position and presentation of baby

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.

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.

Products and Services

• A Book: Obstetricks
• 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 a part of the cutting-edge research and care that's changing medicine.

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 transverse 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

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

Copyright © 2024 Merck & Co., Inc., Rahway, NJ, USA and its affiliates. All rights reserved.

• Trying to Conceive
• Signs & Symptoms
• Pregnancy Tests
• Fertility Testing
• Fertility Treatment
• Weeks & Trimesters
• Staying Healthy
• Preparing for Baby
• Complications & Concerns
• Pregnancy Loss
• Breastfeeding
• School-Aged Kids
• Raising Kids
• Personal Stories
• Everyday Wellness
• Safety & First Aid
• Immunizations
• Food & Nutrition
• Active Play
• Pregnancy Products
• Nursery & Sleep Products
• Nursing & Feeding Products
• Clothing & Accessories
• Toys & Gifts
• Ovulation Calculator
• Pregnancy Due Date Calculator
• How to Talk About Postpartum Depression
• Editorial Process
• Meet Our Review Board

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.

Fetal Presentation: Baby’s First Pose

Share this post

Occiput Anterior

Occiput posterior, transverse position, complete breech, frank breech, changing fetal presentation, baby positions.

The position in which your baby develops is called the “fetal presentation.” During most of your pregnancy, the baby will be curled up in a ball – that’s why we call it the “fetal position.” The baby might flip around over the course of development, which is why you can sometimes feel a foot poking into your side or an elbow prodding your bellybutton. As you get closer to delivery, the baby will change positions and move lower in your uterus in preparation. Over the last part of your pregnancy, your doctor or medical care provider will monitor the baby’s position to keep an eye out for any potential problems.

In the occiput anterior position, the baby is pointed headfirst toward the birth canal and is facing down – toward your back. This is the easiest possible position for delivery because it allows the crown of the baby’s head to pass through first, followed by the shoulders and the rest of the body. The crown of the head is the narrowest part, so it can lead the way for the rest of the head.

The baby’s head will move slowly downward as you get closer to delivery until it “engages” with your pelvis. At that point, the baby’s head will fit snugly and won’t be able to wobble around. That’s exactly where you want to be just before labor. The occiput anterior position causes the least stress on your little one and the easiest labor for you.

In the occiput posterior position, the baby is pointed headfirst toward the birth canal but is facing upward, toward your stomach. This can trap the baby’s head under your pubic bone, making it harder to get out through the birth canal. In most cases, a baby in the occiput posterior position will either turn around naturally during the course of labor or your doctor or midwife may help it along manually or with forceps.

In a transverse position, the baby is sideways across the birth canal rather than head- or feet-first. It’s rare for a baby to stay in this position all the way up to delivery, but your doctor may attempt to gently push on your abdomen until the baby is in a more favorable fetal presentation. If you go into labor while the baby is in a transverse position, your medical care provider will likely recommend a c-section to avoid stressing or injuring the baby.

Breech Presentation

If the baby’s legs or buttocks are leading the way instead of the head, it’s called a breech presentation. It’s much harder to deliver in this position – the baby’s limbs are unlikely to line up all in the right direction and the birth canal likely won’t be stretched enough to allow the head to pass. Breech presentation used to be extremely dangerous for mothers and children both, and it’s still not easy, but medical intervention can help.

Sometimes, the baby will turn around and you’ll be able to deliver vaginally. Most healthcare providers, however, recommend a cesarean section for all breech babies because of the risks of serious injury to both mother and child in a breech vaginal delivery.

A complete breech position refers to the baby being upside down for delivery – feet first and head up. The baby’s legs are folded up and the feet are near the buttocks.

In a frank breech position, the baby’s legs are extended and the baby’s buttocks are closest to the birth canal. This is the most common breech presentation .

By late in your pregnancy, your baby can already move around – you’re probably feeling those kicks! Unfortunately, your little one doesn’t necessarily know how to aim for the birth canal. If the baby isn’t in the occiput anterior position by about 32 weeks, your doctor or midwife will typically recommend trying adjust the fetal presentation. They’ll use monitors to keep an eye on the baby and watch for signs of stress as they push and lift on your belly to coax your little one into the right spot. Your doctor may also advise you to try certain exercises at home to encourage the baby to move into the proper position. For example, getting on your hands and knees for a few minutes every day can help bring the baby around. You can also put cushions on your chairs to make sure your hips are always elevated, which can help move things into the right place. It’s important to start working on the proper fetal position early, as it becomes much harder to adjust after about 37 weeks when there’s less room to move around.

In many cases, the baby will eventually line up properly before delivery. Sometimes, however, the baby is still in the wrong spot by the time you go into labor. Your doctor or midwife may be able to move the baby during labor using forceps or ventouse . If that’s not possible, it’s generally safer for you and the baby if you deliver by c-section.

Image Credit and License

Leave a Reply

Your email address will not be published. Required fields are marked *

Save my name, email, and website in this browser for the next time I comment.

• Stages of Pregnancy
• Foods to Avoid
• Medicines to Avoid
• Pregnancy Road Map

Birth Injuries

• Cerebral Palsy
• Brachial Plexus Injuries & Erb’s Palsy
• Brain Damage
• Meconium Aspiration
• Bone Fractures
• Nerve Damage

Newborn Care

• Baby Development

Legal Issues

• Birth Injury vs. Birth Defect
• Birth Injury Lawsuits
• Proving Your Case
• Elements Of A Case

• Email Address *
• Phone Number *
• Email This field is for validation purposes and should be left unchanged.

Need to talk? Call 1800 882 436. It's a free call with a maternal child health nurse. *call charges may apply from your mobile

Is it an emergency? Dial 000 If you need urgent medical help, call triple zero immediately.

Share via email

There is a total of 5 error s on this form, details are below.

• Please enter your name
• Please enter your email
• Your email is invalid. Please check and try again
• Please enter recipient's email
• Recipient's email is invalid. Please check and try again
• Agree to Terms required

Error: This is required

Error: Not a valid value

Presentation and position of baby through pregnancy and at birth

9-minute read

If you are concerned about your baby’s movements, contact your doctor or midwife for advice immediately.

• If you baby is in a breech presentation, your doctor may recommend trying a technique called an external cephalic version to try and move your baby while they are still in the uterus for an easier birth.

What does presentation and position mean?

Presentation refers to the part of your baby’s body that is facing downwards in the direction of the birth canal.

Position refers to where your baby’s occiput (the bottom part of the back of their head) is in relation to your body.

If your baby is in a breech presentation , then position refers to where your baby’s sacrum (lower back) is in relation to your body.

People — including medical professionals — sometimes use these terms incorrectly. Sometimes when speaking about babies in breech presentation, the word ‘position’ will be used to refer to their presentation. For example, you may read information or hear people say ‘breech position’ instead of ‘breech presentation’.

What are the different types of presentation my baby could be in during pregnancy and birth?

Most babies present headfirst, also known as cephalic presentation. Most babies that are headfirst will be vertex presentation. This means that the crown of their head sits at the opening of your birth canal.

In rare cases, your baby can be headfirst but in face or brow presentation, which may not be suitable for vaginal birth.

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

Read more on breech presentation .

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

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.

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

Related pages

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

• Foetal Version
• Breech Presentation

Need more information?

Top results

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.

Read more on WA Health website

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

Read more on NSW Health website

When a baby is positioned bottom-down late in pregnancy, this is called the breech position. Find out about 3 main types and safe birthing options.

Read more on Pregnancy, Birth & Baby website

Malpresentation is when your baby is in an unusual position as the birth approaches. Sometimes it’s possible to move the baby, but a caesarean maybe safer.

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.

© 2024 Healthdirect Australia Limited

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.

• Type 2 Diabetes
• Heart Disease
• Digestive Health
• Multiple Sclerosis
• Diet & Nutrition
• Supplements
• Health Insurance
• Public Health
• Patient Rights
• Caregivers & Loved Ones
• End of Life Concerns
• Health News
• Thyroid Test Analyzer
• Doctor Discussion Guides
• Hemoglobin A1c Test Analyzer
• Lipid Test Analyzer
• Complete Blood Count (CBC) Analyzer
• What to Buy
• Editorial Process
• Meet Our Medical Expert Board

What Is Cephalic Position?

The ideal fetal position for labor and delivery

• Why It's Best

Risks of Other Positions

• Determining Position
• Turning a Fetus

The cephalic position is when a fetus is head down when it is ready to enter the birth canal. This is one of a few variations of how a fetus can rest in the womb and is considered the ideal one for labor and delivery.

