Fetal Position and its Impact on the Process of Birth

The future mothers do not lose interest in the question of the correct fetal position. Throughout the period of pregnancy, the baby grows and forms in the woman’s abdomen. The baby is moving and changing his position. The success of the process of delivery depends on the fetal position at the end of pregnancy. Let’s find out more about it.

Fetal Position in the Womb at Different Trimesters

The future baby changes his position throughout the entire period of maturation inside the womb. His position usually changes as follows:

The first 1.5 months – the embryo in the form of a fetal egg moves to the uterus and where it is finally fixed. More often it is fixed on the back wall, but can also take place on the front, upper, lower, and lateral one. For a while, it stays in one position, while the body is being formed.

At 8 weeks, the embryo already resembles a little man, even though its size does not exceed 2 centimeters. During this period, he begins to actively migrate to the uterus, but the woman does not feel it.

At week 9, the movements of the fetus are not less active. It is located in a fetal bladder and moves around the perimeter.

Week 10 is characterized by the fact that the future child not only moves but can push off from the walls of the uterus using hands and legs.

11 weeks also allows the embryo to actively move. The baby makes sharp movements, swimming in the amniotic waters.

Later Terms

Until 24 weeks the position of the child changes, as the baby is moving. Then the activity of the embryo decreases slightly because it grows and there is not much place left.

From the term of 26 weeks, the child takes a position that will be preserved until birth and will become decisive in the course of labor. The most correct fetal position is a cephalic presentation (head first). But not everyone can strictly follow this schedule. Some babies take the final position only after 32 weeks.

Week 36, preparation for labor. It can begin at any time, and even earlier, and the position of the child is important for the normal course of labor.

In case of incorrect fetal position (presentation), the future mother is taken under the control of doctors, as there may be a need for a cesarean section.

Incorrect Fetal Position: Types and Causes

The following position of the unborn child inside the womb is considered incorrect:

• Breech presentation (buttocks or feet first)
• Oblique – almost correct, but with some angle of deviation
• The transverse is across the stomach

The fetus rotates incorrectly inside the womb for the following reasons:

• Not the first pregnancy
• Weak tone of the uterus
• Short umbilical cord
• Too little or too much of amniotic fluid
• Benign formations in the uterine cavity
• Cord entanglement
• Pathology of the development of the uterus or features of its structure
• Presence of a scar after cesarean section or surgical intervention

Not always the wrong fetal position is an indication for the extraction of a child by surgery. Sometimes at the pelvic or oblique position, natural childbirth is possible.

Diagnostics of Fetal Position

To correctly determine the position of the future baby, an ultrasound is performed. At the present stage, a three-dimensional image of the fetus is made, especially when the position is incorrect, in order to know what to prepare for during delivery. Even a normal presentation should be analyzed in order to exclude all possible risks.

Can a Pregnant Woman Determine the Position of the Baby herself?

In general, it is possible to determine the baby’s position by gently palpating your stomach. Later, the baby’s back, arms, and legs are already distinctly felt. In addition, you should pay attention to the baby’s movements. Carefully follow these signs:

• If the baby’s head is on the top, the pushes are more felt on the top of the abdomen, and below are the active movements.
• When the child is in a crossed position, the abdomen will be disproportionately wide. There may also be pain in the navel.
• With the correct position, the legs in the upper abdomen are clearly felt. Pressure occurs in the right hypochondrium in the liver region. The head is clearly palpable at the bottom.
• If the baby is located very low, there will often be a urge to urinate and pressure in this area.
• After 31 weeks of pregnancy, the baby stops moving and prepares to be born, only sometimes it can move his hands and legs.

Fetal Position

There are only two ways of the presentation of the fetus – the pelvic and the head one. During the first and second trimester of pregnancy (up to 28 weeks), this has absolutely no significance, because until this time the baby is active enough inside the uterus. He is still small and there is enough space for his acrobatic exercises.

Before 30 weeks of pregnancy 30-35 future mothers out of 100 have a pelvic presentation of the baby. But as the fetus grows, it takes a fairly stable position in the uterus, and by the time of delivery (on average – by 40 weeks), most babies take the prefrontal preference for births, and only 3-4 infants out of 100 are born in the pelvic presentation.

Head Position

A cephalic presentation or head presentation or head-first presentation is a situation at childbirth where the fetus is in a longitudinal lie and the head enters the pelvis first; the most common form of cephalic presentation is the vertex presentation where the occiput is the leading part (the part that first enters the birth canal). All other presentations are considered abnormal. They are either more difficult to deliver or not deliverable by natural means.

The head position is considered most favorable for childbirth because in this case, the head of the fetus (the largest part of the baby’s body) passes through the birth canal first. The remaining parts of the body (trunk, legs) are born quickly and without difficulty.

Pelvic Position (Breech Presentation)

A breech birth occurs when a baby is born bottom first instead of head first. In such a situation, difficulties may arise because the head is a bigger part of the body. Around 3-5% of pregnant women at term 37–40 weeks will have a breech baby.

Most babies in the breech position are born by an operation because it is safer than being born vaginally.

Births in the pelvic presentation are considered pathological due to a large number of complications in the mother and the fetus since the less voluminous pelvic end is born first and difficulties arise when removing the head. In case of a leg presentation, the doctor restrains the child’s birth by hand, until the child squats to prevent the leg from falling out, after such a manual the glutes are born first.

Pelvic presentation is not an absolute indication for a C-section. The question of the method of delivery is decided depending on the following factors:

• The size of the fetus (with breech presentation, a fetus weighting more than 3500 g. is considered to be large, whereas with usual births – more than 4000 grams)
• The size of the mother’s pelvis
• Type of pelvic presentation (legs or buttocks)
• The sex of the fetus (for the girl, births in pelvic presentation are less risky than for the boy, since the boy may have injury of genital organs)
• The age of the woman
• The course and outcome of previous pregnancies and births

There is another condition, which can be called an incorrect position of the fetus. This is a transverse position, in which the head and pelvic end are located in the lateral parts of the uterus, and the fetal shoulder is near the exit from the uterus. In this situation, natural childbirth is impossible in general.

Lateral and Oblique Fetal Position

The transverse and oblique positions of the fetus are an absolute indication for cesarean section. Natural birth is impossible. Such a situation is determined in 0.2-0.4% of cases.

The transverse position may be due to tumors in the uterus (for example, fibroids), which prevent the normal position; in women who gave birth several times due to overgrowth of the uterus; with a large fetus; with a short umbilical cord or cord entanglement.

If the Wrong Fetal Position is Diagnosed

The first thing – do not panic. If the correct presentation is determined from 31 weeks, up to 36 there is still time. Special gymnastics is prescribed, which will help the future mother to correctly turn the baby, but even if it does not work, there is no reason to be upset. Modern methods of surgical intervention are not very traumatic and are aimed as safely as possible to help the baby appear.

Incorrect position of the baby is not a reason for intense worry. It is better to protect your health and your baby from the negative impact of pregnancy stress. Experienced doctors will do everything possible to make the child see the light healthy.