--- Baby Position ---
Is your baby lying breech? Are you worried about what that might mean for you and your baby?
Is there such a thing as a right way for baby to lie?
There certainly is an ideal way for baby to lie in the later stages of pregnancy. An optimal position for birthing is a baby who is lying with her head down, and her back towards your front or side. This is the position that is easiest for baby to make her decent during labour and delivery. When baby is lying with her back to yours (posterior), it can mean a longer and slower labour. If your baby is lying with her head up and her bottom down, she is considered to be breech, and your LMC will discuss your options for birthing her.
Why is my baby lying in that position?
Just because your baby is breech during parts of your pregnancy, it doesn't mean she will remain breech right up to the birth. Having said that though, as she gets bigger it does get harder for her to move, so your LMC will be keeping a close eye on your baby's position over the last few weeks of your pregnancy. It's often a mystery as to why babies lie in a breech position although there are some factors that make it a higher likelihood including previous breech birth, older maternal age, first time pregnancies and at times the position of the placenta. Suffice to say, it is nothing you have done wrong to cause this, and there is plenty you can do to encourage your baby into her best position for birthing.
Will my baby change position on her own?
Despite your baby's increasingly cramped quarters, she can still manage some remarkably large movements in those last few weeks of pregnancy. Most babies end up head down by around 36 weeks, although some leave it even later to show which position they are going to settle into. There are plenty of recommendations you can follow to help baby move towards or settle into a good position, and you LMC will be a great source of information and encouragement with this.
How can I help my baby shift into a better birthing position?
The good news is there is a lot you can do to help your baby move, and using gravity is one of them! Be upright, walk and move on your feet and keep as active as you are able throughout your pregnancy. The combination of moving and gravity really helps baby to find her right position. Our current lives often include a lot of time sitting, and especially sitting with your knees higher than or parallel to your hips (think slouchy couches and desk based postures). What this does is tips your pelvis backwards making it less than an ideal angle for baby's head to descend into, and also creates a greater curve in your lower back.
Your baby's back is quite heavy compared to her limbs, and she will often rest with her spine against yours if you sit like this a lot. This is known as a posterior position, and is also not an ideal birthing position. When you do sit, try and have your hips higher than your knees, and lean forward a little. Sitting on a back turned chair can be both helpful and comfortable right through to the end of pregnancy. Swiss balls can be a good option, but check the size of the ball that you are on - too often we see mothers who are diligently using a Swiss ball that is way too small for them, leaving their hips lower than their knees and poor posture through their lower back. More often than not, you will need a larger ball than you think, not to mention that it has to hold up a little more weight as your pregnancy progresses!
Can Osteopathy turn my baby??
This is a question that is commonly asked by mothers whose baby is not yet lying in the best position. The short answer in our opinion is no. A baby can become significantly distressed from an attempt to be turned, and in some mothers preterm labour can be initiated; neither of which can be appropriately managed in an osteopathic clinic. There is a good reason why this is considered as a significant medical procedure, and one that requires a high level of experience and monitoring.
The long answer is that osteopathic treatment may help to give baby more space to move freely herself, which may at times result in her moving to a head down position. Areas of tightness through the muscles and ligaments that surround the uterus may create small areas of pressure that are hard for baby to move past; lower rib restrictions limit the amount of space baby has under the ribcage, and pelvic bone alignment issues may create a less than perfect "bowl" for the baby to descend into. An osteopath skilled in pregnancy care can address all of these issues for you, and also give the right take home advice to support your baby to either change position or remain in a good position.
What medical options do I have?
There is a medical procedure known as ECV (External Cephalic Version). Essentially this means an experienced maternity care provider puts her hands on the outside of your belly (external) and attempts to turn the baby into a head down position (cephalic). Usually this is attempted as late as possible in the pregnancy to give baby a chance to turn herself, but not so late that baby has little space to manoeuvre (often around 37 weeks). More than half of ECVs are successful in turning baby to a head down position, and in doing so significantly reduce the rate of C-section . ECVs do carry some risk, including distress to the baby, and as such it is performed with foetal monitoring before and after the procedure, and often with ultrasound guidance as well.
Ok, so I am sitting with my knees low and moving lots. Should I still come and see you?
Yes. Those are all the right things to be doing. What you can't do for yourself is relieve the tightness and tensions that may be surrounding your pelvis and contributing to baby's position. Give us a call, we are happy to chat over the phone if you want to sound us out before deciding to come, or our reception team can make an appointment for you directly.