 6 inches long. You won't feel pain when the surgery begins. But according to Anne Wigglesworth, MD, an OB-GYN practicing in Manhattan, Kansas, many patients feel a bit of a pinch as the peritoneum—the shiny, hard-to-anesthetize tissue that lines the abdomen—is reached. Most doctors do a horizontal cut through your abdomen and uterus, although vertical cuts may be done on rare occasions.

Soon you may feel a fair amount of painless prodding, which means the baby is being moved into position. This part is not all that different from a vaginal birth , at least for the surgeon. "I have to reach my hand underneath the baby's head to form a cradle so I can pull the head out," explains Amy Moore, MD, an OB-GYN in New York City. Because the pregnant person can't push, she says, "I push the top of the uterus and elevate the head out of the pelvis, getting the shoulders and body to follow." Doctors will also cut the umbilical cord and remove the placenta.

Before you know it, there will be a baby in the room. "A lot of times, if you ask, the doctor will either drop the surgical screen a bit or hold the baby up over it so you can see them as soon as they come out," explains says Bruce Flamm, MD, a partner physician at Kaiser Permanente Medical Center in Riverside, California.

From the time the incision is made, the baby can be delivered in as little as two minutes or as long as half an hour, depending on the circumstances. Usually you get to see your baby before they're whisked away for care.

After your C-section, the spotlight moves off you as experts clean your baby, administer the APGAR test, and place them in the "warmer," which has radiant heat above it and keeps the baby's body temperature steady.

Once the baby has been given a clean bill of health, the obstetrician comes back to close you up—the most complex part of the C-section. "It's like putting together a puzzle," says Dr. Wigglesworth. Your provider will stitch up the uterus, realign the outer layers, and close the skin with either dissolving stitches (which take longer to put in) or staples (which require removal a few days later).

It's common to experience nausea or a bout of the shakes (although medical science has no explanation for this normal side effect). You'll spend the next hour or so in the recovery room with a heart monitor and an oxygen saturation monitor attached to your finger. Your legs will start coming back to life—sometimes gradually and sometimes in spurts. As the anesthesia wears off, you may feel itchy all over for a while; if it gets bad, you'll be offered an antihistamine.

Afraid you won't be able to bond with your baby immediately? After the birth, ask if your partner (if you have one) can hold the baby while you're being stitched up, if the baby can accompany you to the recovery room, and if you can breastfeed immediately . Unless the baby or parent needs immediate medical treatment, most hospitals will accommodate parents' expressed wishes for early bonding opportunities, says Dr. Flamm.

Day of C-section

On the day of the C-section, you'll likely have a pump to deliver a low dosage of a narcotic, such as morphine, as needed. Some doctors will let you eat solids, while others will have you wait 24 hours or until you pass gas, a sign that your intestines are functioning normally. You'll need loads of rest, and you'll wear pads for a few days for the bleeding .

On the second day, you'll be switched from the pump to an oral painkiller. The catheter will come out, and you'll be asked to walk to the bathroom. If you are pushed before you feel ready, it's not because staff is being sadistic; it's always important to get your lungs and muscles working after surgery. Dr. Moore strongly recommends "as much pain medicine as you need so that you can move around as much as possible."

The second day will also bring an unusual interest in your intestinal activity. You may even feel a sensation like a humming motor inside you. This means that your intestines are getting back into gear after pain medications, which slow down your bowels.

By the third or fourth day, depending on whether you're also recovering from labor, you will be sent home. If you're extremely tired, push for as long a hospital stay as possible to rest.

Two weeks later

After two weeks, you'll go back to your provider for a wound check to make sure your incision is healing well. At six weeks, you'll have a postpartum visit . Along with your physical health, make sure to discuss your mental health with your provider too. Conditions like postpartum depression and postpartum anxiety are common, so it's important to discuss any symptoms you may be feeling.

C-Section Recovery Tips

To speed recovery, eating healing foods can help. Lisa Kimmel, MS, RD, CSSD, sports nutritionist at Yale University, recommends protein sources (such as lean meats, eggs, nuts, beans, and legumes) and low-fat dairy products. She also advises to eat specific nutrients, including zinc (found in seafood, meats, and whole grains), vitamin C (citrus fruits, strawberries, red bell peppers), and vitamin A (carrots, sweet potatoes, mangoes).

Also, make sure to rest as much as you can. Get help from family, friends, or your partner if you have one. You may also consider hiring a postpartum doula to help during this critical healing time.

Common C-section side effects include:

Weakness
Discomfort when coughing, sneezing, or laughing
Tenderness around incision (This will last for the first few weeks and you should watch it closely. If it becomes very red or inflamed, or if you start running a fever, call your health care provider, since this could be a sign of infection .)

Also, most people notice that their actual scar is numb from the nerves being cut, but this numbness should go away over the next few months. Your scar should continue to get lighter and look better with time, and eventually it'll fade to almost the color of your skin.

Future Pregnancies After a C-Section

There is no clear answer on how many C-sections a person can have . But having one C-section doesn't necessarily mean you'll have to have one again for a subsequent pregnancy. You may be able to have a vaginal birth after a C-section if that's what you'd prefer. It's important to make an informed decision with your health care provider and weigh the risks.

Births – Method of Delivery . CDC. 2023.

Outcomes and Complications After Repeat Cesarean Sections Among King Abdulaziz University Hospital Patients . Mater Sociomed . 2019.

Pruritus and postoperative nausea and vomiting after intrathecal morphine in spinal anaesthesia for caesarean section: Prospective cohort study . SageJournals. 2018.