About 96% of babies are born in the cephalic position. Most settle into it between the 32nd and 36th weeks of pregnancy . Your healthcare provider will monitor the fetus's position during the last weeks of gestation to ensure this has happened by week 36.

If the fetus is not in the cephalic position at that point, the provider may try to turn it. If this doesn't work, some—but not all—practitioners will attempt to deliver vaginally, while others will recommend a Cesarean (C-section).

Getty Images

Why Is the Cephalic Position Best?

During labor, contractions dilate the cervix so the fetus has adequate room to come through the birth canal. The cephalic position is the easiest and safest way for the baby to pass through the birth canal.

If the fetus is in a noncephalic position, delivery becomes more challenging. Different fetal positions have a range of difficulties and varying risks.

A small percentage of babies present in noncephalic positions. This can pose risks both to the fetus and the mother, and make labor and delivery more challenging. It can also influence the way in which someone can deliver.

A fetus may actually find itself in any of these positions throughout pregnancy, as the move about the uterus. But as they grow, there will be less room to tumble around and they will settle into a final position.

It is at this point that noncephalic positions can pose significant risks.

Cephalic Posterior

A fetus may also present in an occiput or cephalic posterior position. This means they are positioned head down, but they are facing the abdomen instead of the back.

This position is also nicknamed "sunny-side up."

Presenting this way increases the chance of a painful and prolonged delivery.

There are three different types of breech fetal positioning:

• Frank breech: The legs are up with the feet near the head.
• Footling breech: One or both legs is lowered over the cervix.
• Complete breech: The fetus is bottom-first with knees bent.

A vaginal delivery is most times a safe way to deliver. But with breech positions, a vaginal delivery can be complicated.

When a baby is born in the breech position, the largest part—its head—is delivered last. This can result in them getting stuck in the birth canal (entrapped). This can cause injury or death.

The umbilical cord may also be damaged or slide down into the mouth of the womb, which can reduce or cut off the baby's oxygen supply.

Some providers are still comfortable performing a vaginal birth as long as the fetus is doing well. But breech is always a riskier delivery position compared with the cephalic position, and most cases require a C-section.

Likelihood of a Breech Baby

You are more likely to have a breech baby if you:

• Go into early labor before you're full term
• Have an abnormally shaped uterus, fibroids , or too much amniotic fluid
• Are pregnant with multiples
• Have placenta previa (when the placenta covers the cervix)

Transverse Lie

In transverse lie position, the fetus is presenting sideways across the uterus rather than vertically. They may be:

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

If a transverse lie is not corrected before labor, a C-section will be required. This is typically the case.

Determining Fetal Position

Your healthcare provider can determine if your baby is in cephalic presentation by performing a physical exam and ultrasound.

In the final weeks of pregnancy, your healthcare provider will feel your lower abdomen with their hands to assess the positioning of the baby. This includes where the head, back, and buttocks lie

If your healthcare provider senses that the fetus is in a breech position, they can use ultrasound to confirm their suspicion.

Turning a Fetus So They Are in Cephalic Position

External cephalic version (ECV) is a common, noninvasive procedure to turn a breech baby into cephalic position while it's still in the uterus.

This is only considered if a healthcare provider monitors presentation progress in the last trimester and notices that a fetus is maintaining a noncephalic position as your delivery date approaches.

External Cephalic Version (ECV)

ECV involves the healthcare provider applying pressure to your stomach to turn the fetus from the outside. They will attempt to rotate the head forward or backward and lift the buttocks in an upward position. Sometimes, they use ultrasound to help guide the process.

The best time to perform ECV is about 37 weeks of pregnancy. Afterward, the fetal heart rate will be monitored to make sure it’s within normal levels. You should be able to go home after having ECV done.

ECV has a 50% to 60% success rate. However, even if it does work, there is still a chance the fetus will return to the breech position before birth.

Natural Methods For Turning a Fetus

There are also natural methods that can help turn a fetus into cephalic position. There is no medical research that confirms their efficacy, however.

• Changing your position: Sometimes a fetus will move when you get into certain positions. Two specific movements that your provider may recommend include: Getting on your hands and knees and gently rocking back and forth. Another you could try is pushing your hips up in the air while laying on your back with your knees bent and feet flat on the floor (bridge pose).
• Playing stimulating sounds: Fetuses gravitate to sound. You may be successful at luring a fetus out of breech position by playing music or a recording of your voice near your lower abdomen.
• Chiropractic care: A chiropractor can try the Webster technique. This is a specific chiropractic analysis and adjustment which enables chiropractors to establish balance in the pregnant person's pelvis and reduce undue stress to the uterus and supporting ligaments.
• Acupuncture: This is a considerably safe way someone can try to turn a fetus. Some practitioners incorporate moxibustion—the burning of dried mugwort on certain areas of the body—because they believe it will enhance the chances of success.

A Word From Verywell

While most babies are born in cephalic position at delivery, this is not always the case. And while some fetuses can be turned, others may be more stubborn.

This may affect your labor and delivery wishes. Try to remember that having a healthy baby, and staying well yourself, are your ultimate priorities. That may mean diverting from your best laid plans.

Speaking to your healthcare provider about turning options and the safest route of delivery may help you adjust to this twist and feel better about how you will move ahead.

Glezerman M. Planned vaginal breech delivery: current status and the need to reconsider . Expert Rev Obstet Gynecol. 2012;7(2):159-166. doi:10.1586/eog.12.2

Cleveland Clinic. Fetal positions for birth .

MedlinePlus. Breech birth .

UT Southwestern Medical Center. Can you turn a breech baby around?

The American College of Obstetricians and Gynecologists. If your baby is breech .

Roecker CB. Breech repositioning unresponsive to Webster technique: coexistence of oligohydramnios .  Journal of Chiropractic Medicine . 2013;12(2):74-78. doi:10.1016/j.jcm.2013.06.003

By Cherie Berkley, MS Berkley is a journalist with a certification in global health from Johns Hopkins University and a master's degree in journalism.

Why would posterior position matter in labor?  The head is angled so that it measures larger. The top of the head molds less than the crown.

Baby’s spine is extended, not curled, so the crown of the head is not leading the way. Baby can’t help as much during the birth process to the same degree as the curled up baby.

Some posteriors are easy, while others are long and painful, and there are several ways to tell how your labor will be beforehand. After this, you may want to visit What to do when….in Labor .

Belly Mapping ® Method tips:  The Right side of the abdomen is almost always firmer, but the direct OP baby may not favor one side or the other. Baby’s limbs are felt in front, on both sides of the center line. A knee may slide past under the navel. 

The OP position (occiput posterior fetal position) is when the back of the baby’s head is against the mother’s back. Here are drawings of an anterior and posterior presentation.

• When is Breech an Issue?
• Belly Mapping® Breech
• Flip a Breech
• When Baby Flips Head Down
• Breech & Bicornuate Uterus
• Breech for Providers
• What if My Breech Baby Doesn't Turn?
• Belly Mapping ®️ Method
• After Baby Turns
• Head Down is Not Enough
• Sideways/Transverse
• Asynclitism
• Oblique Lie
• Left Occiput Transverse
• Right Occiput Anterior
• Right Occiput Posterior
• Right Occiput Transverse
• Face Presentation
• Left Occiput Anterior
• OP Truths & Myths
• Anterior Placenta
• Body Balancing

Look at the above drawing. The posterior baby’s back is often extended straight or arched along the mother’s spine. Having the baby’s back extended often pushes the baby’s chin up.

Attention: Having the chin up is what makes the posterior baby’s head seem larger than the same baby when it’s in the anterior position.

Because the top of the head enters (or tries to enter) the pelvis first, baby seems much bigger by the mother’s measurements. A posterior head circumference measures larger than the anterior head circumference.

A large baby is not the same issue, however. The challenge with a posterior labor is that the top of the head, not the crown of the head leads the way.

A baby with their spine straight has less ability to wiggle and so the person giving birth has to do the work of two. This can be long and challenging or fast and furious. Also, there are a few posterior labors that are not perceived different than a labor with a baby curled on the left.

Why? Anatomy makes the difference. Learn to work with birth anatomy to reduce the challenge of posterior labor by preparing with our Three Balances SM and more.

What to do?

