In most cases, babies in gestation are placed upside down from the 32nd week of pregnancy (in which they have had children may occur a few weeks later) and remain in that posture until delivery. This is because the head is the part of his body that weighs the most and because the uterus acquires a pear shape, with the narrowest area below, so that the child is more comfortable with the culete and the legs, its widest part, in the upper area (being upside down does not make them dizzy or pose any problem).
And if the baby doesn’t turn around, what?
But you may pass this date and your baby will continue to sit in the womb or go through. The tocoginecologist can detect it by touch (Leopold maneuvers) and confirm it with ultrasound. And if the expected date for delivery approaches that you cannot be born vaginally, you will schedule a C-section. However, there are things you can do before to try to turn it and turn it upside down.
And your obstetrician, if he dominates a maneuver called external cephalic version, too.
What to do if you are still breech
There are reasons why some babies, too few, cannot turn around, such as a too short umbilical cord, a significant lack or excess of amniotic fluid, low implantation of the placenta, uterine problems (malformation, fibroids) and fetal malformations If this is not your case, between weeks 32 and 36 you can try to turn it with these exercises and methods.
- Put on cats, put your head and chest on the floor, raise the culete and move your hips (“scrub the floor”, advised our grandmothers) to leave space in the uterus so that it can be dislodged and turned. Two or three times a day.
- Lie on the floor on your back, rest your legs on the couch by putting a large cushion under your pelvis so that it is elevated (with a thin pillow under your head to be more comfortable) and stays that way for 20 minutes. Do it twice a day and then walk.
- In the pool or the sea, dive and do the pine.
- Use visualization (see with the imagination of the baby who turns upside down) and haptonomy, conscious caresses in the belly, to “encourage” to change positions.
- It emits music next to your vagina and illuminates with a flashlight to attract the baby to that area.
- If you get it (you will notice it) and the ultrasound confirms it, abandon these practices, walk to fit the head and try to be upright (sleep semi incorporated).
What is the external cephalic version (VCE)
It is an obstetric maneuver performed in the hospital in week 36 or 37, without anesthesia (although it is annoying), or in week 39 with spinal anesthesia.
The doctor, who has to be an expert in doing it, is pressing with the hands in different areas of the belly to remove the baby’s buttocks from the pelvis and turn it (before a medication is injected into the mother to relax the uterus, which is a very strong muscle). It is done with monitoring, to monitor the well-being of the baby, and with the ultrasound guidance.
It is a practice that was almost abandoned a few years ago, because the caesarean section was chosen, and now it returns. The World Health Organization and the Gynecology and Obstetrics societies of many countries, including ours, have varied their protocols and now recommend it as a safe option, in normal pregnancy, which should try to reposition the baby who is Buttocks or pierced and make the delivery vaginal, better than resorting directly to caesarean section.
VCE cannot always be done
However, there are situations in which VCE cannot be done, such as placenta previa, premature detachment of the placenta even if minimal, low amniotic fluid, moms with hypertension or heart problems or babies weighing more than 3,500 grams. Mothers with Rh negative and Rh positive fetus are also banned because of the risk of blood exchange (1%).
There may be complications, which are rare (0.14%), such as a ruptured pouch, a blood uterus or a delivery. This may be vaginal, if the baby has been turned and the head has been fitted, or by emergency caesarean section.
You may also not be able to turn the baby in the three attempts, at most, that marks the protocol. In 40-70% of cases (the percentage is higher in multiparous women and if the baby is small) the VCE maneuver is successful.
After the VCE you may have stomachache, but the pregnancy will continue and you can have a natural birth. But if it does not work, or if the baby is disengaged, it turns (it is rare, but sometimes it happens, more in multiparous women) and in the end they have to do the caesarean section, think that although it is not your ideal delivery, what matters is that Your son arrived well.
What will the delivery be like?
The part of the body that the baby fits will condition it.
- Cephalic (95%). Head down, the baby pushes with the crown. It is the ideal position for vaginal delivery. If it is facing your spine (anterior cephalic) it is even easier than if it is in posterior cephalic (its back in your spine).
- Buttocks or feet (3%). The baby is sitting in your pelvis and fits the culete or one foot or both. If it is not possible to turn it over, a C-section is scheduled.
- Face (1%). Head down, insert the face into the canal instead of the crown. It requires caesarean section.
- Transverse (0.8%). It is horizontal in the uterus, you may put an arm or an elbow. It will be caesarean section.