Postpartum Depression . StatPearls. 2022.

Vaginal Birth After Cesarean Delivery . StatPearls. 2022.

Fetal Presentation, Position, and Lie (Including Breech Presentation)

Key Points |

Abnormal fetal lie or presentation may occur due to fetal size, fetal anomalies, uterine structural abnormalities, multiple gestation, or other factors. Diagnosis is by examination or ultrasonography. Management is with physical maneuvers to reposition the fetus, operative vaginal delivery , or cesarean delivery .

Terms that describe the fetus in relation to the uterus, cervix, and maternal pelvis are

Fetal presentation: Fetal part that overlies the maternal pelvic inlet; vertex (cephalic), face, brow, breech, shoulder, funic (umbilical cord), or compound (more than one part, eg, shoulder and hand)

Fetal position: Relation of the presenting part to an anatomic axis; for vertex presentation, occiput anterior, occiput posterior, occiput transverse

Fetal lie: Relation of the fetus to the long axis of the uterus; longitudinal, oblique, or transverse

Normal fetal lie is longitudinal, normal presentation is vertex, and occiput anterior is the most common position.

Abnormal fetal lie, presentation, or position may occur with

Fetopelvic disproportion (fetus too large for the pelvic inlet)

Fetal congenital anomalies

Uterine structural abnormalities (eg, fibroids, synechiae)

Multiple gestation

Several common types of abnormal lie or presentation are discussed here.

Transverse lie

Fetal position is transverse, with the fetal long axis oblique or perpendicular rather than parallel to the maternal long axis. Transverse lie is often accompanied by shoulder presentation, which requires cesarean delivery.

Breech presentation

There are several types of breech presentation.

Frank breech: The fetal hips are flexed, and the knees extended (pike position).

Complete breech: The fetus seems to be sitting with hips and knees flexed.

Single or double footling presentation: One or both legs are completely extended and present before the buttocks.

Types of breech presentations

Breech presentation makes delivery difficult ,primarily because the presenting part is a poor dilating wedge. Having a poor dilating wedge can lead to incomplete cervical dilation, because the presenting part is narrower than the head that follows. The head, which is the part with the largest diameter, can then be trapped during delivery.

Additionally, the trapped fetal head can compress the umbilical cord if the fetal umbilicus is visible at the introitus, particularly in primiparas whose pelvic tissues have not been dilated by previous deliveries. Umbilical cord compression may cause fetal hypoxemia.

Predisposing factors for breech presentation include

Preterm labor

Uterine abnormalities

Fetal anomalies

If delivery is vaginal, breech presentation may increase risk of

Umbilical cord prolapse

Birth trauma

Perinatal death

Face or brow presentation

In face presentation, the head is hyperextended, and position is designated by the position of the chin (mentum). When the chin is posterior, the head is less likely to rotate and less likely to deliver vaginally, necessitating cesarean delivery.

Brow presentation usually converts spontaneously to vertex or face presentation.

Occiput posterior position

The most common abnormal position is occiput posterior.

The fetal neck is usually somewhat deflexed; thus, a larger diameter of the head must pass through the pelvis.

Progress may arrest in the second phase of labor. Operative vaginal delivery or cesarean delivery is often required.

Position and Presentation of the Fetus

Toward the end of pregnancy, the fetus moves into position for delivery. Normally, the presentation is vertex (head first), and the position is occiput anterior (facing toward the pregnant patient's spine) with the face and body angled to one side and the neck flexed.

Abnormal presentations include face, brow, breech, and shoulder. Occiput posterior position (facing toward the pregnant patient's pubic bone) is less common than occiput anterior position.

If a fetus is in the occiput posterior position, operative vaginal delivery or cesarean delivery is often required.

In breech presentation, the presenting part is a poor dilating wedge, which can cause the head to be trapped during delivery, often compressing the umbilical cord.

For breech presentation, usually do cesarean delivery at 39 weeks or during labor, but external cephalic version is sometimes successful before labor, usually at 37 or 38 weeks.

Cookie Preferences

This icon serves as a link to download the eSSENTIAL Accessibility assistive technology app for individuals with physical disabilities. It is featured as part of our commitment to diversity and inclusion. M

Election 2024
Entertainment
Newsletters
Photography
Personal Finance
AP Investigations
AP Buyline Personal Finance
AP Buyline Shopping
Press Releases
Israel-Hamas War
Russia-Ukraine War
Global elections
Asia Pacific
Latin America
Middle East
Election Results
Delegate Tracker
AP & Elections
Auto Racing
2024 Paris Olympic Games
Movie reviews
Book reviews
Financial Markets
Business Highlights
Financial wellness
Artificial Intelligence
Social Media

Despite Supreme Court ruling, the future of emergency abortions is still unclear for US women

Katie Mahoney, left, and Rev. Patrick Mahoney, chief strategy officer for Stanton Healthcare, an Idaho-based pregnancy center that does not provide abortions, outside the Supreme Court on June 27, 2024, in Washington. (AP Photo/Mark Schiefelbein)

Katie Mahoney, left, and Rev. Patrick Mahoney, chief strategy officer for Stanton Healthcare, an Idaho-based pregnancy center that does not provide abortions, read the text of a Supreme Court decision outside the Supreme Court on Thursday, June 27, 2024, in Washington. The Supreme Court cleared the way Thursday for Idaho hospitals to provide emergency abortions for now in a procedural ruling that left key questions unanswered and could mean the issue ends up before the conservative-majority court again soon. (AP Photo/Mark Schiefelbein)

