If there is one word that fits any pregnancy, that word is anxiety. This term is not necessarily negative nor is it necessarily related to any kind of illness. We are talking about that eagerness to meet your baby, to touch them, to be able to take care of them, to fulfill your role as a mother. And in the midst of this whirlwind of thoughts and all this anxiety, problems can appear at any time during pregnancy. Towards the end of pregnancy is when, generally, anxiety increases and, if a problem arises at this point, it can be overwhelming for many. It is time for the baby to prepare to be born, but what if the baby doesn’t engage? Today we are going to talk about how to deal with this type of situation.
How to Know if the Baby Has Engaged?
When we talk about pregnancy, there are no fixed rules, meaning everything can vary depending on the conditions and how that pregnancy is progressing1. However, it is possible to identify certain patterns to get an idea of how things will happen. A baby usually engages at the 36th week of pregnancy, although this engagement can occur later or only at the time of labor. A woman usually notices that the baby has engaged when her breathing starts to improve, as well as heartburn which also tends to lessen. When the baby is engaged, that is, in the birth position, the woman usually has more difficulty walking, and her bladder gets even more compressed, making her need to urinate more frequently2.
The Mother’s Role in Engagement
Of course, a woman’s body naturally prepares for the baby’s arrival, but the more a woman works her muscles, the easier labor will be. The same goes for engagement, since it is the woman’s muscles that perform this complicated task of “turning” the baby head down. Now, remember that strengthening your muscles does not mean a woman should do regular exercises on her own. There are specific exercises for pregnant women, such as water aerobics and walking, which not only get the muscles more prepared for engagement, but also help with blood circulation and prevent a host of other problems. This is even more true for first-time mothers, since from the second child on, the muscles are already more accustomed and engagement happens more naturally. 
What to Do When the Baby Doesn’t Engage?
There is nothing that can truly be done if the baby doesn’t engage. Of course there are ways to induce labor, but in general, there is nothing to do, especially because there is no need to do anything. Although the mother plays a fundamental and active role in her body’s relationship with the baby, there are cases in which the body acts on its own and this is one of them. Of course, a pregnant woman who has taken better care of her health will have a better chance that this automatic activity of the body will be performed more easily, but even so, it is not something that can be controlled.
Can the Baby Engage Only During Labor?
Yes. There are cases where the baby only engages during labor, which can be very worrying for mothers, but it is not something that uncommon. The fact that the baby takes a while to engage can make many women desperate, as many fear cesarean surgery, either because of the more complicated recovery or because they want a vaginal birth. But all this worry is unnecessary, because often your body solves the “problem” on its own. This later engagement happens much more frequently with mothers who have already had children, but it can also happen to first-time mothers. Even though it is concerning, muscle strength plays a big role here, as it usually takes care of getting the baby into a cephalic presentation and ready to be born. When this doesn’t happen, there’s no need to worry either, but it is quite likely that a doctor will indicate a cesarean.
Indications for Cesarean
First of all, it is important to clarify that the baby not being in the cephalic presentation3, meaning not being engaged head down, does not always mean that a cesarean section is necessary. These days, it is common to see deliveries with breech or transverse presentation, meaning the baby is feet down or “sideways” in the mother’s belly. On the other hand, although vaginal births with these types of presentation are possible, they are more complicated and require much greater delicacy. Cesarean is often recommended in these cases to eliminate risks and ensure the birth is a success. The final decision is up to the doctor, but you can talk with them and express your wishes. Often, your preference can be considered and, if your body is in good condition, you can have a vaginal birth. Situations like when the baby does not engage normally raise many questions and even despair, but as you have seen, the professionals who deal with this kind of issue are usually more than prepared to handle it. This means that much of your job at this moment is to stay calm and understand the possible paths to follow. Your child will still need you a lot in life and, for this reason, it’s good to save some energy for the near future. You can be sure that you’re definitely going to need it. Also see: Shoulder Presentation – What It Is and How to Reverse It Photo: StockSnap
