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How do I know what position my baby is inside of me, and where will I feel movement?
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You wanted to know how you can tell what position your baby is inside of you. And ultimately, you can only tell this for sure by having an ultrasound done. An ultrasonographer or a trained doctor can look and see what position the baby is actually in. The position we want them to be in is the vertex position, and that is where the baby is head down in your pelvis. Now, a baby can also be breech, or head up with feet down, foot down, or bum down.
So another question you had was where would you feel movement based on the baby's position? And if you imagine the baby being head down, they're in the fetal position, if they're laying in your belly like this, then you're likely to feel lots of kicks and punches on the side the baby isn't sitting in, because the side that they are sitting on will have the head down low, and the backbone, and the bum on top. And you'll also feel some shifts and movements in the bottom of your belly. If your baby is in the breech position, the movement may feel a little bit different, because the baby's arms and legs are up top.
So around 28 weeks, 25% of babies are breech. At 32 weeks, only 7-14% are breech. And by full-term (or 37 weeks), only 3% are breech, meaning 97% of babies have figured out that they need to be head down. So it's not cost-effective to ultrasound everyone and see what position the baby is in. In the latter end of the 3rd trimester, your doctor will look for position when they're checking you at your appointments, and they can do this a few different ways. One is called Leopold's maneuver, where they feel the woman's belly, and they try to feel for the head, and the backbone, and the bum, and get a sense for how the baby is oriented. When we check your cervix, we can also feel for a head (if you're dilated at all) and get a sense for what position the baby is in. If there's any questions about it, then of course the doctor will ultrasound to determine if the baby is indeed breech or not.
Now, a lot of women also want to know, if my baby is head down at the end, are they likely to stay? And it depends on what baby this is for you. If it's your first, then it's likely. But if you've had babies before, the uterus is more stretchy, and of course, that's defining the space your baby can move around in. So if it's a little more stretchy, the baby will have more ability to move around and flip. So a baby could possibly be vertex at 37 weeks, breech at 38 weeks, vertex again at 39 weeks - I've seen that a lot in practice over the years as a Labor & Delivery nurse. There are many other factors that go into the position a baby will be in. The umbilical cord, the placenta location, and also the shape of the woman's uterus will determine how they're lying. A baby can actually also be side-lying. That's called transverse position.
Now, if your baby is breech at the end of pregnancy, what can be done about that? There's a lot of different things out there that you might read about that you can try in order to see if your baby will flip spontaneously, but there's not really any science behind that. I've heard putting a bag of cold peas on your belly to scare the baby into the head down position, but you have to remember, there's a lot of layers between your skin and the baby, so they're not really feeling that. Some people have talked about acupuncture or standing on their heads. I definitely don't recommend standing on your head, because that's a hazard for anyone who's not pregnant, but especially when you're pregnant and your center of gravity has shifted.
Talk with your doctor about it, and if they've determined that your baby is in the breech position, they'll talk to you about the plan for delivery. In some cases, the doctor determines that an external cephalic version (or ECV) might be appropriate for the woman, as long as the placenta is in a good location, the umbilical cord is not around the baby's neck, there's enough fluid surround the baby. They might say, "Let's try to rotate the baby." So we bring you into the hospital setting, goo up your belly, and from the outside, the doctor tries to manipulate the baby into the head down position. So if your doctor talks to you about that, then you can ask them more specific questions and decide if it's something that you would like to try.
So another question you had was where would you feel movement based on the baby's position? And if you imagine the baby being head down, they're in the fetal position, if they're laying in your belly like this, then you're likely to feel lots of kicks and punches on the side the baby isn't sitting in, because the side that they are sitting on will have the head down low, and the backbone, and the bum on top. And you'll also feel some shifts and movements in the bottom of your belly. If your baby is in the breech position, the movement may feel a little bit different, because the baby's arms and legs are up top.
So around 28 weeks, 25% of babies are breech. At 32 weeks, only 7-14% are breech. And by full-term (or 37 weeks), only 3% are breech, meaning 97% of babies have figured out that they need to be head down. So it's not cost-effective to ultrasound everyone and see what position the baby is in. In the latter end of the 3rd trimester, your doctor will look for position when they're checking you at your appointments, and they can do this a few different ways. One is called Leopold's maneuver, where they feel the woman's belly, and they try to feel for the head, and the backbone, and the bum, and get a sense for how the baby is oriented. When we check your cervix, we can also feel for a head (if you're dilated at all) and get a sense for what position the baby is in. If there's any questions about it, then of course the doctor will ultrasound to determine if the baby is indeed breech or not.
Now, a lot of women also want to know, if my baby is head down at the end, are they likely to stay? And it depends on what baby this is for you. If it's your first, then it's likely. But if you've had babies before, the uterus is more stretchy, and of course, that's defining the space your baby can move around in. So if it's a little more stretchy, the baby will have more ability to move around and flip. So a baby could possibly be vertex at 37 weeks, breech at 38 weeks, vertex again at 39 weeks - I've seen that a lot in practice over the years as a Labor & Delivery nurse. There are many other factors that go into the position a baby will be in. The umbilical cord, the placenta location, and also the shape of the woman's uterus will determine how they're lying. A baby can actually also be side-lying. That's called transverse position.
Now, if your baby is breech at the end of pregnancy, what can be done about that? There's a lot of different things out there that you might read about that you can try in order to see if your baby will flip spontaneously, but there's not really any science behind that. I've heard putting a bag of cold peas on your belly to scare the baby into the head down position, but you have to remember, there's a lot of layers between your skin and the baby, so they're not really feeling that. Some people have talked about acupuncture or standing on their heads. I definitely don't recommend standing on your head, because that's a hazard for anyone who's not pregnant, but especially when you're pregnant and your center of gravity has shifted.
Talk with your doctor about it, and if they've determined that your baby is in the breech position, they'll talk to you about the plan for delivery. In some cases, the doctor determines that an external cephalic version (or ECV) might be appropriate for the woman, as long as the placenta is in a good location, the umbilical cord is not around the baby's neck, there's enough fluid surround the baby. They might say, "Let's try to rotate the baby." So we bring you into the hospital setting, goo up your belly, and from the outside, the doctor tries to manipulate the baby into the head down position. So if your doctor talks to you about that, then you can ask them more specific questions and decide if it's something that you would like to try.
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