U.S. Health Secretary Xavier Becerra, right, listens as Jillaine St. Michel, a patient who was forced to travel to Seattle to access an abortion speaks during a conversation with local patients and providers who have been impacted by Idaho’s abortion restrictions held at the Linen Building in Boise, Idaho, Wednesday, June 26, 2024. (AP Photo/Kyle Green)

The Supreme Court building is seen on Thursday, June 27, 2024, in Washington. (AP Photo/Mark Schiefelbein)

U.S. Health Secretary Xavier Becerra speaks to participants during a conversation with local patients and providers who have been impacted by Idaho’s abortion restrictions held at the Linen Building in Boise, Idaho, Wednesday, June 26, 2024. (AP Photo/Kyle Green)

U.S. Health Secretary Xavier Becerra, left, thanks Jillaine St. Michel, holding 5-month-old Tucker, for participating after a conversation with local patients and providers who have been impacted by Idaho’s abortion restrictions held at the Linen Building in Boise, Idaho, Wednesday, June 26, 2024. (AP Photo/Kyle Green)

Copy Link copied

WASHINGTON (AP) — The U.S. Supreme Court did not settle the debate over whether federal law requires hospitals to stabilize pregnant patients with emergency abortions on Wednesday, despite saying Idaho hospitals can provide abortions in medical emergencies even with the state’s restrictions.

The court delivered a 6-3 procedural ruling that left key questions still lingering about whether states can ban doctors from providing emergency abortions that save a woman from serious infection or organ loss.

Health and legal experts say Thursday’s order that divided the Supreme Court’s conservatives does nothing to protect pregnant women in other states with strict abortion bans, where state bans might conflict with a federal law that the Biden administration argues requires emergency abortions.

“The decision the Supreme Court released this morning doesn’t shed any light on how that conflict will or should be resolved,” said Joanne Rosen, the co-director of the Johns Hopkins Center for Law and the Public’s Health.

Here is a look at emergency abortions in the U.S., the federal law that the Biden administration says requires hospitals to provide them, and why the debate on the legality of those abortions is far from resolved.

How often do pregnancies threaten a woman’s health?

Every year, about 50,000 women in the U.S. develop life-threatening complications during pregnancy, including sepsis, hemorrhaging or the loss of reproductive organs.

In rare cases with some of those complications, doctors might terminate the pregnancy, especially when there is no chance for a fetus to survive. For example, if a woman’s water breaks during the second trimester, a condition known as preterm premature rupture of membranes, the fetus may not be viable and continuing the pregnancy means that the patient may risk developing sepsis, an infection that can be deadly.

Sepsis and blood loss are some of the most common causes of maternal deaths in the U.S. Last year, nearly 700 women died while pregnant, giving birth or immediately following childbirth, according to the Centers for Disease Control and Prevention.

Idaho doctors say at least a half-dozen pregnant women have been airlifted to get emergency treatment in other states since January when the strict abortion ban, which allows doctors to perform abortion if a woman’s life but not her health is at risk, took effect.

What protections does the federal law provide pregnant patients in emergency rooms?

The law, called t he Emergency Medical Treatment and Active Labor Act or “EMTALA,” requires emergency rooms to offer a medical exam if you turn up at their facility. The law applies to nearly all emergency rooms — any that accept Medicare funding.

Those emergency rooms are required to stabilize patients if they do have a medical emergency before discharging or transferring them to another hospital. And if the ER doesn’t have the resources or staff to properly treat that patient, staff members are required to arrange a medical transfer to another hospital, after they’ve confirmed the facility can accept the patient.

Hospitals that violate the federal law risk their Medicare funding and can face steep fines from the federal government.

Why are Idaho and the U.S. Supreme Court involved?

Since the Supreme Court overturned the constitutional right to an abortion , Democratic President Joe Biden’s administration has told hospitals that abortion is considered stabilizing care that EMTALA requires.

The Biden administration sued Idaho over its strict abortion ban, which only allowed exceptions to save a woman’s life, arguing that the law prevented ER doctors from offering an abortion if a woman needed one in a medical emergency.

Attorneys for Idaho argued there’s no conflict between the state and federal law since Idaho allows doctors to perform an abortion if the woman’s life is at risk.

On Thursday, the justices reinstated a lower court order that had allowed hospitals in Idaho to perform emergency abortions to protect a pregnant patient’s health, saying that the U.S. Supreme Court got involved in the case too quickly.

What does the ruling mean for other states with strict abortion bans?

Very little – for now. The U.S. solicitor general has said several other states have abortion bans that are so strict, they might be in conflict with the federal law. But the Supreme Court didn’t directly address possible conflicts between the laws in its ruling.

Texas, for example, is suing the federal government over its guidance that says hospitals must provide abortions for women who need one in medical emergencies.

The 5th Circuit Court of Appeals ruled against the administration in January, finding that EMTALA does not require Texas hospitals to provide abortions in emergency rooms. The Justice Department has appealed that decision.

“The availability of abortions in emergency medical cases in Texas will continue to be extraordinarily limited,” Rosen of Johns Hopkins said.

Doctors in states like Florida and Missouri have said they are afraid to treat patients with an abortion since the bans were enacted. The federal government has also found hospitals in those states have violated EMTALA in some cases where pregnant patients were turned away or not properly treated.

On Thursday, in a concurring opinion that also expressed dissent, Justice Ketanji Brown Jackson argued the court should have settled the debate for doctors and patients alike.

“For as long as we refuse to declare what the law requires, pregnant patients in Idaho, Texas, and elsewhere will be paying the price,” Jackson said.

