Your antenatal care - Your baby's position As the end of your pregnancy approaches, your baby will have grown so much that movement within the womb becomes increasingly restricted. And in the third trimester, particularly as the time for delivery approaches, your caregiver will show more concern about your baby’s position. Often, in the final weeks, days or even hours of pregnancy, your baby’s head will ‘drop’ deep into your pelvis, perhaps making it easier to breathe and reducing heartburn as your upper organs become less squished. But unfortunately, there will be more squishing deeper down, meaning possibly even more pressure on your bladder and a waddly, duck-like run to the loo as a result. Called ‘engaging,’ this lowering of the baby’s head into the pelvis might happen from around week 35 for first-time mothers; but it also may not happen until you are actually in labour – particularly if you have a large baby or you have already had a baby. ‘Engaging’ is the final part of your baby’s move into the pelvis before beginning the journey into the world; but before your baby’s head can engage, there’s some jostling for position that happens in the last trimester. Most babies – more than 90 percent – will move into the best position for delivery on their own. But sometimes, babies are back-to-front, or upside-down. The good news is that, with a bit of luck, you might be able to persuade your baby to turn around before the end of your pregnancy. Before I was pregnant myself, I recall a heavily-pregnant friend telling me that she lay upside-down on an ironing board three times a day to encourage her baby to turn. I thought the strain of pregnancy had got to her and she had finally cracked! A couple of years later, I found myself, heavily pregnant, lying upside-down on my own ironing board, realising that my life had, indeed, already changed beyond my wildest dreams. The position of your baby plays an important part in the way that your birth will unfold; if your baby does not move into the “right” position, you will have a very different labour and birth than you perhaps expected. Anterior PositionIn the anterior position, your baby is head down, facing towards your spine. This is also called the ‘optimal foetal position’ (OFP) and is the ideal position for birth as the shape of your baby’s head will fit best through the pelvic girdle. If your baby is in the anterior position, that’s great. Posterior PositionIn the posterior position, your baby is head down, but facing your belly – so the back of your baby’s head will be against your spine. Often, a baby who starts labour in a posterior position will actually turn themselves around before starting to move down the birth canal. Birth can be more difficult if your baby is in the posterior position because the pressure of your baby’s spine against your back can cause backache which continues between contractions. It may also make the birth longer as it is a more difficult journey through the pelvis for your baby; and your baby may need to have an assisted delivery with forceps or vacuum extraction. Your midwife or caregiver can help with suggestions to help ease the birth of a posterior baby; an active birth including varied positions to relieve labour pain – particularly birthing on hands and knees - can reduce discomfort, with many women reporting that lower back massage or heat packs have helped. Breech positionBy about 37 weeks, your baby’s head will become very heavy and hopefully, gravity will encourage the baby to tip head-down. At 30 weeks, nearly a third of all babies are ‘breech’ (head up, sitting with their bottom wedged into your pelvis). But by around 37 weeks, less than five percent of babies will still be in the breech position – and about a quarter of those babies will turn themselves around, either before labour starts or in the early part of labour. If you go into labour and your baby is breech, it is most likely that your doctor or midwife will recommend a caesarean section delivery. Although it is possible for a breech baby to be delivered safely vaginally, there is a much higher risk of complications, such as a hip-socket displacement or compressed umbilical cord (which can cause lack of oxygen and possible brain damage). A caesarean birth is generally considered less risky in the case of a baby presenting in a breech position. Discuss your options carefully with your caregiver should your baby be in breech position in the final weeks before birth so that you are mentally prepared. Discouraging the Posterior PositionNew Zealand midwife Jean Sutton and childbirth educator Pauline Scott have written several books about how a mother’s positions and movement in pregnancy influences her baby’s position in the womb. They argue that the sedentary Western lifestyle has led to a big increase in babies in a posterior position in the final section of pregnancy. But by encouraging better posture – and avoiding positions where you are hunched over a desk or steering wheel or reclining into a soft lounge – it is more likely that your baby will present in the anterior position. From about 30 weeks, you can try a variety of movement-based tips to encourage your baby into an anterior position – but do check with your midwife or doctor before trying these tips:
Discouraging the Breech PositionTalk to your midwife or doctor about the options you have if your baby is in a breech position. There are quite a few commonly-used techniques used with varying success; but do check with your caregiver before trying these. Some may not be advisable if you have complications such as a low-lying placenta or high blood pressure.
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Expert Tips
from Alex - NSW Midwives Assoc.The best measurement of your baby’s health is that it is active (lots of movements) and its mother is looking after herself and is seeing a health care provider regularly. |
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