Topic Overview

By the end of a pregnancy, a fetus is typically positioned head-down (vertex), ready to pass head first through the birth canal. Sometimes a fetus is in a bottom-down, or breech, position as the due date approaches. Postural management is a way of attempting to turn a fetus from a breech to a vertex position by lying or sitting in a certain position several times a day.

Postural management is controversial, because it has not been proved effective for turning a breech fetus into a head-down position. This practice has not been studied very much. More research is needed to find out if it works.

Postural management is generally considered a safe practice for pregnant women. But be sure to consult a doctor before trying any of these methods, especially when being treated for a medical condition, such as high blood pressure.

Postural management methods that use gravity to try to turn the baby’s head down toward the cervix include:

• Propping up your hips by lying back on a firm surface with your feet on the floor and your knees bent. Raise your hips up by about 12 in. (30.5 cm) using large pillows (such as couch cushions) placed under your lower back and buttocks.
• Raising your hips by lying on a slanted board. One end of a wide board (such as a full-size ironing board) is propped up about 12 in. (30.5 cm) to 18 in. (45.7 cm) off the floor, on the seat of a couch or sturdy chair. Lie on the board with your head toward the floor, your knees bent, and your feet flat on the board.
• Sitting in a knee-to-chest position with your thighs pressed against your stomach.

These positions are usually held for 15 minutes and repeated several times a day for a week or more. It is helpful to do them with an empty stomach and bladder and to relax as much as possible while in position. You may need some help getting into the correct position safely. Because you may feel lightheaded when you get up, have someone help you rise slowly to prevent a fall.