Could the Supreme Court revisit this issue?

Yes. With the Idaho case being sent back to the lower court and the Texas case under appeal, it’s an issue that could land back at the Supreme Court soon.

And six judges have now tipped their hand.

The court’s three liberal judges – Jackson, Elena Kagan, and Sonia Sotomayor – said in their decision that the federal law says women should be able to get abortions in medical emergencies, despite state bans. Three conservative justices – Samuel Alito, Neil Gorsuch and Clarence Thomas – disagreed that the federal law is that specific, and pointed out that it was written in a way that requires hospitals to treat the “unborn child.”

That leaves Justices Amy Coney Barrett, Brett Kavanaugh and John Roberts in play.

“They don’t want to have to make a decision now,” said Rob Gatter, a law professor at St. Louis University, who is an expert on health policy. “That’s a recipe for saying, somebody else deal with this first, you get it wrong first, you give it a first try, let me see how this goes.”

COLLEGE FOOTBALL 25 SIGHTS AND SOUNDS DEEP DIVE

Welcome back to the Campus Huddle, your home for news and information about EA Sports College Football 25, straight from the developers! Before we hear from our developers, Ohio State’s own Kirk Herbstreit is back giving an inside look into the Sights and Sounds of #CFB25!

Christian Brandt here, Senior Game Designer, proud alumni of Penn State and College Football fanatic. As the Presentation Lead, I am here to take you through all the sights and sounds of College Football 25.

During our development, we came in every day with the reminder that “Every team is someone's favorite team” . This led us to focus on ensuring the presentation contained as much of the detail, sights, sounds and traditions of the 134 FBS Schools as possible in College Football 25. Below is a behind the scenes guide of how a team of college football fanatics came together and packed it all into the game!

SIGHTS AND SOUNDS

Picture this, you are playing as Penn State getting ready to take on your opponent. This all starts with your team running out of the tunnel to Zombie Nation blasting and the whole stadium chanting “We Are Penn State”.

We recreated that feeling, sound, and visuals of pre-game as if you are down on the field with them. There is nothing like it and we wanted to make sure that you could experience the same feeling that these players have when you are walking out as your favorite team.

Gameday tradition is a key element of what separates Saturday from Sunday all around the country. Knowing this, we went to painstaking lengths to build out and capture the sights and sounds of College Football.

To nail down that authentic feeling of College Football, the school atmosphere is where it all begins. Walk out of the tunnel with 100,000 family and friends screaming for you, supporting you. We stay up close and personal with our camera style throughout the game. This is done so you can feel the excitement with our epic run outs for each team and feel like you are just as much a part of this team as the real players.

Motion Capture

Motion capture was the key to ensuring the accuracy and detail of all the props from historical items to the brand new traditions of gameday. Every prop was built to its accurate size and weight then mocapped in a studio, allowing real people to interact with them. Simply using a stand-in object would not replicate authenticity.

We built a 2-story ramp to replicate “THE HILL” for the Clemson runout. We hired stunt actors to give us their best jumps in the “middle” of the hill and run down that ramp like they were getting ready to meet their rival for the biggest game of their lives.

We built the Notre Dame stairs leading to the classic tradition of tapping on the “Play Like A Champion” sign. For Purdue, we built their rotating bass drum to pay off their pre-game show.

Georgia, Boston College, Louisiana-Lafayette, and Florida State each have tear through banners when they enter the field. To mocap this, we first created a door frame to mocap the header touches like for Virginia Tech, Wisconsin, and many others. Then we hung pool noodles from the top of that. The players ran through tearing between the pool noodles to simulate the effect of ripping the banner down the middle.

For the Gators tunnel, we traveled to Gainsville to get an exact scan of the gator statue that the players tap on their way from the locker room to the field. We also created a prop with the exact height to mocap tapping the Gator head then walking down the tunnel to the swamp sign overhead.

While those are just a few examples of the lengths we went to, you can be sure there is something for fans of every team. We’re talking cannons going off for kickoffs and TD’s, smoke for UCF TD’s, and all the way to the fountain at Arkansas State.

Speaking of Gameday, Mascots are one of the most fun aspects of College Football. The variety and detail is unmatched across sports. This encompasses everything from humans in massive costumes to real animals! We have 50 total mascots in the game including 40 Team Mascots and 10 real animals representing their schools.

For the mascots we initially did a lot of internal research for each one. Checking on what's unique about each mascot and what do fans enjoy about them the most.

For example, the Texas Hook’ Em had “follow me eyes”, the team worked to get that same level of practical effect in the game.

Along the way we talked to alumni and our school contacts to find out even more little details. Mascots such as the Stanford tree that change every year or even animal mascots that grew over time, such as Ralphie from Colorado, we did adjustments on her as she aged into her reins.

Fun things that we learned along the way like how Boomer and Sooner have the OU logo painted on their hooves

I know we couldn’t touch on all the mascots we have in-game but be sure to check out your favorite school and see what unique quirks you can find out about them!'

When we talk about a team of developers that loves College Football, this is what we mean. One of our developers got in on the action as a stand in, to ensure all the animal run outs were perfect. Go Stew “Dubs”!

Turnover Traditions, the “New Era”

Not only do we have the classic school traditions in the game, but the “New Era” of traditions including Turnover and Touchdown props made it into the game as well. All this action takes place during gameplay and examples of what you might see are chainsaws, championship belts, basketball hoops, and even a THRONE!

