Breech is a descriptor of the presentation of the part of the baby in relation to the mother’s pelvis. Most babies enter the maternal pelvis head first (cephalic), but about 4% of babies at term (37-42 weeks gestation) enter bottom or feet first into the maternal pelvis, known as breech.
There are three types of breech presentation: flexed or complete breech (hips flexed with knees flexed), extended or frank breech (hips flexed, legs extended) and footling breech (hips less flexed or not flexed with feet beneath the baby’s bottom). Of these the most common is the extended or frank breech presentation.
If you have consented to ultrasound scans they can usually tell you what position the baby is in, but this information may also be found during internal (vaginal) examination if you have chosen to have them.
Flexed or complete breech babies are said to be easier to turn when attempting External Cephalic Version (ECV) and they are already curled up in a ball, but ECV success also depends on other elements such as how low in the pelvis the baby is and how much fluid there is around the baby. Flex or complete breech babies occasionally drop their knees or feet during labour and birth to become footling breech and some extend their legs up when then descend down the birth canal.
Extended or frank breech babies may not be as easy to turn by ECV, but they are well positioned for labour as there is little chance of them becoming footling breech and their bottoms sit nicely on the cervix.
Footling breech babies cause some concern due to the increased risk of the umbilical cord coming down and being compressed (cord prolapse). There are also concerns that a footling breech baby won’t put uniform pressure on the cervix during labour unlike a bottom or a head, which could lead to slower progress during labour. If you have a footling breech you can still give birth naturally, it is just worth knowing what additional concerns there are.