It is good if the child has taken the classical position, that is, he is head down (doctors call this position the head previa). However, some children prefer to sit down with their legs or ass down (pelvic presentation) or take a transverse or oblique position. The appearance of pelvic presentation is due to a variety of reasons: prematurity, low attachment of the placenta, uterus with a septum (double), one-horned uterus, myomatous node, due to which the baby does not have enough space and which prevents it from developing, excess or deficiency of amniotic fluid (hydrophobia or scarce water) , stretched after several births uterus.
There is an opinion that this position also depends on the maturity of the vestibular apparatus of the child, therefore, the shorter the gestation period, the more often the baby fits the ass or legs forward.
Since initially the uterus has the shape of a pear, “looking” down, the baby “has to” take on a position in which it is most comfortable for him. This may explain the classic position of the child in the uterus, when in the widest place it places the largest part of the body – the ass.
The ideal position of the child (headache presentation), doctors determine in the seventh month of pregnancy during an ultrasound, vaginal examination or palpation (palpation) of the abdomen. The latter method allows you to find a voluminous and soft butt in the upper part of the uterus, a round and hard head – in the lower part, and on the sides from different sides – the back, handles, legs of the baby.
Usually, in a baby presentation, the child is born quite easily (the midwife only helps him with this). However, sometimes during childbirth, the so-called extension of the head occurs – the baby’s head, passing through the small pelvis of the mother, does not lean towards the breast, but leans back.
In this case, the first through the birth canal moves the forehead or face of the baby. Most often, facial or frontal presentations occur in women who do not become mothers for the first time, in addition, this has a narrow pelvis, saddle uterus, polyhydramnios, placenta previa, uterine fibroids, premature, small, or, on the contrary, large children.
Frontal presentation can be determined by vaginal examination, it can not be corrected, and, as a rule, childbirth has to end with a cesarean section. Facial presentation is also established only during childbirth: the fingers of the obstetrician determine the eyes, nose, mouth of the baby.
Usually such deliveries lead through the natural birth canal, but sometimes you have to have an operation.
Pelvic presentation – the opposite of the classical position. There are several varieties of it.
Breech presentation – in the lower part of the uterus is the baby’s ass, and its legs are extended along the body.
Mixed breech presentation – the child sits “in Turkish”, the legs are bent and turned to the entrance to the small pelvis (this position is twice as rare compared to the previous one).
Foot previa – in the lower part of the uterus are one or two legs of the child.
To decide how the baby will be born, the doctor must assess the condition of the expectant mother: her age, pelvis size, height and weight of the child (too big or too small), the position of the fetal head (whether it is tilted to the breast or folded back ), determine the final version of the pelvic presentation (gluteus, mixed, foot), the sex of the child. Quite often, doctors speak in favor of a cesarean section.
However, if the weight of the child is small, the head is tilted to the chest, and the pelvis of the future mother is of normal size, the obstetrician-gynecologist may agree on natural childbirth.
If your baby refuses to take the correct position, know that he is not the first and not the only one. Be sure to ask all your questions to a doctor who can explain to you how to “guide” the child on the right path and what to do if nothing happens.
The transverse position of the child is determined using an external study: the baby’s head and buttocks are located on the sides of the woman’s body. If the gestation period is more than 30 weeks, the expectant mother can try to “rotate” the baby with the help of special exercises. To do this, lie down on a hard surface and, turning now on the right, then on the left side, stay in this position for about ten minutes.
You need to repeat these exercises 3-4 times and do them three times a day before meals. If the position of the child is corrected, doctors recommend wearing a bandage to secure the effect.
If not, you do not need to wear a bandage, because there is hope that the baby will turn over and take the correct position.
If the doctors determined the lateral position of the child with the expectant mother, she will need to come to the maternity hospital at 37–38 weeks of gestation. The doctor will examine and prepare the patient for cesarean section: delivery through the birth canal is theoretically possible, but they are fraught with many complications.
