Ideally, your baby should be head-down and facing your back by the time you go into labor, but this seldom happens. In this article, we explore the different positions of babies in the womb, providing facts concerning various fetal positions and their implications.
According to an OB-GYN in New York City, Laura Riley, M.D., your kid will move widely throughout the womb, but at the end of your pregnancy, they will assume their final position. Not all infant positions are created equal when it comes to labor and delivery, and certain positions may necessitate intervention for birth.
Learn about fetal positions and how to tell if your baby is head-down by reading on.
The anterior position (also termed occiput anterior, cephalic, or vertex position) is favorable for delivering delivery. In this position, your baby’s head is facing your back and is positioned near the birth canal. This head-first position causes the cervix to stretch, making it easier to deliver the rest of the baby’s body.
Hence, when does a baby turn its head down, given that they are always moving in the womb? According to Dr. Riley, most babies automatically settle this way between 32 and 36 weeks of pregnancy.
The posterior position (also known as occiput posterior position) indicates that the baby is face-up, or “sunny side up,” instead of face-down, so that the heaviest portion of their head sits towards your lower back as opposed to your abdomen. In this position, the parent and infant are essentially back-to-back.
This position generally results in lengthier labor since the baby’s head has to rotate further to be born. Moreover, it might cause severe back discomfort during birth.
According to a 2015 study published in Trials, the posterior position is the most common of the less-than-ideal fetal positions for labor: 15% to 32% of infants are in this position at the onset of labor, and 10% to 20% of infants are still in this position during the second stage of labor. Approximately 18% of emergency cesarean procedures involve posterior placement.
The good news is that newborns in this condition frequently change position during childbirth. According to George Mussalli, M.D., director of Maternal Fetal Medicine at Bronx-Lebanon Hospital in New York City, if an early epidural is avoided, just around 8% of babies are posterior when it’s time to push. In fact, delaying an epidural until active labor (after 6 cm of dilation) reduces the possibility of posterior presentations, according to a study published in the Journal of Perinatal Education.
Additionally, a 2014 literature review in BMC Pregnancy and Delivery indicated that specific labor positions—like being on hands and knees—may promote posterior newborns to turn.
If your baby doesn’t turn around on their own, a health care provider could try to rotate the infant manually. If that doesn’t work—and your labor goes on for too long and starts to pose a threat to you or your baby—your doctor may propose a C-section.
Breech position indicates the baby’s butt or feet are presenting first; essentially, they are right-side up rather than head-down. Around 3% to 4% of full-term newborns are in breech presentation at term, according to the American Academy of Obstetricians and Gynecologists (ACOG).
Hazards connected with a baby being in a breech position include umbilical cord prolapse (when the umbilical cord slips out before the baby) and the baby’s head getting stuck during vaginal delivery.
If a C-section is required, there are also dangers associated with the surgery, such as bleeding, damage, anesthetic difficulties, and increasing risks with future pregnancies and births.
Owing to the higher dangers associated with this presentation, a healthcare practitioner may try to adjust your baby’s position using a “version” (external cephalic version or ECV) (external cephalic version or ECV). Dr. Riley explains that for a version, the doctor or midwife will attempt to move the baby by pressing on your tummy and the baby’s head.
There are potential hazards associated with the surgery, including membrane rupture, fetal heart rate fluctuations, placental abruption, and premature labor. Thus, some individuals may not be suitable candidates for ECV due to their specific pregnancy risk factors.
What happens if your breech infant does not turn head down? While not always necessary, research indicates that it is safer to deliver a breech baby via cesarean surgery. A 2015 Cochrane review of three studies, encompassing more than 2,000 participants, indicated that planned cesareans resulted in fewer fetal deaths or serious injuries; nevertheless, they did result in more postpartum abdominal pain for the gestational parent and increased future pregnancy-related risks.
In a transverse or occiput transverse position, your baby is horizontally positioned across your uterus rather than head-up or head-down. This position enhances the possibility that the shoulder rather than the head will pass through the birth canal first.
This is an uncommon posture for a fetus close to term. Researchers concur, however, that a C-section must be performed to avert problems such as cord prolapse, uterine rupture, and traumatic birth if this occurs.
How to Determine Whether a Baby Is Lying Down
How, then can you determine if your child is in the optimal position for delivery? During prenatal checkups, a healthcare provider will feel your abdomen with their hands. A suspected posterior, transverse, or breech position can be confirmed using ultrasonography.
You may also determine the position of your baby based on fetal movements. For instance, newborns in a posterior position will kick the front center section of the abdomen, resulting in a flattened abdomen appearance.
In the breech position, on the other hand, you might feel kicks near your belly button if their legs are down (you may feel more normal kicks around your ribs if their legs are up) (you may feel more normal kicks around your ribs if their legs are up). What’s more, you might notice a hard bulge around your ribs; this is your baby’s head, and their whole body should move if you gently massage it.
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