From the moment a mother-to-be receives the news that she’s pregnant, the first anxieties start to stay on her mind, constantly nagging at her. Doubts, worries, and questions arise, including about the baby’s position. There is a lot of talk about the breech position, but what are the difficulties for the baby to be born when in this position? Each pregnancy is unique and there is no magic formula for the best pregnancy, nor a recipe for the most peaceful birth of all. Ah! Childbirth. This is one of the topics that keeps pregnant women up at night.
Pregnancy Concerns
Imagining if the baby will be born at the right time, if the birth will be natural, if the baby will be in the right position at the right moment or if the baby will decide to stay in breech position (sitting) right when it should already be head down. These are questions that don’t end when the pregnancy does! Being a mom is forever, and even after you’re holding your little one in your arms, with each new phase new worries will arise, and this is how it will be for many years to come (or literally for all the years ahead). Maybe this whirlwind of doubts and concerns is really training to prepare you for the intense emotions of motherhood. Even if you can’t predict everything, it’s always good to stay informed and try to clear as many doubts as possible. We’ll help you with some important information about the baby’s position for delivery, especially how to act if your baby is sitting, in the breech position. Happy reading!
How to Know if the Baby is Engaged at the Time of Labor
Around the 36th week the baby begins to prepare for birth, positioning the head or bottom down, fixed in the mother’s pelvis. It’s not enough for the baby just to be head down, as many think, because the baby may be head down but still high up, for example, and thus is not considered engaged, the ideal position for birth1.
When Does the Baby Turn?
This position is expected at this stage, but it doesn’t always happen this way. Many babies, even at this advanced phase of pregnancy, remain sitting in the breech position. Though it’s not the ideal position, there’s no need to be afraid, it’s still possible for the baby to turn before birth2. As the baby develops and grows in size and weight, the lower part of the uterus becomes wider, exactly where it will accommodate either the head or bottom of the baby, depending on its position. When this happens, you will likely notice it’s easier to breathe and your heartburn feels much better. On the other hand, trips to the bathroom will become even more frequent because you’ll feel the urge to urinate more and may feel greater discomfort when walking. It’s at this moment that people start to comment that your belly has dropped. When the baby remains in the breech position, you likely won’t notice these changes. But don’t worry, in your final checkups the doctor will check the baby’s position, and is able to confirm just by palpating your abdomen whether the baby is engaged, sitting, or in another position.
Can the Baby Engage at Labor?
But don’t worry if you are already in your 8th month and your doctor observes that your baby is in the breech position. In many cases, babies only settle into the pelvis at the time of labor itself, with the help of contractions, and this is perfectly normal. Even so, if the big moment comes and the baby remains in the breech position and doesn’t engage, it is still possible to have a calm and safe birth. Trust your doctor, who will be prepared to bring your treasure into the world in the best way possible.
The Baby is Sitting, What Should You Do?
The baby moves a lot during pregnancy and it is natural to adopt different positions throughout this process. From the 8th month, the baby starts to prepare for birth and most will assume the cephalic position, head down. Although this is considered the best position for birth, many babies are still born via vaginal delivery even while in breech position. But if the time is coming and the baby hasn’t engaged? And if it is sitting? Don’t panic, after all, your baby already has a mind of its own… And regardless of the position, whether breech or cephalic, labor will happen when it’s time. Whether by natural birth or Cesarean section. Of course, extra care will be taken if the baby is in breech position, but even so everything can go smoothly.
Maneuver to Turn the Baby
There is a maneuver called “external cephalic version,” also known by the initials “ECV.” It is a procedure where the doctor manipulates the mother’s belly to change the baby’s position. It is a good alternative for turning a breech baby head down to allow for a normal birth without extra worries. This maneuver can cause placental abruption and lead to an emergency delivery. Therefore, it must only be performed by a doctor, in the hospital and with baby monitoring. It is a common technique in other countries, but in Brazil it is still not widely practiced and there are few doctors trained to do it. If your baby is in breech position and labor is approaching, talk to your doctor about this maneuver.
Natural Birth or Cesarean Indication?
When the baby is engaged, head down, this is considered the ideal position for a natural birth because the baby’s head is the widest part of its body — with the head coming out first, the rest of the body follows more easily. That’s why a C-section is often recommended if the baby is breech. But it’s not a rule! Even if the baby is breech, it is still possible to have a normal birth, but with some precautions. Certain criteria must be considered to ensure a safe decision3. In addition to an experienced professional, ideally, natural birth in these cases should occur when labor starts spontaneously, the mother’s pelvis is favorable, and there has not been a previous Cesarean or other recent uterine surgery. The baby’s size and position of the umbilical cord are also important factors. If time is running out and your baby insists on staying sitting, calmly in breech position, waiting until it’s ready, your doctor will need to assess delivery options with you. A normal birth is usually best, but the priority is always to guarantee safety and well-being for you and your baby. Remember that each pregnancy is unique and special, so it’s hard to say exactly how everything will turn out. For first-time moms, everything is more mysterious, with worries and the desire to predict how things will go when the long-awaited time comes. Wondering if the baby is at risk of being born early, whether it will be engaged at birth, or worrying if the baby remains in breech position in the last weeks of pregnancy. For experienced moms, even though they’ve already been through it, contrary to what new mothers might think, things don’t change much. No pregnancy is ever the same as another, so in terms of knowing exactly what will happen, experience doesn’t help much. See also: Normal Birth Positions to Try Photo: SLT-A58