The Field We Play On

Where you play is one of the most important aspects of your College Football experience. We are proud to say that we worked hard to deliver as many stadiums with as much accuracy as possible. This was achieved by visiting local venues such as the University of Florida to gather detailed references from every corner of the stadium that we could possibly find.

For schools that were farther away, we requested reference materials, and over 80 schools responded, providing an average of 1,000 photos each, amounting to a staggering amount of nearly 80,000 photos to reference from.

Additionally, we plan to update stadiums post launch as we receive new architecture and designs from schools so that CFB 25 is authentic to everything you see on Saturdays.

To streamline the stadium creation process, the team utilized a specialized stadium toolkit that allowed us to develop all of the essential structures for a stadium in record time. Things like tunnels, stairs, and stands are crucial to the authenticity of a College Football Stadium and this tool allowed us to curate that experience for you.

This toolkit enabled the artists to focus on crafting unique architectural details and implementing real-time lighting effects, ensuring that each stadium was both accurate and visually stunning. This efficient workflow allowed the team to meet the ambitious goal of building over 150 stadiums within a single production cycle while maintaining high quality and attention to detail.

Suit Up in Your favorite uniform

College threads are ever changing each year and even game to game for some teams. Real-world uniforms are made with countless variations of: Cloth materials, stitching patterns, colors, patches, stripes, logos, names and numbers. To be able to create uniforms for 134 teams with multiple variations and helmets we had to create a brand new toolset which allowed artists and designers to build uniforms in real time seeing their work instantly in-engine. This allowed the team to create incredibly detailed uniforms across 134 different schools.

Emotional Soundscape

As we were getting the sights locked in, we knew the sounds would be just as critical to nail to ensure the soundscape of College Football delivered. The feeling of being at a game - The Crowd, Band, Cheerleaders, Chants, PA Music between plays is unlike any other sport.

Crowd Noise

Over the last two seasons, we worked with ESPN to capture crowd audio straight from their broadcasts. From Autzen Stadium to Death Valley (both of them), and more, this content will function as our crowd noise, swells, and reactions that you’ll experience in every game you play.

Remember that OT game from 2022 between LSU and Alabama? Yeah, we were there. And we got all of it.

In addition to that game in Baton Rouge, we ended up capturing crowd noise from 41 games in places like Oregon State, Georgia, Florida State, Duke, UCLA, Texas, West Virginia, Georgia Tech, Miami, Ole Miss, Missouri, Kentucky, NC State, North Carolina, USC, Florida, Auburn, Louisville, Washington, Alabama, Michigan and from the previously mentioned, LSU, Clemson and Oregon.

This Is My Fight Song

One of our Feature Producers Torsten Staley, Oregon Marching Band Alumni, traveled to Nashville to record every team's Fight Song. We utilized an amazing group of musicians who were just as passionate as us in getting these songs right. Many were previous students and alumni from schools like Oklahoma, North Texas, Vanderbilt, USC, Auburn, and Tennessee.

Not only did we record each team's fight songs, but we also recorded many of the rousers that are normally heard between plays and during pressure moments throughout a game. Some examples include “Go Gators” and “Roll Tide Roll” for those stadium-rousing moments, “Dies Irae” and “Mars” for those 3rd and 4th down defensive moments, and a few others that you’ll just have to find out for yourself…

Over 180 school band songs and drum grooves, including all 134 fight songs, are in the game. This process took 11 days, across 3 different groupings of players, Marching Percussion, Brass, and Winds. We are so excited for you to hear and experience each one of these songs - whether it’s a classic like “Hail to the Victors” from Michigan; for the first time ever in our College Football game history, “War Eagle” from Auburn, or one you may be hearing for the first time…by the way, the JSU Fight Song from Jacksonville State, SLAPS!

Crowd Themes

Another example of what makes college football so special are the theme games when the crowd comes together in unison to create a pattern across the stadium. From the checkerboard pattern at Tennessee, to the triple stripe layout at Boise State. We have over 170 different patterns for schools that have them in real life.

Each seat in the stadium was hand set up seat by seat to match the patterns. Also if your school has multiple themes, those are in too. Here we have the Stripe Out, the Helmet Stripe, and then to one of the most electric atmosphere’s in College Football, the White Out game.

Dynamic Attendance

A new feature to help bring more authenticity into the game revolves around attendance levels in the stadium. To help paint a better picture, here is a great example from one of our team members who was playing a Dynasty with FIU. During the first couple of games the stands were not very full which resulted in a lower home field advantage stadium pulse. Once he landed a big win on the road at Indiana and the team record was 7-0, the stands were becoming more full to start the game. By the end of the season with a 10-1 record and finishing in the top 25 rankings, home games would result in sell out crowds and the home field advantage pulse meter was now rocking high on the way to the conference championship.

Crowd Section Layouts

In addition to seeing the unison of the crowd come together for key matchups, each and every stadium is setup with its band section, away visitors section, and student section. Also schools are equipped with pageantry props accurate to life such as Pom-Poms at Michigan and Tennessee, towels at South Carolina and Pitt, and even the Tiger Tails for Missouri.

High Energy Student Sections

The student section is the life-blood of the stadium that brings the energy, passion, and emotion that spreads across the full stadium creating that over the top college football atmosphere that we all love. We all know what the students do all game, stand and cheer, so in the game the student section stands the whole game cheering on their team. We captured both male and female actors screaming at the top of their lungs to recreate those high intensity 3rd down moments. Not only are the big moments captured but also the heartbreaking ones. Anyone remember the Surrender Cobra? It’s in the game, just don’t miss that game winning field goal and you will be spared.