• Three Balances SM
• Dip the Hip
• Psoas Release
• Almost everything on this website except Breech Tilt

In Labor, do the above and add,

• Abdominal Lift and Tuck
• Other positions to Open the Brim
• Open the Outlet during pushing

There are four posterior positions

The direct OP is the classic posterior position with the baby facing straight forward.   Right Occiput Transverse   (ROT) is a common starting position in which the baby has a bit more likelihood of rotating to the posterior during labor than to the anterior.   Right Occiput Posterior   usually involves a straight back with a lifted chin (in the first-time mother). Left Occiput Posterior places the baby’s back opposite the maternal liver and may let the baby flex (curl) his or her back and therefore tuck the chin for a better birth. These are generalities, of course. See a bit more about posterior positions in   Belly Mapping ® on this website. Want to map your baby’s position? Learn how with the   Belly Mapping ® Workbook .

Pregnancy may or may not show symptoms.   Just because a woman’s back doesn’t hurt in pregnancy doesn’t mean the baby is not posterior. Just because a woman is quite comfortable in pregnancy doesn’t mean the baby is not posterior. A woman can’t always feel the baby’s limbs moving in front to tell if the baby is facing the front.

The four posterior fetal positions

Four starting positions often lead to (or remain as) direct   OP   in active labor.   Right Occiput Transverse   (ROT),   Right Occiput Posterior   (ROP), and Left Occiput Posterior (LOP) join direct OP in adding labor time. The LOP baby has less distance to travel to get into an LOT position.

As labor begins, the high-riding, unengaged Right Occiput Transverse baby slowly rotates to   ROA , working past the sacral promontory at the base of the spine before swinging around to LOT to engage in the pelvis. Most babies go on to OA at the pelvic floor or further down on the perineal floor.

If a baby engages as a ROT, they may go to OP or ROA by the time they descend to the midpelvis. The OP baby may stay OP. For some, once the head is lower than the bones and the head is visible at the perineum, the baby rotates and helpers may see the baby’s head turn then! These babies finish in the ROA or OA positions.

Feeling both hands in front, in two separate but low places on the abdomen, indicates a posterior fetal position. This baby is Left Occiput Posterior.

Studies estimate 15-30% of babies are OP in labor. Jean Sutton in   Optimal Fetal Positioning   states that 50% of babies trend toward posterior in early labor upon admission to the hospital. Strong latent labor swings about a third of these to LOT before dilation begins (in “pre-labor” or “false labor”).

Recent research shows about 50% of babies are in a posterior position when active labor begins, but of these, 3/4 of them rotate to anterior (or facing a hip in an occiput transverse, head down position.

Jean Sutton’s observations, reported in her 1996 book, indicates that some babies starting in a posterior position will rotate before arriving to the hospital. Ellice Lieberman observed most posteriors will rotate out of posterior into either anterior or to facing a hip throughout labor. Only 5-8% of all babies emerge directly OP (13% with an epidural in Lieberman’s study). At least 12% of all   cesareans   are for OP babies that are stuck due to the larger diameter of the OP head in comparison to the OA head. It’s more common for ROT, ROP, and OP babies to rotate during labor and to emerge facing back (OA). Some babies become stuck halfway through a long-arc rotation and some will need a cesarean anyway.

The three anterior starting positions for labor

Why not ROA? ROA babies may have their chins up and this deflexed position may lengthen the course of labor. Less than 4% of starting positions are ROA, according to a Birmingham study. This might not be ideal for first babies, but is not a posterior position either.  

The spectrum of ease across posterior labors

Purchase Parent Class

Baby’s posterior position may matter in labor

With a posterior presentation, labor may or may not be significantly affected. There is a spectrum of possibilities with a posterior baby. Some women will not know they had a posterior baby because no one mentions it. Either the providers didn’t know, or didn’t notice. If labor moved along, they may not have looked at fetal position clues since there was no reason to figure out why labor wasn’t progressing. If a woman didn’t have back labor (more pain in her back than in her abdomen), the provider may not have been “clued into” baby’s position.

Some posterior babies are born in less than 8 hours and position did not slow down labor. Some posterior babies are born in less than 24 hours and position did not slow down labor enough to be out of the norm. Some posterior babies are born in less than 36-48 hours without the need for interventions.

Some posterior labors are manageable when women are mobile, supported, and eat and drink freely, as needed. Some posterior labor needs extra support that a well-trained and experienced doula may provide, but that typically a mate or loved one would not have the skills or stamina to keep up with. Some posterior labors progress only with the help of a highly-trained pregnancy bodyworker or deep spiritual, or otherwise a non-conventional model of care. Or, they seem only able to finish with medical intervention.

Some posterior labors are served by an epidural, meaning the pelvic floor relaxes enough for the baby to rotate and come out. Some epidurals, on the other hand, make it so that a woman can not finish the birth vaginally.

NOTE:   Parents should know — some birth researchers, like Pediatrician John Kennell, are seriously asking whether a mother’s epidural turns off her body’s release of pain-relieving hormones which a baby relies on during childbirth. Some babies can’t turn and can’t be born vaginally and must be born by   cesarean. This is a spectrum of possibilities. I’ve seen every one of the above possibilities several times and can add the wonderful experience of seeing a woman laughing pleasurably and squatting while her posterior baby slid out on to her bedroom floor.

Possible posterior effects, some women will have one or two and some will have many of these:

The forehead that overlaps the pubic bone after labor starts must turn and drop into the pelvis to allow the birth to happen naturally. A cesarean finish of the labor is possible. Look at Abdominal Lift and Tuck in Techniques to guide you to solutions for easier engagement and progress.

• Longer pregnancy (some research shows this and some doesn’t)
• The amniotic sac breaking (water breaks, membranes open, rupture of membranes) before labor (1 in 5 OP labors)
• Not starting in time before induction   is scheduled
• Labor is longer and stronger and less rhythmic than expected
• Start and stop   labor pattern
• The baby may not engage, even during the pushing stage
• Longer early labor
• Longer active labor
• Back labor (in some cases)
• Pitocin may be used when labor stalls (but a snoring good rest followed by oatmeal may restore a contraction pattern, too)
• Longer pushing stage
• Maybe a woman has all three phases of labor lengthened by the OP labor or one or two of the three phases listed
• Sometimes the baby’s head gets stuck turned halfway to anterior – in the transverse diameter. This may be called a transverse arrest (not a   transverse lie ).
• More likely to tear
• More likely to need a vacuum (ventouse) or forceps
• More likely to need a   cesarean

These effects are in comparison to a baby in the   left occiput anterior   or   left occiput transverse   fetal position at the start of labor.

Who might have a hard time with a posterior baby?

This family just had a fast posterior birth of their second child! Ease in labor includes other factors beyond baby position.

• A first-time mom
• A first-time mom whose   baby hasn’t dropped into the pelvis by 38 weeks gestation   (two weeks before the due date)
• A woman with an   android pelvis   (“runs like a boy,” often long and lanky, low pubis with narrow pubic arch and/or sitz bones close together, closer than or equal to the width of a fist)
• A woman whose baby, in the third trimester, doesn’t seem to change position at all, over the weeks. He or she kicks in the womb and stretches, but whose trunk is stationary for weeks. This mother’s broad ligament may be so tight that she may be uncomfortable when baby moves.
• A woman who has an epidural early in labor (data supports this), before the baby has a chance to rotate and come down.
• A woman who labors lying in bed
• Low-thyroid, low-energy woman who has gone overdue (this is my observation)
• A woman who lacks support by a calm and assured woman who is calming and reassuring to the birthing mother (a doula)
• A woman put on the clock
• A woman who refuses all help when the labor exceeds her ability to physically sustain her self (spilling ketones, dehydration, unable to eat or rest in a labor over X amount of hours which might be 24 for some or 48 for others)
• A woman whose birth team can’t match an appropriate technique to the needs of the baby for flexion, rotation, and/or descent from the level of the pelvis where the baby is currently at when stuck

Who is likely to have an easy time with a posterior baby?

• A second-time mom who’s given birth readily before (and pushing went well)
• A posterior baby with a tucked chin on his or her mama’s left side with   a round pelvic brim
• An average-sized or smaller baby
• Someone whose posterior baby changes from right to left after doing inversions and other   balancing work , though the baby is still posterior
• A woman with a baby in the Left Occiput Posterior, especially if the baby’s chin is tucked or flexed
• A woman who gets bodywork, myofascial release, etc.
• A woman whose posterior baby engages, and does not have an   android (triangular) pelvis or a small outlet
• And of all of these, what is necessary is a pelvis big enough to accommodate the baby’s extra head size
• A woman who uses active birthing techniques — vertical positions, moves spontaneously and instinctively or with specific techniques from Spinning Babies ® , and other good advice
• A woman in a balanced nervous state, not so alert and “pumped up,” on guard, etc.

