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In obstetrics, the term “cephalic presentation” is used to describe a situation in which the baby is delivered head first. This delivery presentation is the safest and most common. Abnormal presentations such as a breech, in which the buttocks or feet come out first, can be dangerous, and may require intervention in the form of a caesarian section for delivery. As a pregnancy progresses into the later stages, a doctor can check on the position of the fetus to make sure that it is lining up properly for delivery.
The natural tendency is for the fetus to fall into a cephalic presentation, usually one in which the crown of the head is delivered first. The shape of the uterus is designed in such a way that this position is promoted as the most natural one for the fetus to move into as it grows larger and space become limited. However, the baby may lie in various ways with a cephalic presentation, and some of them can be dangerous for the baby or the mother. Having the baby come out brow first, for example, can make for a difficult delivery.
The fetus begins to move into position for delivery before the mother goes into labor. If a doctor suspects that a fetus is not moving into the cephalic presentation, she or he may make suggestions which are intended to turn or move the baby into position. Fetal ultrasound can be used to see if the fetus is in the right place, and obstetricians can also tell with palpation. This can also be used to determine if the baby is in an awkward position, but still in a cephalic presentation, to plan ahead for delivery.
Presentations can become complicated when a woman is carrying multiples. This is one of the many reasons that multiples are regarded as a potentially high risk pregnancy. If the doctor suspects that the presentation of a singleton or multiple pregnancy is too risky, a recommendation for a cesarean section may be made. This can be done out of concern for the baby or the mother, and very rapid intervention is available if a delivery starts to go wrong.
The vast majorities of pregnancies end up in a cephalic presentation. The small fraction that do not can be dealt with in a variety of ways. Different doctors or midwives may have different recommendations for handling breech and other positions during labor and delivery.