Hand Signals

Next, we researched schools and captured each team's hand signal traditions. During pre-game run outs and after positive plays throughout the game, you will be able to see the fans supporting the team.

A few examples include:

Wisconsin's “W”
The Miami “U”
Nebraska “Bones”
Duke “Bull City”
NC State “Wolfpack”
East Carolina “Finger Hook”
SMU “Pony Ears”
Kansas State “ WC / Wildcat”
TCU “Go Frogs”
Rutgers “Chop”
North Texas “Eagle Claw”
Rice “Owl Wings”
UTEP “Picks Up”
UTSA “Shaka Y”
New Mexico State “Guns Up”
Ball State “Chirp”
Northern Illinois “Go Huskies”
Washington “Dubs Up”
Texas A&M “Gig Em”
Louisiana “UL”
South Alabama “J-Hand”
Texas State “"Eat 'Em Up, Cats" and "The Heart of Texas State"
Sam Houston “Claw”
Plus Many More

Another huge tradition, essential to College Football, is stadium-wide chants. The fans, alumni, and students all work together to fire up their players as an inspirational rally cry or to intimidate the opposition when your favorite team needs a critical stop.

For schools we weren’t able to visit, we went to the top of the parking garage at our Orlando Studio and yelled out each chant over and over again to nail down the pace and accuracy for each chant needed. 11 sessions later, we ended up capturing over 220 chants for our game. From O-H-I-O for Ohio State to the 3rd Down Chirps for the Cardinals of Ball State, we’ve covered as many as possible.

Not only will you hear the chants, but many are timed to the mass crowd movements like “Let’s Go Blue” with the crowd pumping their arms into the air three times or the War Chant with the WHOLE stadium doing the tomahawk chop.

Beyond what I’ve already mentioned, here are just a few more of the chants to listen for…

Texas - Texas! Fight!
TCU - RIFF RAM
Auburn - WARRRRRRRRR EAGLE! HEY!
Missouri - MIZ!! ZOU!!
Minnesota - SKI U MAH! SKI U MAH! SKI U MAH!
Kansas - ROCK CHALK!!! JAYHAWK!!!
Army: The Rocket and GO ARMY! BEAT NAVY!
Liberty - MOVE THE CHAINS!
Texas State - TEXAS!! STATE!!
Southern Miss - NASTY BUNCH! NASTY BUNCH! NAAAASTY BUNCH!
Ball State - CHIRP! CHIRP! CHIRP!
Georgia Southern - WHOSE HOUSE!? OUR HOUSE!!
APP State - APP!!! STATE!!!
East Carolina - PURPLE!! GOLD!!
SMU - SMU! SMU! SMU!
SEC Schools - S-E-C! S-E-C! S-E-C! S-E-C!
Plus Many Many MORE!!!

Iconic Voices in the Booth

Any experience in our games isn’t complete without voices to speak to the action on the field. In College Football 25, we have two iconic Broadcast Teams lined up for you!

The celebrated team of Chris Fowler and Kirk Herbstreit will be on the call in your Dynasty and Road to Glory seasons when your weekly matchup is declared the Game of the Week. They will also be present if you reach a Conference Championship game, each game of the College Football Playoff, and the College Football Playoff National Championship Game.

But like I said, we have two teams that will be a part of your playing experience. Referring back to the Thursday Night broadcasts in the final years of our original iteration, the iconic crew of Rece Davis, Jesse Palmer and David Pollack will be on the call for the other games on your Dynasty and Road to Glory schedule.

Each commentary team will be available in Play Now when you’re looking to just get a quick game in.

We chose these talented individuals because of the impact they have had in the commentary space for College Football and we felt it was best to give you the most authentic and unique experience to date. The team recorded 68,000+ lines, over 870 hours, and all of it was recorded remotely in the talent's homes and in at least 3 different countries. Each member of our commentary team couldn’t be more excited to be a part of this experience!

Studio Updates

As fans of College Football, we know that week-to-week games are happening at all times. Through studio updates, you’ll be informed of the latest news from around the country. Long-time ESPN Studio Host, Kevin Connors, will be jumping in from time to time to call out national upsets, scores for games you care about in your conference, or updates on how your rival is doing when in Dynasty mode. These updates will happen whether you are playing in a Dynasty that is offline or online. For an Online Dynasty, you’ll hear about scores from other members in your Dynasty if they have already finished their match-up that week.

Celebrations

No season is complete without a championship celebration. Celebrations come with the glamor, flair, and the most important aspect of it all, the hardware. We built each trophy from scratch, matching the weight and dimensions of real life trophies such as the National Championship. After building the foundations, we brought the trophies into the motion capture studio and had the team hold these trophies as if they had just won. We did this to maximize our authenticity when you celebrate in-game, you will see players actually feeling the weight when they hold the Championship trophy.

PIP and Game Flow

Presentation is not just about the visuals and audio but how the game flows and feels from play to play. We have built a whole new look and feel to the game that takes our authentic atmosphere & pageantry wrapped into our new streamlined PIP Dynamic Playcall experience.

Team members Chris Husein, UCF Alumni - Sr. Experience Designer, and Alejandro Thornton, FSU and FIU Alumni - Tech Designer, helped develop the new play call screen very early in the production cycle. We tested dozens of layout variations throughout the year until hitting on the right one. In this new streamlined experience you won’t miss a beat of the action and will be informed on important information pertaining to the situation and game. Once the play is finished, the screen shrinks to the top left corner as replays and pageantry continue to show, you can start navigating the playbook while also viewing important updates / informative data in the top right corner.