Any woman may also have an easier time than public opinion might indicate, too, just because she isn’t on this list. Equally, just because she is on the “hard” list doesn’t mean she will have a hard time for sure. These are general observations. They are neither condemnations nor promises. Overall, some posterior babies will need help getting born, while some posterior babies are born easily (easy being a relative term).

Let’s not be ideological about posterior labors.

While most posterior babies do eventually rotate, that can still mean there is quite a long wait – and a lot of physical labor during that wait. Sometimes it means the doula, midwife, nurse, or doctor is asking the mother to do a variety of position changes, techniques, and even medical interventions to help finish the labor. Patience works for many, but for some a   cesarean   is really the only way to be born. Read   What To Do When…in Labor .

What causes a baby to be posterior?

There is a rising incidence of posterior babies at the time of birth. We know now that epidural anesthesia increases the rate of posterior position at the time of birth from about 4% (for women who don’t choose an epidural in a university birth setting) up to about 13% (Lieberman, 2005). Low thyroid function is associated with fetal malposition such as posterior or breech. (See   Research & References .)

Most babies who are posterior early in labor will rotate to anterior once labor gets going. Some babies rotate late in labor, even just before emerging. Studies such as Lieberman’s show that at any given phase of labor, another 20% of posterior babies will rotate so that only a small number are still posterior as the head emerges.

My observations are that the majority of babies are posterior before labor. The high numbers of posterior babies at the end of pregnancy and in the early phase of labor is a change from what was seen in studies over ten years old. Perhaps this is from our cultural habits of sitting at desks, sitting in bucket seats (cars), and leaning back on the couch (slouching). Soft tissues such as the psoas muscle pair or the broad ligament also seem to be tight more often from these postures, from athletics (quick stops, jolts, and falls), from accidents, and from emotional or sexual assault.

Being a nurse or bodyworker who turns to care for people in a bed or on a table will also twist the lower uterine segment (along with some of the previously mentioned causes). This makes the baby have to compensate in a womb that is no longer symmetrical. Less often, the growing baby settles face-forward over a smaller pelvis, or a triangular-shaped pelvis (android). At the end of pregnancy, the baby’s forehead has settled onto a narrower than usual pubic bone, and if tight round ligaments hold the forehead there, the baby may have a tough time rotating. These are the moms and babies that I’m most concerned with in my work at Spinning Babies®. A baby that was   breech   beyond week 30 – 34 of pregnancy will flip head down in the posterior position. A woman with a history of breech or posterior babies is more likely to have a breech or posterior baby in the next pregnancy. However, she may not have an as long labor.

The best way to tell if your baby is OP or not, usually, is if you feel little wiggles in the abdomen right above your pubic bone. These are the fingers. They’d feel like little fingers wiggling, not like a big thunk or grinding from the head, though you might feel that, too. The little fingers will be playing by the mouth. This is the easiest indication of OP. The wiggles will be centered in the middle of your lower abdomen, close to the pubic bone. If you feel wiggles far to the right, near your hip, and kicks above on the right, but not near the center and none on the left, then those signal an   OA   or   LOT   baby (who will rotate to the OA easily in an active birth). After this, you might go to   What to do when…in Labor.

Check out our current references in the   Research & References   section.

Contact to Listing Owner

• 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.

BLOG CATEGORIES

• Can I get pregnant if… ? 3
• Child Adoption 19
• Fertility 54
• Pregnancy Loss 11
• Breastfeeding 29
• Changes In Your Body 5
• Cord Blood 4
• Genetic Disorders & Birth Defects 17
• Health & Nutrition 2
• Is it Safe While Pregnant 54
• Labor and Birth 65
• Multiple Births 10
• Planning and Preparing 24
• Pregnancy Complications 68
• Pregnancy Concerns 62
• Pregnancy Health and Wellness 149
• Pregnancy Products & Tests 8
• Pregnancy Supplements & Medications 14
• The First Year 41
• Week by Week Newsletter 40
• Your Developing Baby 16
• Options for Unplanned Pregnancy 18
• Paternity Tests 2
• Pregnancy Symptoms 5
• Prenatal Testing 16
• The Bumpy Truth Blog 7
• Uncategorized 4
• Abstinence 3
• Birth Control Pills, Patches & Devices 21
• Women's Health 34
• Thank You for Your Donation
• Unplanned Pregnancy
• Getting Pregnant
• Healthy Pregnancy
• Privacy Policy

Share this post:

Similar 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

What does it mean for a baby to be sunny-side up?

How common is it for a baby to be in posterior position, how will i know if my baby is in posterior position, if my baby is posterior, does that mean i'll have back labor, if my baby is posterior at birth, how will it affect my delivery, how will delivering in a posterior position affect my baby, risk factors for posterior position, is there anything i can do to make it less likely that my baby will be sunny-side up.

A baby who's head-down but facing your front instead of your back is said to be in the posterior position. You may also hear this position referred to as "face-up" or "sunny-side up." A small percentage of babies end up in this position at birth. 

If your baby is sunny-side up at birth, it will be harder for them to get through your pelvis during a vaginal birth , and you may have a more complicated delivery.

The technical term is occiput posterior (OP) position. This term refers to the fact that the back of your baby's skull (the occipital bone) is in the back (or posterior) of your pelvis. 

It depends on how close you are to delivery. While as many as 34 percent of babies are posterior when labor starts, only 5 to 8 percent of them are posterior at birth.

It's common for a baby's position to change during labor, often more than once. Most babies rotate on their own to the face-down position before birth.

Your caregiver will probably be able to tell by doing a manual exam in the second stage of labor (when the cervix is completely dilated). An ultrasound can be done to confirm the position. (Some providers use ultrasound routinely to determine the position of baby's head.)

No. Back labor – the intense lower back pain that many women feel during labor – was long thought to be more likely when the baby is facing up. But research using ultrasound (much more accurate than a clinical exam, especially in the first stage of labor) suggests that this assumption is probably wrong. Researchers have found that women whose babies are face up are no more likely to suffer back labor or more intense pain than those whose babies are facing down or sideways.

Mothers whose babies are face-up at birth:

• Tend to push longer.
• More commonly need Pitocin to stimulate contractions.
• Have a significantly higher risk of having an assisted vaginal delivery or C-section.
• Are more likely to have an episiotomy and severe perineal tears than moms whose babies are in the more favorable face-down position.
• Have a greater risk of postpartum hemorrhage.

Some doctors and midwives may attempt to turn a posterior baby by manual rotation. Once you're fully dilated, they reach into your vagina, put their hand or fingers on your baby's head, and try to rotate it. (Sometimes this is done while using ultrasound.)

It may take a few contractions to get the baby into a face-down position, and it doesn't always work. Still, manual rotation has been shown to reduce the need for cesarean section and severe perineal tears.

The posterior position at birth is associated with a higher risk of short-term complications for the baby, such as lower five-minute Apgar scores , a greater likelihood of needing to be admitted to the neonatal intensive care unit (NICU), and a longer hospital stay.

You're more likely to have a baby in the OP position at delivery if:

• This is your first baby.
• You're 35 years of age or older.
• You're obese .
• You're African American.
• You've had a previous OP delivery.
• You have a small pelvis.
• You're 41 weeks or more.
• Your baby weighs 8 pounds 13 ounces or more.
• Your placenta is attached to the front of your uterus (anterior placenta).

There's some debate over whether epidural anesthesia is a risk factor. Many studies (but not all) show a link between having an epidural during labor and having a baby who is posterior at birth. Some research suggests that it's because the epidural relaxes the mom's pelvic muscles, which in turn keeps the baby from rotating out of the OP position.

Some argue that having a posterior baby (and often a longer and possibly more painful labor) makes it more likely for a woman to request an epidural. But there are studies that refute this idea, concluding that women who request epidurals (and those who don't) have a similar proportion of babies in OP position during labor.

Probably not. You may have heard that being on your hands and knees during late pregnancy or labor helps rotate your baby face-down, but current research suggests that being on all fours won't reduce the likelihood that your baby will be in the posterior position at birth.

That said, if your back aches, you may want to give this position a try anyway. Research shows that being on your hands and knees during labor may offer some relief from back pain.

Was this article helpful?

