How To Tell If Baby Is Head Down

Are you wondering how to tell if baby is head down?  There are 3 main methods used to determine if baby is in a head down position:

1. Leopold’s maneuvers
2. The location of the baby’s heartbeat
3. Ultrasound

At some point in the last trimester, your baby is going to settle into his favorite position for birth.  Most babies will move to a head down position by around 28–30 weeks of pregnancy, and 97% will be head down at birth.  This is ideal for moms planning a natural birth, since it’s the position most likely to lead to a safe and uncomplicated labor and birth (1).

However, some babies stay in a breech position or transverse lie past 34 weeks of pregnancy.  If attempts to turn the baby aren’t successful, chances are your little one will be born through a cesarean birth. 

With that in mind, it’s understandable that many moms want to know how to tell if baby is head down as early as possible.  Starting at around week 27 of your pregnancy, your doctor will check baby’s position during each prenatal visit. Expect them to use one, or a combination, of the following techniques:

How to Tell If Baby Is Head Down #1:  Leopold’s Maneuvers

Leopold’s maneuvers are a technique where your doctor or midwife will check your baby’s position by pressing her hands into your abdomen and feeling the baby.  You can even try it yourself at home! It’s done in 4 steps:

Step 1:

Begin by pressing around the top of your uterus — an area known as the fundus. 

• If baby is head down, you will feel a bottom.  Baby’s bottom feels soft with small bones protruding out. 
• If baby is in a breech position, a head will be felt.  The head is hard, firm, and will move independent of baby’s body.

Step 2:

Next, feel for the location of your baby’s back by placing your hands on the side of your abdomen. 

• Baby’s back will feel firm and smooth. 
• Hands and feet are found on the other side, and will feel small and knobby.

Step 3:

Now feel for the round head lying just above the pubic bone. 

• If the head is down but isn’t engaged in the pelvis yet, you may be able to gently push it back and forth.

Step 4:

Finally, place both hands on your lower abdomen and move gently down the sides of the uterus towards your pelvis. 

• Your doctor will do this to feel if baby’s head is well flexed and tucked into the chest.

How Accurate are Leopold Maneuvers?

After all 4 maneuvers are done, your doctor will have a fairly accurate picture of your baby’s position.  With that said, it takes a lot of practice to get good at this technique.  It’s also difficult to do on a mom who is overweight or has lots of amniotic fluid.  So, unfortunately it’s not 100% accurate.

How to Tell If Baby Is Head Down #2:  Location of Heartbeat

The location of your baby’s heartbeat can also be very telling about whether your baby is head down.  If the head is down near the pelvis, it makes sense that baby’s heartbeat would be found just above the pelvis, below your belly button.

How Accurate is the Location of the Heartbeat?

Still, the location of the heartbeat is also not entirely reliable.  Electronic monitors (dopplers are commonly used) may pick up the beat, even if the monitor is far from the heart.  Additionally, since water carries sound, the results can be skewed if you have extra amniotic fluid.

Other Info Provided by the Heartbeat

In the picture above, the dots show the general location of baby’s heartbeat in relation to the most common head down positions. It can be a fun exercise to see what extra information the location the heart beat can tell you about baby’s position in the pelvis.  Here’s a brief explanation of the abbreviations:

• Right (R) or left (L) side of the pelvis
• Occiput (O) is a fancy word that describes the back of baby’s head.  It means that the head is the body part pointing downward into the pelvis.
• Anterior (A) or posterior (P) help you know whether the back of baby’s head is pointing towards the front (anterior) or back (posterior) of your pelvis.

Are you interested in learning more? Check out these posts on Spinning Babies to learn more about each position: ROP, ROA, LOA, LOP

How to Tell If Baby Is Head Down #3:  Ultrasound

Are you wondering how to tell if baby is head down with 100% accuracy? Ultrasounds are your answer!

Ultrasounds allow your caregiver to clearly view your baby and her position inside the uterus.  However, they aren’t routinely performed to tell the baby’s position.  It would likely only be used only if both Leopold’s maneuvers and the location of the heartbeat suggest that baby may not be head down.

Kopa Birth’s online birthing classes allow you to prepare for a natural hospital birth from the comfort of your own home, 24/7. Enroll today in our free online childbirth class and start preparing for your natural birth!

References:

(1) Ladewig, P., London, M., & Davidson, M.  (2006).  Contemporary Maternal-Newborn Nursing Care, 6th edition.  Pearson Education Inc.  Upper Saddle River, NJ.  p 392, 426-428.

(2)  The American College of Obstetricians and Gynecologists.  (2017).  Frequently Asked Questions Special Procedures: Ultrasound Exams.  Retrieved from https://www.acog.org/Patients/FAQs/Ultrasound-Exams.