When to expect a baby to turn head down during pregnancy

• Your baby is likely to turn head down after the 20th week of pregnancy. 
• A sign that your baby went head down is pelvic discomfort — your doctor can confirm via ultrasound. 
• If the baby doesn't move into a head-down position, it increases the risk of a breech birth.

For the majority of your pregnancy, the baby in your womb has been dependent on you for everything. But as you near your due date, you need something in return. You need your baby to move into a head-down position. 

The medical term for this is vertex presentation. And it's important because it means that during natural birth, the baby will travel through the birth canal head-first, increasing your chance of a smooth and safe delivery.

A fetus will go into head-down position between 20 and 39 weeks

Luckily, babies go into a head-down position on their own in roughly 97% of pregnancies. However, exactly when they are likely to go into that position depends on how far along you are in your pregnancy. 

It's different for everyone, but usually, the baby will go into the head-down position after the 20-week mark. 

"As the pregnancy progresses, the likelihood that the baby will be head-down, or vertex presentation, will increase," says Gerardo Bustillo, MD, OB-/GYN at MemorialCare Orange Coast Medical Center. "Before 28 weeks, it's about a 75% chance, and at 32 weeks, which is eight weeks before the due date, it's about a 90% chance."

Full term is when you reach the 97% chance.  

How to tell if your baby has gone head down

Some pregnant people can feel when the baby's gone head down. When the baby's head is up, you're more likely to experience discomfort under the ribs and to feel kicking in the lower belly. 

When the baby is head down, you'll probably be feeling kicking higher up in the belly, and discomfort or pressure in the pelvis rather than the upper belly. And if you can't tell for sure, your doctor will be able to. 

"Oftentimes we can tell just by examining the abdomen from the outside. Also, [a doctor] can feel a head usually during a pelvic examination because it definitely feels a lot harder than a butt or feet, but ultrasound is the gold standard for confirming the presentation," says Bustillo. 

What happens when a baby doesn't go head down in time

If your baby doesn't move into a head-down position, that increases your risk of what's called a breech birth, which is when the baby usually emerges feet or butt-first. 

"A baby that's delivered either butt or feet first has a much higher risk of increased morbidity as well as mortality. The risk of asphyxia [oxygen deprivation] during labor and delivery is much higher," says Bustillo.

Not to mention, it can be a lot harder to deliver the baby in a breech position, which can result in physical trauma to both the baby and mother. 

If you're getting close to your due date and the baby is breech, there are a few things you can do.

• Expectant management: This is a wait-and-see approach. There is a chance the baby can change positioning without any extra help. "About 25% of breech babies will spontaneously convert into a head-down position," says Bustillo. 

• Breech exercises: You can try to do some simple movements and exercises to get the baby to change position. Every doctor may recommend a different type of exercise, but as for Bustillo, "I tell my patients to get on all fours like a cat and to kind of raise their buttocks higher than the rest of their body and just to stay in that position for five to ten minutes a couple of times a day. It's kind of an old midwifery technique."
• External Cephalic Version: This is an attempt for the doctor to physically turn the baby from the outside of your belly. However, it doesn't always work, and there can be potential trauma to the baby and the placenta. 
• C-section: Bustillo says many people with breech presentation will have a C-section to reduce traumatic risks associated with vaginal birth. 

Insider's takeaway

You can expect your baby to go head down after 20 weeks of pregnancy. You can sometimes tell that your baby has entered the head-down position if you start to feel more pressure in your pelvis, and you experience more kicking in the upper belly. Your doctor will be able to confirm your baby's position using an ultrasound.

When a baby doesn't go head down in time, it increases the risk of a breech birth, which can cause issues during delivery. There are some methods, such as breech exercises, that can help your baby change positions prior to the due date. It's possible that your baby will spontaneously change positions, but if not, your doctor will likely recommend having a C-section.

Regardless if your baby is head down or not, or if you're giving birth vaginally or by C-section, your team of doctors and nurses will do their very best to ensure a safe delivery for both you and your baby.

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