Signs and treatment of postpartum hemorrhage

What is back labor?

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

What's the Apgar score?

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 .

Medline Plus. 2022. Delivery presentations. https://medlineplus.gov/ency/patientinstructions/000621.htm Opens a new window Opens a new window [Accessed August 2023]

Castel P et al. 2019. Pathophysiology, diagnosis and management of occiput posterior presentation during labor.  Gynecologie, Obstetrique, Fertilite & Senologie 47(4):370-377. https://europepmc.org/article/med/30753901 Opens a new window [Accessed August 2023]

Ghi T et al. 2016. Narrow subpubic arch angle is associated with higher risk of persistent occiput posterior position at delivery Ultrasound Obstetrics and Gynecology 48(4):511. https://www.ncbi.nlm.nih.gov/pubmed?term=26565728 Opens a new window [Accessed August 2023]

Lieberman E et al. 2005. Changes in fetal position during labor and their association with epidural analgesia. Obstetrics & Gynecology 105(5 Pt 1):974-82. https://www.ncbi.nlm.nih.gov/pubmed/15863533 Opens a new window [Accessed August 2023]

Masturzo B et al. 2017. Sonographic evaluation of the fetal spine position and success rate of manual rotation of the fetus in occiput posterior position: A randomized controlled trial. Journal of Clinical Ultrasound 45(8):472-476. https://www.ncbi.nlm.nih.gov/pubmed?term=28369942 Opens a new window [Accessed August 2023]

Pergialiotis V et al. 2020. Risk factors for severe perineal trauma during childbirth: An updated meta-analysis. European Journal of Obstetrics & Gynecology and Reproductive Biology 247: 94-100. https://www.sciencedirect.com/science/article/pii/S0301211520300932 Opens a new window [Accessed August 2023]

Shaffer B et al. 2011. Manual rotation to reduce caesarean delivery in persistent occiput posterior or transverse position. Journal of Maternal Fetal Neonatal Medicine 24(1): 65-72. https://pubmed.ncbi.nlm.nih.gov/20350240/ Opens a new window [Accessed August 2023]

Tempest N et al. 2019. Babies in occiput posterior position are significantly more likely to require an emergency cesarean birth compared with babies in occiput transverse position in the second stage of labor: A retrospective observational study. Acta Obstetricia et Gynecologica Scandinavica 99(4):537-545. https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/aogs.13765 Opens a new window [Accessed August 2023]

Tempest N et al. 2017. Neonatal and maternal outcomes of successful manual rotation to correct malposition of the fetal head; A retrospective and prospective observational study. PLoS One 12(5): e0176861. https://pubmed.ncbi.nlm.nih.gov/28489924/ Opens a new window [Accessed August 2023]

Vitner D et al. 2015. Prospective multicenter study of ultrasound-based measurements of fetal head station and position throughout labor. Ultrasound Obstetrics Gynecology 46(5):611. https://www.ncbi.nlm.nih.gov/pubmed?term=25678449 Opens a new window [Accessed August 2023]

Where to go next

14 Sex Positions to Try When You Can't Get Close Enough to Your Partner

• Jamie is a Senior Editor for The Knot where she oversees all sex and relationship editorial content.
• Before joining The Knot Worldwide, she worked with an array of digital publications that include Brides, The Zoe Report, Bustle and MyDomaine.
• Jamie graduated with a degree in English and Media, Culture & Communications from New York University.

Can't get enough? Ahem . As your resident Senior Sex & Relationships Editor, I've more or less taken a sacred vow (joking) to bring you a plethora of sex positions to try if and when the mood strikes—a task that I don't take frivolously (not joking). Case in point: these particularly passionate moves that aim to bring you closer than ever to your partner. And I'm talking in every sense of the word.

First thing is first: A couple may not necessarily need sex to share or deepen intimacy. In fact, you can find cuddle positions for couples right here . But if it's lusty, electric romps that you're after, these new sex positions to try all incorporate romantic, intimate elements. Think: full-body touches, prolonged eye contact and cuddly caresses. They'll hopefully intensify encounters and heighten romantic feelings, deepening your connection in more ways than one. (Hot, right?)

Bring on the serotonin. Here are 14 friction-fueled sex positions to try when you're in those lovey-dovey feels.

The Position: The Lotus

What it is: While one partner is seated, the other should sit on top of them with their legs wrapped around their torso. Deep kisses, cuddles and penetration (either with a penis, strap-on, or double-sided dildo) are all options here.

Why you'll love it: You'll be face-to-face with your partner, so this one is great if you're big on eye contact. Moreover, you'll be able to fully embrace one another and maximize touch in this position.

The Position: Spooning+

What it is: Not just for post-coital cuddles, spooning can be part of the main event too. Face the same direction as your partner, lying on your sides. With the arms of the partner in back wrapped around the other's body, you can engage in penetration from behind and/or use your hands to stimulate one another's genitals.

Why you'll love it: Back-of-neck kisses, full-body contact and a tight embrace? Sign us up. Hot tip: This position also offers the perfect opportunity to whisper sweet nothings in your love's ear.

The Position: Mutual Masturbation

What it is: Yes, it counts! A mutual masturbation sesh allows for both vulnerability and the chance to learn more about what the other feels pleasurable. Using your hand or a toy , get yourself off while watching your partner masturbate simultaneously. Try to hold eye contact—or watch your partner's genitals—throughout the experience.

Why you'll love it: You can be lying side-by-side and facing each other, or on video chat if you're in a long-distance relationship . It's hot—and requires a ton of trust.

The Position: Legs-Up Missionary

What it is: We love a self-descriptive name! This move takes the missionary position and levels up both the penetration and intimacy by having the partner on the bottom lift up their legs once the penis or strap-on is inserted.

Why you'll love it: Deep penetration, plus room to incorporate a toy if desired.

The Position: Sideways 69

What it is: Another modification on a classic, this sex position has both partners performing oral sex on one another simultaneously. Instead of ye olde 69 though, where you and your partner lay on top of one another, try lying on your sides with your faces at each other's genitals.

Why you'll love it: Unlike traditional 69, you'll be able to steal more lusty glances at your partner throughout the position. Bonus: Without the weight of your partner on top of you (or vice versa), you'll be able to enjoy this position for longer.

The Position: Make-Out Moves

What it is: Remember how hot just kissing used to be? Well, it still is! Devote an entire sex sesh to kissing. Go from a hot and heavy make-out to kissing down their neck, chest and torso before giving and receiving prolonged oral sex with eye contact. Leave hidden hickies if you desire and have consent.

Why you'll love it: Going back to the basics and slowing things down can amplify sensation and emotion.

The Position: The Sexed-Up Snuggle

What it is: Lying face-to-face, wrap your arms and legs around one another as if you're snuggling or giving a bear hug. Just when you think you can't get any closer, add penetration or genital stimulation by grinding on one another.

Why you'll love it: You'll be able to kiss deeply, share intense eye contact and whisper to one another in this intimate position.

The Position: The Tabletop

What it is: Here, one partner will lie on their back while the other lies on top of them (also face up). The partner on the bottom will be able to explore their love's genitals intimately and penetrate them if desired while maintaining full body contact.

Why you'll love it: All that skin-to-skin contact is electrifying in its own right, but this sex position to try also allows for intense clitoral stimulation too.

The Position: X-Rated

What it is: In this sex position, one partner will lie down and lift their right leg over their partner's left. The other will bring their pelvises together by putting their right leg over their partner's left. Together, your legs will form an X (or "scissors"). Grind together or add penetration.

Why you'll love it: Slow, deep thrusts can intensify intimacy and prolong the experience.

The Position: Play It Again

What it is: Did you know that some sex toys can be synced with music and vibe in rhythm with the beat? Utilize this tech in the most romantic of ways by queuing up "your" song while using the vibrator. Extend your sex sesh (and show effort) by putting together a sexy playlist—or build anticipation by editing one together side-by-side.

Why you'll love it: You and your partner will be able to enjoy the additional stimulation of a sex toy in a new way while reflecting on your relationship and shared connection.

The Position: Clear the Table

What it is: You probably remember this one from your favorite smutty romance novel : In this sex position to try, the partner being penetrated will sit on the edge of a table or countertop, using their legs to draw their love closer, while the penetrating partner will enter them while standing.

Why you'll love it: The ability to full-arm embrace each other and share long, deep kisses are the main draws here.

