your doctor can tell and he can show you how to feel for the head if it's down there. my son's head was down but started going lower earlier than normal so it was harder for him to feel the head.
my baby was laying sideways a while back when i was 36weeks and i could tell. it was very uncomfortable and very painful when he moved. once he started to turn i could tell how he was laying, he did a full circle. just a about two weeks ago i found out he was posterior which i couldn't tell but it made sense with the type of movement's i was feeling. but now i know he's head down and he's not posterior.