In late pregnancy, the fetal position is assessed to determine how the fetus lies in the uterus before birth. This is usually done from week 36 onwards. The midwife examines the abdomen by palpation, attempting to locate the head, back and buttocks. The purpose is to determine whether the fetus is in a head-down position, which is the most common and favourable for birth. If the position is unclear, ultrasound can be used to confirm it.

In a head-down position, the fetal head is located towards the pelvis. In a breech position, the buttocks or feet are pointing downward. In some cases, the fetus can lie across the uterus, known as transverse position. The position is documented in the medical record and may be followed at subsequent visits. If the fetus is in breech or transverse position, or if the head is not engaged in the pelvis, follow-up or further assessment may be planned. A doctor may assess whether an external cephalic version is appropriate or if planning for delivery needs to be discussed.

The assessment shows how the fetus is positioned at the time of examination and may change before labour begins, particularly before week 37. It is part of the later pregnancy checks but is performed only in the final stage of pregnancy.

Alma’s tips 🌿

• A helpful tip can be to ask how the fetal position is recorded in the medical notes, if you want to follow changes between visits.

• You can ask the midwife to show how she can feel the head, back or buttocks if you want to understand how the position is assessed.

• If the baby is positioned head-up and buttocks-down, a turning procedure is performed at the delivery unit.

• You can also ask at which week the fetal position typically becomes relevant for delivery planning.