The Position: The Ballet Dancer

What it is: With both lovers standing and facing each other, the partner being penetrated should lift and wrap one of their legs around the hips of the other, guiding their partner's penis, strap-on or a dildo inside.

Why you'll love it: This intimate, face-to-face position only works if you trust one another in both a physical and emotional sense.

The Position: The Butterfly

What it is: One partner should lie down on their back with their legs and feet in the butterfly position (if you've ever had a bikini wax, you'll be familiar). Their partner should penetrate by laying on top of them, holding eye contact.

Why you'll love it: Situated face to face, you'll be able to stare deeply into your partner's eyes and kiss them to your heart's content. This position may be particularly comfortable if the partner on the bottom has lower back pain as it'll open up their hips, allowing them to relax into the position and sensations.

The Position: Tantric Massage

What it is: While giving your partner a massage without sex as a part of the experience is great, tantric massages can involve massaging the yoni (the labia and clitoris) and/or lingam (the penis). Plus, the practice encourages a spiritual and energetic connection with your partner. You can learn more about this technique here.

Why you'll love it: Long, lustful touches, a body-relaxing massage and an intensified emotional connection—need we go on?

• Current Employees
• Duke & Durham
• Human Resources
• Connect With Us
• External Applicants
• Current Duke Employees
• Duke Health Careers

Experienced RN - Mother Baby - Days - Duke University Hospital

Durham, NC, US, 27710

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

About Duke University Hospital

Pursue your passion for caring with Duke University Hospital in Durham, North Carolina, which is consistently ranked among the best in the United States and is the number one hospital in North Carolina, according to U.S. News and World Report for 2023-2024. Duke University Hospital is the largest of Duke Health's three hospitals and features 1048 patient beds, 65 operating rooms, as well as comprehensive diagnostic and therapeutic facilities, including a regional emergency/trauma center, an endo-surgery center, and more.

Duke Nursing Highlights:

• Duke University Health System is designated as a Magnet organization
• Nurses from each hospital are consistently recognized each year as North Carolina's Great 100 Nurses.
• Duke University Health System was awarded the American Board of Nursing Specialties Award for Nursing Certification Advocacy for being strong advocates of specialty nursing certification.
• Duke University Health System has 6000 + registered nurses
• Quality of Life: Living in the Triangle!
• Relocation Assistance (based on eligibility)

Expereienced RN - Days - Duke University Hospital 

Duke University Health System- Duke University Hospital seeks to hire an experienced Registered Nurse who will embrace our mission of Advancing Health Together.

Department Profile:

The Duke Birthing Center at Duke University Hospital is active in delivering exemplary care for each patient to ensure an excellent patient experience, every time.  This position is for the postpartum section of the Duke Birthing Center, serving primarily high risk families. The facilities were recently renovated with 24 designated postpartum beds. This unit provides care for more than 3500 families each year, supporting rooming in accommodations. This unit was recently recognized as the # 1 Maternity Care Center in North Carolina!

Ideal candidates will be able to function as a part of a large multidisciplinary team in a shared governance environment, and have a passion for  family centered care. Multiple opportunities here for growth and development through committee work and education!   Work Hours & Shifts: Full Time/ 36 hours weekly - Day shift

Job Summary:

As a Clinical Nurse with Duke University Health System, you will make providing service your priority while caring for the whole person in a patient-centered atmosphere. The Clinical Nurse (RN) is responsible for providing and supervising direct and indirect total nursing care responsibilities. Utilizing the nursing process (assessing, planning, implementing and evaluating) in achieving the goals of the nursing department. Plan and provide advanced and/or specialized nursing care for patients in guided by DUHS Professional Practice model participate in the clinical ladder program, educational activities, departmental committees, research projects or other health related projects as assigned. Provide nursing services to patients and families in accordance with the scope of the RN as defined by the North Carolina Board of Nursing. Adheres to all rules and regulations of all applicable local, state and federal agencies and accrediting bodies. Actively participates in outstanding customer service and accepts responsibility in maintaining relationships that are equally respectful to all.

Knowledge, Skills, Education, and Experience Required :

·         Minimum 1 year of experience required.

·         Graduation from an accredited Bachelor’s Degree in Nursing (or higher), Associate's Degree in Nursing or Nursing Diploma program is required.

All registered nurses without a Bachelor's degree in Nursing (or higher) will be required to enroll in an appropriate BSN program within two years of their start date and to complete the program within five years of their start date

Licensure, Certification or Registration Required:

·         Current registration with North Carolina State Board of Nursing as a registered professional nurse OR current compact RN licensure to practice in the state of North Carolina required.

·         BLS (or higher) certification required.

·         Professional specialty certification (preferred).

Duke is an Affirmative Action/Equal Opportunity Employer committed to providing employment opportunity without regard to an individual's age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status.

Duke aspires to create a community built on collaboration, innovation, creativity, and belonging. Our collective success depends on the robust exchange of ideas—an exchange that is best when the rich diversity of our perspectives, backgrounds, and experiences flourishes. To achieve this exchange, it is essential that all members of the community feel secure and welcome, that the contributions of all individuals are respected, and that all voices are heard. All members of our community have a responsibility to uphold these values.

Essential Physical Job Functions: Certain jobs at Duke University and Duke University Health System may include essentialjob functions that require specific physical and/or mental abilities. Additional information and provision for requests for reasonable accommodation will be provided by each hiring department.

Nearest Major Market: Durham Nearest Secondary Market: Raleigh

Duke is an Affirmative Action / Equal Opportunity Employer committed to providing employment opportunity without regard to an individual’s age, color, disability, gender, gender expression, gender identity, genetic information, national origin, race, religion, sex, sexual orientation, or veteran status. Read more about Duke’s commitment to affirmative action and nondiscrimination at hr.duke.edu/eeo.

Governor Newsom Unveils Revised State Budget, Prioritizing Balanced Solutions for a Leaner, More Efficient Government

Published: May 10, 2024

The Budget Proposal — Covering Two Years — Cuts Spending, Makes Government Leaner, and Preserves Core Services Without New Taxes on Hardworking Californians

Watch Governor Newsom’s May Revise presentation here

WHAT YOU NEED TO KNOW:  The Governor’s revised budget proposal closes both this year’s remaining $27.6 billion budget shortfall and next year’s projected $28.4 billion deficit while preserving many key services that Californians rely on — including education, housing, health care, and food assistance.

SACRAMENTO – Governor Gavin Newsom today released a May Revision proposal for the 2024-25 fiscal year that ensures the budget is balanced over the next two fiscal years by tightening the state’s belt and stabilizing spending following the tumultuous COVID-19 pandemic, all while preserving key ongoing investments.

Under the Governor’s proposal, the state is projected to achieve a positive operating reserve balance not only in this budget year but also in the next. This “budget year, plus one” proposal is designed to bring longer-term stability to state finances without delay and create an operating surplus in the 2025-26 budget year.

In the years leading up to this May Revision, the Newsom Administration recognized the threats of an uncertain stock market and federal tax deadline delays – setting aside $38 billion in reserves that could be utilized for shortfalls. That has put California in a strong position to maintain fiscal stability.

“Even when revenues were booming, we were preparing for possible downturns by investing in reserves and paying down debts – that’s put us in a position to close budget gaps while protecting core services that Californians depend on. Without raising taxes on Californians, we’re delivering a balanced budget over two years that continues the progress we’ve fought so hard to achieve, from getting folks off the streets to addressing the climate crisis to keeping our communities safe.” – Governor Gavin Newsom

Below are the key takeaways from Governor Newsom’s proposed budget:

A BALANCED BUDGET OVER TWO YEARS.  The Governor is solving two years of budget problems in a single budget, tightening the state’s belt to get the budget back to normal after the tumultuous years of the COVID-19 pandemic. By addressing the shortfall for this budget year — and next year — the Governor is eliminating the 2024-25 deficit and eliminating a projected deficit for the 2025-26 budget year that is $27.6 billion (after taking an early budget action) and $28.4 billion respectively.

CUTTING SPENDING, MAKING GOVERNMENT LEANER.  Governor Newsom’s revised balanced state budget cuts one-time spending by $19.1 billion and ongoing spending by $13.7 billion through 2025-26. This includes a nearly 8% cut to state operations and a targeted elimination of 10,000 unfilled state positions, improving government efficiency and reducing non-essential spending — without raising taxes on individuals or proposing state worker furloughs. The budget makes California government more efficient, leaner, and modern — saving costs by streamlining procurement, cutting bureaucratic red tape, and reducing redundancies.

