What Are Leopold Maneuvers?

Pregnant patient with healthcare provider
Ariel Skelley/Getty Images.

Ariel Skelley/Getty Images

What Are Leopold Maneuvers?

Leopold maneuvers are a series of four maneuvers used to determine the position and presentation of your baby in-utero, as well as estimate your baby's weight.

"This process allows medical professionals to not only make a birth weight estimate but also address any underlying problems that may occur down the road," explains Mackenzie Schutz, RN.

These maneuvers get their name from the influential 19th-century German obstetrician and gynecologist Christian Gerhard Leopold, who discussed and propagated their use among other physicians.

How Are Leopold Maneuvers Performed?

There are four distinct Leopold Maneuvers. These include:

  • Fundal Grip: Your healthcare provider will palpate your upper abdomen with both hands to feel for your baby's head, trunk, and bottom in order to get an idea of your baby's size and position.
  • Umbilical grip: Your provider will apply deep pressure with the palm of their hands while using the other hand to feel your uterus. This allows them to identify the location of your baby's back and small parts.
  • Pawlik's grip: Your provider will use their fingers and thumb to feel what part of your baby is in your lower abdomen, just above the birth canal, to see if they're in the right position. This maneuver assesses fetal weight and amniotic fluid volume.
  • Pelvic grip: Your provider will move their fingers towards your pelvis then slide their hands over the side of your uterus to determine where your baby's brow is located.

Leopold maneuvers should only be performed by qualified medical professionals who have received training on how to perform them safely. You shouldn't attempt to do them yourself.

Why Are They Performed?

"Leopold maneuvers a wonderful way to determine quickly how the fetus is lying in a person's uterus," explains Kecia Gaither, OB/GYN, doctor maternal-fetal medicine, and director of perinatal services at NYC Health and Hospitals/Lincoln. "And, in experienced hands, they can give an estimate of fetal weight."

They're also low-cost, non-invasive, and don't require the use of expensive equipment such as an ultrasound. Plus they tell your provider how ready your baby is for birth so they can better prepare for your labor.

Ideal Position

At the beginning of your pregnancy, your baby will move around your womb freely, but towards the end, they should get into a certain position. Before birth, your baby should be head-down, facing your back, with its chin tucked to its chest so that its head is ready to enter the pelvis. This is called the cephalic presentation and it is the ideal position for delivery.

Most babies will settle into this position between the 32nd and 36th week of your pregnancy. This position makes labor less complicated. Around 96% of babies will be born in the cephalic position.

Cephalic Posterior Position

This position is also known as an occiput position or it's sometimes nicknamed "sunny-side-up." It means that your baby is positioned head down, but they're facing out instead of towards your spine. This position could increase your chances of a painful and prolonged delivery.

Breech Position

A breech position means that your baby's bottom is facing downwards. There are three different breech positions:

  • Frank breech: The baby's legs are up with feet near the head
  • Footling breech: One or both legs is lowered in the cervix
  • Complete breech: The baby's bottom is first and its knees are bent

Any of these positions can make for a riskier delivery so you are at risk of a C-section delivery if the baby doesn't change position before labor.

Transverse Lie

Your baby might also be in a transverse lie position at the end of the third trimester, which means they are lying sideways across your uterus instead of vertically. If they don't change position, it could make for dangerous labor, so a C-section will be required.

Fetal Weight Estimate

Fetal weight estimates help your healthcare provider plan for birth, too. In general, a baby who is estimated to be 10 pounds or more might require a C-section birth because your baby could get caught in the birth canal.

Risks and Contraindications

There are no known risks for using Leopold Maneuvers, as long as they are being performed by qualified medical professionals. However, they are not always accurate at determining the position or estimated weight of your baby before the 36th week of your pregnancy. So, your medical provider will not likely use them before your 36-week checkup.

For your own comfort, your provider will likely ask you to pee before they do the procedure, because a full bladder can make it difficult to really determine your baby's position with accuracy.

Your provider might also not use these maneuvers if you were in an accident. "If blunt force trauma has occurred during pregnancy, it may be best to use an ultrasound to avoid any further bruising that could be worsened by palpating," explains Shutz.

Leopold maneuvers are very accurate, but it is possible that your healthcare provider will still perform an ultrasound prior to your delivery to confirm your baby's position, particularly if they are concerned that your baby is in a transverse or breech position.

Leopold Maneuvers are difficult to perform on people who are obese because it is difficult to feel the baby's position.

They are also more complicated to perform on patients who have polyhydramnios, which is when you have too much amniotic fluid surrounding your baby, as well as people with fibroids.

A Word From Verywell

Leopold maneuvers are usually performed after 36 weeks by your healthcare provider to determine your baby's position and estimate their birth weight. This will help you and your provider be better prepared for your labor and determine if it might be safer to perform a c-section. The maneuvers should not hurt and they are very accurate, though your provider might still perform an ultrasound to confirm any findings.

Was this page helpful?
7 Sources
Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Superville SS, Siccardi MA. Leopold maneuvers. In: StatPearls. StatPearls Publishing; 2021.

  2. Kachlík, David, Kästner, Ingrid, Baca, Vaclav. Christian Gerhard Leopold: Fascinating History of a Productive Obstetrician Gynecologist. Obstetrical & gynecological survey. 2012. DO - 10.1097/OGX.0b013e31823662d7

  3. Tell, Noor; Omuso, Inara MD; Hunter, Krystal MBA; Khandelwal, Meena MD. Accuracy of Leopold's Maneuver Compared to Ultrasound in Estimating Fetal Birth Weight. Obstetrics & Gynecology: May 2019 - Volume 133 - Issue - p 23S-24S

    doi: 10.1097/01.AOG.0000559397.09291.a3

  4. Glezerman M. Planned vaginal breech delivery: current status and the need to reconsider. Expert Rev Obstet Gynecol. 2012;7(2):159-166. doi:10.1586/eog.12.2

  5. Cleveland Clinic. Fetal positions for birth. Updated March 4, 2020.

  6. Wei Y, Yang H. [Variation of prevalence of macrosomia and cesarean section and its influencing factors]Zhonghua Fu Chan Ke Za Zhi. 2015;50(3):170-6. doi:10.3760/cma.j.issn.0529-567x.2015.03.002

  7. Superville SS, Siccardi MA. Leopold maneuvers. In: StatPearls. StatPearls Publishing; 2021.