Types of information panels you will see throughout the game:

Stat Compares - Today, Season, Career, vs Last Week, vs Opponent
Impact Players - Who are they, why are they impact players showing their abilities
Ranking - Top players from around the country in TD’s, rushing yards, etc…
Rankings - Conference, Media and Coaches Poll, and potential Playoff brackets
Wear and Tear, Field Goal Kicker range and much more
We have over 400 panels to keep each game feeling fresh and new

And there it is, a behind the scenes look at the presentation of College Football 25.. We can’t wait for you to experience the world that we have and will continue to pour our passion into. To us, this truly is THE most authentic and unique College Football experience ever produced. Next up, our incredible teammates over on the Dynasty Team will be providing a Deep Dive into all things coming to Dynasty Mode.

See you on the field soon, “We Are!!!”

- Christian Brandt and the dev team

College Football 25 launches worldwide on July 19th, 2024. Pre-order the Deluxe Edition* or the EA SPORTS™ MVP Bundle** and play 3 days early. Conditions and restrictions apply. See disclaimers for details. Stay in the conversation by following us on Facebook , Twitter , Instagram , YouTube , and Answers HQ .

Pre-order the MVP Bundle*** to make game day every day, and get both Madden NFL 25 and College Football 25 with exclusive content.

FOLLOW US @EASPORTSCollege

Sign-up for our newsletter to be the first to know about new updates.

RELATED NEWS

College football 25 rankings week showcase, college football 25 gameplay deep dive, welcome to college football 25.

IMAGES

Cephalic presentation of baby in pregnancy
Cephalic Presentation of Baby During Pregnancy
Labor and Birth Processes
What Is a C-section
What Is a C-section
Fetal presentations. A-C, Breech (sacral) presentation. D, Shoulder

VIDEO

Vaginal Delivery Vs C/Section Delivery
Abortion
Normal Delivery vs. C-Section: Benefits and Risks Explained
C-Section Births Increase
Eckelstone Lamaze
Money Box

COMMENTS

Fetal presentation before birth
Frank breech. When a baby's feet or buttocks are in place to come out first during birth, it's called a breech presentation. This happens in about 3% to 4% of babies close to the time of birth. The baby shown below is in a frank breech presentation. That's when the knees aren't bent, and the feet are close to the baby's head.
Fetal presentation: Breech, posterior, transverse lie, and more
Fetal presentation, or how your baby is situated in your womb at birth, is determined by the body part that's positioned to come out first, and it can affect the way you deliver. ... Like the transverse lie, this position is more common earlier in pregnancy, and it's likely your provider will intervene if your baby is still in the oblique lie ...
Fetal Presentation, Position, and Lie (Including Breech Presentation)
Toward the end of pregnancy, the fetus moves into position for delivery. Normally, the presentation is vertex (head first), and the position is occiput anterior (facing toward the pregnant person's spine) and with the face and body angled to one side and the neck flexed. Variations in fetal presentations include face, brow, breech, and shoulder.
Your Guide to Fetal Positions before Childbirth
Breech presentation happens when your little one's feet or buttocks are in position to be delivered first, and make up just under 5 percent of all pregnancies. Your provider will likely order an ultrasound toward the end of your pregnancy if they suspect your baby is in a breech position.
If Your Baby Is Breech
In the last weeks of pregnancy, a fetus usually moves so his or her head is positioned to come out of the vagina first during birth. This is called a vertex presentation.A breech presentation occurs when the fetus's buttocks, feet, or both are in place to come out first during birth. This happens in 3-4% of full-term births.
Fetal Positions for Labor and Birth
This presentation can lead to more back pain (sometimes referred to as "back labor") and slow progression of labor. In the right occiput posterior position (ROP), the baby is facing forward and slightly to the right (looking toward the mother's left thigh). This presentation may slow labor and cause more pain. Tips to Reduce Discomfort
Breech Position: What It Means if Your Baby Is Breech
Very rarely, a problem with the baby's muscular or central nervous system can cause a breech presentation. Having an abnormally short umbilical cord may also limit your baby's movement. Smoking. Data shows that smoking during pregnancy may up the risk of a breech baby.
Transverse fetal lie
Transverse lie refers to a fetal presentation in which the fetal longitudinal axis lies perpendicular to the long axis of the uterus. It can occur in either of two configurations: The curvature of the fetal spine is oriented downward (also called "back down" or dorsoinferior), and the fetal shoulder presents at the cervix ( figure 1 ).
Breech Presentation
Breech Births. In the last weeks of pregnancy, a baby usually moves so his or her head is positioned to come out of the vagina first during birth. This is called a vertex presentation. A breech presentation occurs when the baby's buttocks, feet, or both are positioned to come out first during birth. This happens in 3-4% of full-term births.
Presentation and position of baby through pregnancy and at birth
If your baby is headfirst, the 3 main types of presentation are: anterior - when the back of your baby's head is at the front of your belly. lateral - when the back of your baby's head is facing your side. posterior - when the back of your baby's head is towards your back. Top row: 'right anterior — left anterior'.
Breech Presentation: Types, Causes, Risks
Breech presentation is typically diagnosed during a visit to an OB-GYN, midwife, or health care provider. Your physician can feel the position of your baby's head through your abdominal wall—or ...
Breech Presentation
Epidemiology. Breech presentation occurs in 3% to 4% of all term pregnancies. A higher percentage of breech presentations occurs with less advanced gestational age. At 32 weeks, 7% of fetuses are breech, and 28 weeks or less, 25% are breech. Specifically, following one breech delivery, the recurrence rate for the second pregnancy was nearly 10% ...
How Long Does a C-Section Take? All You Need To Know
Day of C-section. On the day of the C-section, you'll likely have a pump to deliver a low dosage of a narcotic, such as morphine, as needed. Some doctors will let you eat solids, while others will ...
Fetal Presentation, Position, and Lie (Including Breech Presentation)
Toward the end of pregnancy, the fetus moves into position for delivery. Normally, the presentation is vertex (head first), and the position is occiput anterior (facing toward the pregnant patient's spine) with the face and body angled to one side and the neck flexed. Abnormal presentations include face, brow, breech, and shoulder.
Medical reasons for a c-section
So a c-section is safer for your baby. You have a medical condition that may make vaginal birth risky, like diabetes or high blood pressure. Diabetes is when you have too much sugar in your blood. This can damage organs in your body, like blood vessels and nerves. High blood pressure is when the force of blood against the walls of the blood ...
Mississippi sets new laws on Medicaid during pregnancy, school funding
Medicaid during pregnancy . Mississippi will allow earlier Medicaid coverage during pregnancy to try to improve health outcomes for mothers and babies in a poor state with the worst rate of infant mortality in the U.S. The "presumptive eligibility" law says Medicaid will pay for a pregnant woman's outpatient medical care up to 60 days ...
What is the federal law at the center of the Supreme Court's latest
"The EMTALA case is based on the false premise that pregnant women cannot receive emergency care under pro-life laws," said Kelsey Pritchard, the group's state public affairs director after the case was heard earlier this year. "It is a clear fact that pregnant women can receive miscarriage care, ectopic pregnancy care and treatment in ...
Despite Supreme Court ruling, the future of emergency abortions is
WASHINGTON (AP) — The U.S. Supreme Court did not settle the debate over whether federal law requires hospitals to stabilize pregnant patients with emergency abortions on Wednesday, despite saying Idaho hospitals can provide abortions in medical emergencies even with the state's restrictions. The court delivered a 6-3 procedural ruling that left key questions still lingering about whether ...
College Football 25 Sights and Sounds Deep Dive
Christian Brandt here, Senior Game Designer, proud alumni of Penn State and College Football fanatic. As the Presentation Lead, I am here to take you through all the sights and sounds of College Football 25. The Vision. During our development, we came in every day with the reminder that "Every team is someone's favorite team".
Fact checking the CNN presidential debate
A very small percentage of abortions happen at or after 21 weeks of pregnancy. According to data published by the US Centers for Disease Control and Prevention, just 0.9% of reported abortions in ...
Despite Supreme Court ruling, the future of emergency abortions is
For example, if a woman's water breaks during the second trimester, a condition known as preterm premature rupture of membranes, the fetus may not be viable and continuing the pregnancy means ...