PRESERVING CORE SERVICES & SAFETY NETS.  The budget maintains service levels for key housing, food, health care, and other assistance programs that Californians rely on while addressing the deficit by pausing the expansion of certain programs and decreasing numerous recent one-time and ongoing investments.

NO NEW TAXES & MORE RAINY DAY SAVINGS.  Governor Newsom is balancing the budget by getting state spending under control — cutting costs, not proposing new taxes on hardworking Californians and small businesses — and reducing the reliance on the state’s “Rainy Day” reserves this year.

HOW WE GOT HERE:  California’s budget shortfall is rooted in two separate but related developments over the past two years.

• First, the state’s revenue, heavily reliant on personal income taxes including capital gains, surged in 2021 due to a robust stock market but plummeted in 2022 following a market downturn. While the market bounced back by late 2023, the state continued to collect less tax revenue than projected in part due to something called “capital loss carryover,” which allows losses from previous years to reduce how much an individual is taxed.
• Second, the IRS extended the tax filing deadline for most California taxpayers in 2023 following severe winter storms, delaying the revelation of reduced tax receipts. When these receipts were able to eventually be processed, they were 22% below expectations. Without the filing delay, the revenue drop would have been incorporated into last year’s budget and the shortfall this year would be significantly smaller.

CALIFORNIA’S ECONOMY REMAINS STRONG:  The Governor’s revised balanced budget sets the state up for continued economic success. California’s economy remains the 5th largest economy in the world and for the first time in years, the state’s population is increasing and tourism spending recently experienced a record high. California is #1 in the nation for new business starts , #1 for access to venture capital funding , and the #1 state for manufacturing , high-tech , and agriculture .

Additional details on the May Revise proposal can be found in this fact sheet and at www.ebudget.ca.gov .

Recommended

• Click to share on Facebook (Opens in new window)
• Click to share on Twitter (Opens in new window)
• Click to email a link to a friend (Opens in new window)
• Click to copy URL

Victoria’s Secret is bringing its controversial fashion show back to the runway

• View Author Archive
• Follow on Twitter
• Get author RSS feed

Thanks for contacting us. We've received your submission.

The Angels are back.

While Victoria’s Secret tried a revamped version of its iconic fashion show in 2023, the brand announced Wednesday that it was bringing the catwalk spectacular back to its original format with a splashy runway show this year.

The new show “will deliver precisely what our customers have been asking for – the glamour, runway, fashion, fun, wings, entertainment – all through a powerful, modern lens reflecting who we are today,” a spokesperson for the brand tells Page Six Style.

Shop 'til you drop with Post Wanted

Save time and money with the latest deals, discounts, trends, reviews and more.

Thanks for signing up!

Please provide a valid email address.

By clicking above you agree to the Terms of Use and Privacy Policy .

Never miss a story with New York Post newsletters.

Victoria’s Secret tested a new format for its fashion show last year after receiving backlash for not including a diverse range of models in its annual TV special.

The show went on a four-year hiatus after facing  plummeting ratings  in 2018, returning with the “Victoria’s Secret World Tour” in 2023, which was a more fluid pre-taped presentation and streamed on Prime Video.

The brand’s fashion show debuted in 1997 and featured a range of big-name models — dubbed Victoria’s Secret Angels — over the years, with the likes of Heidi Klum, Gisele Bündchen, Naomi Campbell, Kendall Jenner, Claudia Schiffer and Tyra Banks walking the catwalk.

For more Page Six Style …

• See the best celebrity looks of the week in our new series, “Instantly Iconic Style”
• Browse the best fashion and beauty products, according to celebs
• Shop our exclusive merch

Fans eagerly tuned in each year to see the steamy lingerie and performances from artists like Taylor Swift, Rihanna and the Spice Girls, but the special — which swapped between airing on ABC and CBS —  dipped in popularity in the wake of the #MeToo movement.

However, it seems like the company is going back to basics after the “World Tour” special featuring Doja Cat shook things up from the typical runway format.

Though there is no date announced, the brand tells us it’s “thrilled to share a women-led articulation of this iconic property later this year.”

Share this article:

Advertisement

• สมัคร / ล็อกอิน
• ความช่วยเหลือ

Air Force 1 x Tiffany & Co.

Air Force 1 เป็นที่รู้จักครั้งแรกในปี 1982 และสร้างนิยามใหม่ให้รองเท้าบาสเก็ตบอลตั้งแต่คอร์ทพื้นไม้ไปจนถึงพื้นคอนกรีต แถมยังเป็นสนีกเกอร์บาสเก็ตบอลคู่แรกที่ใช้ Nike Air แต่ความล้ำนวัตกรรมก็ยังต้องหลีกทางให้ความเป็นไอคอนในแนวสตรีทของรุ่นนี้

Advertisement

Supported by

Stormy Daniels, Who Testified About Sex With Trump, Will Return to Stand

The porn star at the center of the ex-president’s criminal trial, who will testify again on Thursday, spoke under oath about their encounter at a golf tournament in 2006, a meeting that could shape American history.

• Share full article

By Ben Protess ,  Jonah E. Bromwich ,  Maggie Haberman ,  Michael Rothfeld and Jonathan Swan

When Donald J. Trump met Stormy Daniels, their flirtation seemed fleeting: He was a 60-year-old married mogul at the peak of reality television fame, and she was 27, a Louisiana native raised in poverty and headed to porn-film stardom.

But that chance encounter in Lake Tahoe, Nev., some two decades ago is now at the center of the first criminal trial of an American president, an unprecedented case that could shape the 2024 presidential race.

This week, Ms. Daniels has been on the witness stand telling her side of the story, often in explicit detail. She has already faced five hours of questioning, and after the trial’s midweek hiatus, she is expected to return on Thursday to undergo additional cross-examination from Mr. Trump’s legal team.

The charges against Mr. Trump stem from her story of sex with him during that 2006 celebrity golf tournament in Lake Tahoe, a story she was shopping a decade later, in the closing days of the presidential campaign. Mr. Trump’s longtime lawyer and fixer, Michael D. Cohen, paid Ms. Daniels $130,000 in hush money before Election Day, and the former president is accused of falsifying business records to cover up reimbursements for Mr. Cohen.

The Links Between Trump and 3 Hush-Money Deals

Here’s how key figures involved in making hush-money payoffs on behalf of Donald J. Trump are connected.

On Tuesday, Ms. Daniels’s fast-paced testimony lasted nearly five hours, during which she described an encounter with Mr. Trump, now 77, that he has long denied. Tension gripped the courtroom, her voluble testimony filling a heavy silence. She made jokes; they did not land.

After about a half-hour on the stand, she began to unspool intimate details about Mr. Trump, so much so that the judge balked at some of the testimony. He implied it was gratuitously vulgar, and the defense sought a mistrial.

Ms. Daniels said the future president had invited her to dinner inside his palatial Lake Tahoe hotel suite. He answered the door wearing silk pajamas. When he was rude, she playfully spanked him with a rolled-up magazine. And when she asked about his wife, he told her not to worry, saying that they didn’t even sleep in the same room — prompting Mr. Trump to shake his head in disgust and mutter “bullshit” to his lawyers, loud enough that it drew a private rebuke from the judge, who called it “contemptuous.”

Ms. Daniels then recounted the sex itself in graphic detail. It happened, she said, after she returned from the bathroom and found Mr. Trump in his boxer shorts and T-shirt. She tried to leave and he blocked her path, though not, she said, in a threatening manner. The sex was brief, she said, and although she never said no, there was a “power imbalance.”

“I was staring up at the ceiling, wondering how I got there,” she told the jury, adding that Mr. Trump did not wear a condom.

The testimony was an astonishing moment in American political history and a crowning spectacle in a trial full of them: a porn star, across from a former and potentially future president, telling the world what she was once paid to keep quiet about.

Ms. Daniels, 45, has told her story widely — to prosecutors, reporters, her friends, in a book — but never to jurors, and not with Mr. Trump in the room. Her appearance on the stand appeared to unnerve Mr. Trump as she aired his dirty laundry, under oath, in mortifying detail.

But Ms. Daniels’s story is not just a sordid kiss-and-tell tale; it spotlights what prosecutors say was Mr. Trump’s criminality. He is accused of engineering the false business records scheme to cover up all traces of their tryst: the hush money, the repayment to Mr. Cohen and, yes, the sex.

