During pregnancy, a developing fetus will move into several positions. As labor approaches, most turn so that their head is down. If a fetus is lying horizontally, a cesarian delivery may be necessary.

The ideal position for a fetus just before labor is the anterior position — the fetus faces the pregnant person’s back, and the head points toward the ground.

Most fetuses settle into this position by the last month of pregnancy. The anterior position is also known as the vertex, cephalic, or occiput anterior position.

This position may reduce the chances of complications during pregnancy. Learn more about this and other fetal positions below.

A fetus might be in any of these positions:

  • Left occiput anterior: The head is down, the fetus is facing the pregnant person’s back, and they are in the left side of the womb.
  • Right occiput anterior: The position is the same as that above, but the fetus is in the womb’s right side.
  • Posterior: The head is down, and the back is in line with the pregnant person’s.
  • Transverse lie: The fetus is lying horizontally on its back.
  • Breech: The fetus’s feet point down.

A fetus changes position many times throughout a pregnancy, but by the time of delivery, most are in the occiput anterior position.

The best position for the fetus before delivery is the anterior position. Most get into this position before labor begins.

The fetus’s head is down in the pelvis, facing the pregnant person’s back. The fetus’s back faces the person’s belly.

This means that the fetus’s head can tuck in, with the top pressing down on the cervix. This encourages it to open during labor.

Depending on where in the womb the fetus is, the doctor or midwife may describe the position as left occiput anterior, or LOA, or right occiput anterior, or ROA.

This is also known as the back-to-back position. The fetus’s head points down, and its back rests against the pregnant person’s back.

In this position, it can be difficult for the head to tuck in. This can make passing through the smallest part of the pelvis more challenging and lead to a slower labor and a backache for the pregnant person.

A fetus may be more likely to end up in this position if the person spends long periods sitting or lying down, which may be the case if a doctor recommends bed rest.

The back of a fetus’s body is heavier than the front. A person can encourage the fetus to roll into the ideal position by leaning in the direction in which they want the fetus to move.

This involves the fetus lying horizontally. Most do not remain in this position in the weeks and days leading up to labor.

If a fetus is still in this position just before birth, a cesarean delivery will be necessary.

Otherwise, there is a risk of a medical emergency known called umbilical cord prolapse. It involves the umbilical cord entering the birth canal before the baby.

The breech position involves the fetus resting with the head up instead of down in the pregnant person’s pelvis. Some different types of breech position include:

  • Frank breech: The fetus’s legs are straight up in front of the body, so the feet are near the face.
  • Complete breech: The fetus “sits” with the legs crossed in front of the body, so the feet are near the buttocks.
  • Footling breech: One or both feet hang below the fetus’s bottom. If the birth is vaginal, one or both feet emerge first.

Some reasons why a fetus may remain in a breech position include:

In the case of twins, one fetus may be in an anterior or posterior position while the other is in a breech position.

It is safe for a fetus to be in any of the above breech positions during the pregnancy. But when labor begins, there are some risks if the baby is still in a breech position.

Around 3–4% of fetuses are in breech position by the time of delivery.

The best way to find out is to speak with the doctor or midwife.

At each appointment during the second and third trimesters, the doctor or midwife should feel the person’s abdomen to check the position of the fetus.

At the 35–36 week appointment, they check whether the fetus has moved into an anterior or posterior position. If the healthcare professional is unsure after a physical examination, they may request an ultrasound scan.

It may also be possible for a person to tell which position their developing baby is in.

When the fetus is in the back-to-back, or posterior, position, the pregnancy bump may feel squishy. The person may also feel kicks around the middle of their belly, and some see an indentation around their belly button.

When the fetus is in the anterior position, the person may feel more kicks under the ribs, and their belly button may “pop out.”

Belly mapping is a concept created by Spinning Babies. A person can use it to check the position of the fetus.

Some factors that can help include:

  • any information from a recent scan or hospital visit
  • knowing where the placenta is
  • knowing how much amniotic fluid there is
  • having well-toned abdominal muscles
  • choosing a time when the fetus is active
  • being aware of fetal movements over the last few days

A person can map the position by drawing on a piece of paper or on their belly with a nontoxic marker.

To do belly mapping:

  1. Find a time and place where you can fully or partially lie down for around 15 minutes, with your belly tilted to one side.
  2. Relax and breathe deeply.
  3. Apply gentle pressure with the fingertips to the area around the top of the pelvis or pubic bone. If you feel something hard, it is likely the head. If the area is soft, it is likely the fetus’s bottom. Mark this as a circle on your belly or the paper.
  4. Next, feel around your abdomen for a long, smooth shape, which is likely the back. It may be on one side or another. Mark it as a curved line on your map. If you can only feel soft shapes or limbs, the baby is probably facing forward.
  5. Be aware of any kicks or movements and mark them as dots or waves.
  6. By adding color and other features, you can turn your image into a picture to keep.

Most fetuses adopt a head-down position by delivery. If a fetus is in a breech position at 36 weeks, a doctor or midwife may suggest an external cephalic version (ECV).

This procedure involves the doctor or midwife trying to turn the fetus manually.

First, they give the pregnant person an injected drug that relaxes their uterus. Then, placing their hands on the outside of the person’s belly, the doctor or midwife gently manipulates the fetus from a breech position into a transverse lie position, then into a head-down position.

An ECV does not always work, but it is effective in around 58% of cases.

Also, some fetuses turn by themselves after 36 weeks, and some even turn during labor.

Anecdotal reports suggest that moving into certain positions, taking herbal medicines, and doing particular exercises may help babies in breech adopt a more favorable birthing position. But there is no reliable evidence that any of these methods work.

If a person wants to try these medicines or techniques, it is vital to consult a doctor first.

Below are answers to common questions about fetal positions during pregnancy.

How can you tell how your baby is positioned in the womb?

A hospital scan can show you, but you can also try belly mapping. This involves taking time to relax and feeling for the head, bottom, back, and limbs, and noticing any movements.

What does it mean if the baby is on the left side?

If the fetus is on the left side of the uterus, doctors call this the left occiput anterior position. Some people have traditionally considered this to be the best position at the start of labor, but a 2013 study found no evidence to confirm it.

What is a “normal” position for a baby?

A fetus changes position many times as it develops, but the most common and most helpful position at the time of delivery is the occiput anterior position, in which the head is down, the chin is tucked in, and the fetus is facing the pregnant person’s back.

A fetus moves into many positions throughout pregnancy. During the last few weeks, most move into an anterior position, which is the most helpful position for a vaginal birth.

If a fetus is still in a transverse lie or breech position just before labor, the doctor or midwife takes steps to ensure the safety of the person and the baby during birth.