Appointments at Mayo Clinic

Head down, face down

Head down, face up

Frank breech

Complete and incomplete breech

Products and Services

Mayo Clinic Press

Your gift holds great power – donate today!

Breech, posterior, transverse lie: What position is my baby in?

Fetal presentation and position

Head down, facing down (anterior position)

Head down, facing up (posterior position)

Frank breech

Complete breech

Incomplete breech

Single footling breech

Double footling breech

Transverse lie

Oblique lie

What to know if your baby is breech

What's a sunny-side up baby?

9 of the most jaw-dropping breech birth photos

Raspberry leaf tea is popular during pregnancy – but possible benefits aren't proven

Where to go next

If Your Baby Is Breech

Frequently Asked Questions Expand All

If you have further questions, contact your ob-gyn.

Clinicians: Subscribe to Digital Pamphlets

A Guide to Pregnancy from Ob-Gyns

ACOG Explains

What to Read Next

Fetal Positions for Labor and Birth

Right or Left Occiput Anterior

Right or Left Occiput Transverse

Tips to Reduce Discomfort

Right or Left Occiput Posterior

How a Doctor Determines Baby's Position

How You Can Determine Baby's Position

Breech Position: What It Means if Your Baby Is Breech

What does it mean if a baby is breech?

Breech Births

What are the different types of breech birth presentations?

What causes a breech presentation?

How is a breech presentation diagnosed?

Can a breech presentation mean something is wrong?

Can a breech presentation be changed?

Medical Techniques

ECV will not be tried if:

Complications of EVC include:

Vaginal delivery versus cesarean for breech birth?

What are the risks and complications of a vaginal delivery?

When is a cesarean delivery used with a breech presentation?

Want to Know More?

Compiled using information from the following sources:

BLOG CATEGORIES

Share this post:

Episiotomy: Advantages & Complications

Retained Placenta

What is Dilation in Pregnancy?

Pregnancy Tools

Pregnancy Journeys

What are the different positions my baby could be in during pregnancy and birth?

How will I know what presentation and position my baby is in?

What is the ideal presentation and position for baby to be in for a vaginal birth?

When does a baby usually get in the ideal presentation and position for birth?

What are my options if baby isn't in the ideal presentation or position for a vaginal birth?

Resources and support

Speak to a maternal child health nurse

Related pages

Need more information?

Breech presentation and turning the baby

Breech Presentation at the End of your Pregnancy

External Cephalic Version for Breech Presentation - Pregnancy and the first five years

Labour complications

Having a baby

Anatomy of pregnancy and birth - pelvis

Planned or elective caesarean

Call us and speak to a Maternal Child Health Nurse for personal advice and guidance.

Government Accredited with over 140 information partners

Support this browser is being discontinued for Pregnancy, Birth and Baby