While the defense cast the testimony as a smear, Ms. Daniels provided prosecutors with some useful details. She established the fundamental story of her encounter with Mr. Trump. And she testified that she would have told the same uncomfortable tale in 2016, had she not taken the hush money from Mr. Trump’s fixer.

Who Are Key Players in the Trump Manhattan Criminal Trial?

The first criminal trial of former President Donald J. Trump is underway. Take a closer look at central figures related to the case.

But her testimony, at times, seemed problematic for the prosecutors who had called her. Ms. Daniels testified that money was not her motivation, and that she wanted to get her story out. That could draw skepticism from jurors, who have heard that she accepted the $130,000 and, in exchange, did not tell her story for more than a year.

“My motivation wasn’t money,” she said. “It was motivated out of fear, not money.”

The jury also saw the judge, Juan M. Merchan, scold Ms. Daniels at least twice, instructing her to stick to the questions asked of her. At one point, he even issued his own objection, interrupting her testimony as she began to describe the sexual position she and Mr. Trump assumed.

Justice Merchan, generally a stoic presence with a tight grip over his courtroom, showed rare exasperation as the testimony veered in a scurrilous direction and the trial took on a circuslike atmosphere.

He also asked Ms. Daniels to slow down. She was a rapid-fire talker, prone to laughter and lengthy asides.

Outside the jury’s presence, the judge said that “there were some things better left unsaid” in her testimony and suggested that Ms. Daniels might have “credibility issues.”

Yet he rejected the defense’s bid for a mistrial, instead inviting Mr. Trump’s lawyers to mount an aggressive questioning of Ms. Daniels.

“The more times this story has changed, the more fodder for cross-examination,” he said.

Susan Necheles, the Trump lawyer who led the cross-examination, heeded the judge’s advice.

She painted Ms. Daniels as a lying opportunist. She unearthed excerpts from Ms. Daniels’s book to suggest that her story had changed over time. And in a potentially troublesome moment for Ms. Daniels, Ms. Necheles implied that she had fabricated an account of a Trump supporter threatening her and her daughter in a Las Vegas parking lot, a story she did not share with her baby’s father.

“Your daughter’s life was in jeopardy, and you did not tell her father, right?” Ms. Necheles asked, the implication being that the story was phony.

Ms. Daniels was indignant. And during some cross-examination, she parried effectively, performing even better than she did with her answers to prosecutors.

Her testimony brought full circle one of the earliest scandals that loomed over Mr. Trump’s presidency. Ever since The Wall Street Journal broke the news six years ago that Mr. Cohen had paid her to keep quiet, her story has changed the course of American politics and laid the groundwork for the case.

Over the years, Ms. Daniels has leaned into her Trump-adjacent fame. She has sold merchandise, filmed a documentary, sat for high-profile interviews and written a book that was so tell-all it included detailed descriptions of the former president’s genitalia. Mr. Trump has also dished out insults that ridiculed her appearance, calling her “horseface.”

But at other times, Ms. Daniels appeared tortured, detailing the personal toll of outsize exposure. Suddenly, she was not just a porn star but a threat to a man who commands the most fervent political movement in modern American history. She told reporters she was inundated by threats from Trump supporters, many of which were graphic. She feared for her family and has divorced her third husband, the father of her daughter.

“I have been just tormented for the last five years or so,” she said in the opening scene of “Stormy,” a documentary about her life that was released on Peacock. “And here I am, I’m still here.”

Ms. Daniels joined the trial at a pivotal moment. On Monday, prosecutors had asked two veterans of the Trump Organization’s accounting department to show jurors the 34 records they say Mr. Trump falsified to conceal his reimbursement of Mr. Cohen for the hush money. Those include 11 invoices, 11 checks and 12 entries in Mr. Trump’s ledger that portrayed the payments as normal legal expenses.

The Donald Trump Indictment, Annotated

The indictment unveiled in April 2023 centers on a hush-money deal with a porn star, but a related document alleges a broader scheme to protect Donald J. Trump’s 2016 campaign.

In the weeks ahead, Mr. Cohen is expected to take the stand and connect the dots between the salacious details and the substantive documents. On Tuesday, Ms. Daniels’s testimony took jurors through the smuttier elements of the case.

She began by recounting a difficult childhood in Baton Rouge. Her parents split up when she was young, she said.

She wanted to be a veterinarian and was editor of her high school newspaper. Eventually, she began stripping, she says, because she earned more than she did shoveling manure at a horse stable.

By the time she met Mr. Trump at the golf tournament in 2006, she was a player in porn. She was an actress, and would ultimately find her footing as a director and producer.

Asked to identify Mr. Trump in the courtroom, she called him out as the man in a navy suit jacket. Ms. Daniels, dressed in all black and wearing glasses, reduced the singular former president to just another man in the courtroom.

She spent much of her testimony describing that first encounter in Lake Tahoe. When she met Mr. Trump, she knew he was a golfer and the host of the “The Apprentice,” the reality show that revived Mr. Trump’s celebrity for a new generation. In a memorable line, Ms. Daniels said she also knew that he was “as old or older than my father.”

Later that day, she said, Mr. Trump’s aide approached and invited her to dinner. She says he took her number, but that her initial reaction was “eff no,” abbreviating an expletive.

But her publicist encouraged her: “What could possibly go wrong?”

She then transported jurors inside his hotel room, painting the sprawling suite in minute detail, capturing every aspect down to the color of the tiles.

She said Mr. Trump had taken an interest in her business and asked about unions, residuals and health insurance, as well as about testing for sexually transmitted diseases. “He was very interested in how I segued from becoming just a porn star to writing and directing,” she said.

Ms. Daniels said Mr. Trump told her, “You remind me of my daughter. She is smart and blond and beautiful, and people underestimate her as well.”

She recalled going into the bathroom to do her lipstick, where, she said, she noticed gold tweezers and Old Spice.

Later, they stayed in touch, she said. In 2007, they met at Trump Tower in New York, at a Trump Vodka launch party in Los Angeles and at a Beverly Hills hotel — all interactions that appeared to undercut Mr. Trump’s claims that he barely knew her.

The jury was also shown contact logs from Ms. Daniels’s phone and from Mr. Trump’s assistant’s phone showing that they remained in touch. And when they did talk, she said, Mr. Trump had a nickname for her: “honeybunch.”

They have only spoken through lawyers since then, most notably during the hush-money negotiations. When Ms. Necheles accused Ms. Daniels of using that effort to “extort money from President Trump,” Ms. Daniels objected.

“False,” she said.

“That’s what you did, right?” Ms. Necheles persisted.

“False!” Ms. Daniels shouted.

Reporting was contributed by William K. Rashbaum , Kate Christobek , Jesse McKinley , Wesley Parnell and Matthew Haag .

Ben Protess is an investigative reporter at The Times, writing about public corruption. He has been covering the various criminal investigations into former President Trump and his allies. More about Ben Protess

Jonah E. Bromwich covers criminal justice in New York, with a focus on the Manhattan district attorney’s office and state criminal courts in Manhattan. More about Jonah E. Bromwich

Maggie Haberman is a senior political correspondent reporting on the 2024 presidential campaign, down ballot races across the country and the investigations into former President Donald J. Trump. More about Maggie Haberman

Michael Rothfeld is an investigative reporter in New York, writing in-depth stories focused on the city’s government, business and personalities. More about Michael Rothfeld

Jonathan Swan is a political reporter covering the 2024 presidential election and Donald Trump’s campaign. More about Jonathan Swan

Our Coverage of the Trump Hush-Money Trial

News and Analysis

Michael Cohen, Donald Trump’s former fixer, faced a fierce cross-examination  in the trial, as the defense tried to tear down  the prosecution’s key witness.

Over the course of two days of testimony, Cohen has detailed the $130,000 he gave to the porn star Stormy Daniels  to silence her account of a sexual encounter with Trump, and how Trump repaid him  after winning the presidency.

Trump’s trial has become a staging ground  for Republicans, including House Speaker Mike Johnson  and Senator J.D. Vance of Ohio , to prove their fealty to the former president.

More on Trump’s Legal Troubles

Key Inquiries: Trump faces several investigations  at both the state and the federal levels, into matters related to his business and political careers.

Case Tracker:  Keep track of the developments in the criminal cases  involving the former president.

What if Trump Is Convicted?: Could he go to prison ? And will any of the proceedings hinder Trump’s presidential campaign? Here is what we know , and what we don’t know .

Trump on Trial Newsletter: Sign up here  to get the latest news and analysis  on the cases in New York, Florida, Georgia and Washington, D.C.