is it normal to have cephalic presentation at 29 weeks

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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.

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.

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.

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.

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When Will Your Baby Turn Head Down?

During pregnancy, your baby’s position can change frequently. One of the most important changes occurs when the baby turns to a headfirst, head-down position in the uterus, which often happens toward the end of your pregnancy. Wondering when “should” your baby be head down, or how to tell if your baby is head down? Get these answers as well as more information on the baby’s head-down position, the symptoms of a baby turning head down, and the optimal baby position for birth.

Why Does a Baby Turn to a Head-Down Position for Birth?

So, what does it mean when a baby is head down? Babies generally turn head down toward the birth canal as a part of their natural instinct to get into the best possible position for birth. This is known as the vertex or cephalic presentation . A baby may settle into the optimal position, which is head down and facing the mother's back ( occiput anterior position ), but occasionally they may position themselves head down and face forward ( occiput posterior position ). The face-forward position may cause more discomfort during delivery.

Remember, each pregnancy is unique. If you have any concerns about your baby's position, it's always best to consult your healthcare provider.

When Does a Baby Turn Head Down?

Curious about when a baby “should” be head down? It’s important to remember that the exact timing of when a baby turns head down can vary from pregnancy to pregnancy. Generally, babies turn head down during the third trimester (which ranges from 28 to 40 weeks), a few weeks before birth.

How to Tell if Your Baby Is Head Down

To determine your baby’s position, your healthcare provider will usually perform a physical exam during the final few weeks of your pregnancy, feeling your abdomen to locate your baby’s head. They may also perform an ultrasound to confirm the position, especially if your baby is suspected of being in breech presentation, meaning your baby’s feet or buttocks are positioned downward, lower than the head.

So, how to tell if your baby is head down without an ultrasound? And can you feel when your baby turns head down? You may notice signs and symptoms indicating your baby is turning head down. These could include:

Pressure on your bladder, which may cause frequent urination

Pressure in your pelvis and hips

A reduction of pressure against your diaphragm and lungs, making it easier to breathe

The area where you feel kicks when your baby is head down. You may feel kicks higher in your belly or under your ribs when your baby is head down, whereas in the breech position, you may feel kicks lower in your belly.

These symptoms may be more evident when your baby “drops” lower into your pelvis in preparation for labor. This process is known as lightening .

Remember, every pregnancy is different, and you may not experience any sensation or signs that your baby is head down.

If you're unsure if your baby is head down, your healthcare provider can confirm the position during a prenatal checkup.

What if Your Baby Doesn’t Move Head Down?

When a baby is not head down, they might be in what's known as a breech position or a sideways transverse lie position . In a breech position, the baby's buttocks or feet are positioned to descend down the birth canal first, instead of the head. This position can pose certain risks during vaginal birth , as the baby's head is the last part to emerge. Three main types of breech positions include frank breech, complete breech, and footling breech.

If you're getting closer to your due date and your baby is still not head down, there are a few options that your healthcare provider may consider:

External cephalic version (ECV), a procedure in which a healthcare provider gently manipulates the baby's position from outside the belly. This procedure is usually performed if your baby isn’t in the head-down position after 36 weeks of pregnancy.

A planned cesarean birth ( cesarean section or c-section ) , if the baby's position cannot be changed or poses risks during vaginal delivery.

It's important to discuss these options with your healthcare provider to determine the best course of action for you and your baby. In some cases, your little one may continue to move around and switch positions in the weeks before birth. Again, keep in mind that every pregnancy and birth is unique and your healthcare team will work with you to ensure a safe delivery for both you and your little one.

Can You Help Your Baby Move to a Head-Down Position?

If your baby is not yet in a head-down position and your due date is approaching, you may be wondering how to “get” your baby to turn head down. While you can’t actually make your little one do something, there are some gentle things you can try to encourage them to move, after checking with your healthcare provider. It's important to note that these methods are not guaranteed to work. They include:

Spending time on all fours and rocking back and forth gently

Doing pelvic tilts or rotating your hips in a circular motion

Swimming or walking in water, which can provide buoyancy and help the baby move into a head-down position

Talking to your baby and using gentle and stimulating sounds, such as music, may also encourage them to turn.

Remember to always consult your provider before attempting any exercises or techniques to help your baby move.

The Bottom Line

In the final weeks of pregnancy, you could be concerned about your baby's positioning and wondering “When do babies turn head down?” if your little one hasn't settled into this position yet. But rest assured, your baby still has time to turn head down, and even if they don't do this, there are safe delivery options available. Remember to stay in close communication with your healthcare provider and reach out if you have any questions or concerns. You're doing a great job—keep up the good work!

How We Wrote This Article The information in this article is based on the expert advice found in trusted medical and government sources, such as the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists. You can find a full list of sources used for this article below. The content on this page should not replace professional medical advice. Always consult medical professionals for full diagnosis and treatment.

• American College of Obstetricians and Gynecologists, Your Pregnancy and Childbirth: Month to Month, 7th ed. (Washington, DC: American College of Obstetricians and Gynecologists, 2021).
• ACOG. “If Your Baby is Breech.”
• Cleveland Clinic. “Breech Baby.”
• Cleveland Clinic. “Fetal Positions for Birth.”
• Cleveland Clinic. “Vertex Presentation.”
• Mayo Clinic. “Fetal Presentation Before Birth.”

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