Cephalic presentation, also known as head presentation or head-first presentation, is a situation during childbirth where the fetus is in a longitudinal lie and the head enters the pelvis first. The most common form of cephalic presentation is the vertex presentation, where the occiput is the leading part that first enters the birth canal. All other presentations are abnormal (malpresentations) and are either more difficult to deliver or not deliverable by natural means.

In the cephalic presentation, the baby is head down, chin tucked to chest, facing the mothers back. This position typically allows for the smoothest delivery. Most babies settle into this position within the 32nd to 36th weeks of pregnancy. However, there are different kinds of cephalic positions, and the most common and safest one is where the baby is facing the mothers back.

If the baby is in a different position (not a cephalic presentation), the delivery becomes more challenging. Different fetal positions have a range of difficulties, and the risks can vary depending on the position of the child. Doctors use a technique called external cephalic version (ECV) to get a breech baby into cephalic position. This involves massaging and pushing on the mothers belly to help nudge the baby in the right direction. In some cases, medications that help the mother and her muscles relax can help turn the baby. If the baby is already in cephalic position but not quite facing the right way, a doctor can sometimes reach through the vagina during labor to help gently turn the baby the other way.