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Monday, April 15, 2013

Make Your Baby Turn To Head Down

Having your gyno physically turn your baby from butt in the pelvis (breech presentation) to head down so that you can have a safer and possibly a vaginal birth is called external version. Only about 30% of babies are still breech by your 28 week ultrasound, but by full term, only less than 3% stay that way. So it's not often a subject that comes up. In the year 2000 The American Congress of Obstetricians and Gynecologists had issued a statement that all women should be "offered" a chance for a version if they are still breech at full term. Many are not offered this because their gyno either lost her skills, didn't have the skills, or has other issues that prevent the success of version. For instance, guidelines now say deliver no baby before 39 weeks of pregnancy. But by 39 weeks the baby may be so deep in the pelvis that turning the baby is much less likely, gynos may be wary to induce premature delivery with trying too soon (before 39 weeks) just to turn the baby, so the result is to not even try. And studies of labor after turning show a higher rate of c-section in these babies, perhaps because they already were not going to fit through the pelvis and that was why they were not head down to begin with. Other reasons for external version to not work include what the weight of the baby is, where the placenta sis, whether the back is towards mom's spine, how many contractions the uterus is having, whether there is low fluid, and for the most part these are things your gyno is going to discuss before they attempt to do this external version. There is a small risk of needing an emergency c-section or having the baby die after doing an external version, but these things happen much less than 1%. Moms are often offered exercises as a way to help the baby turn, but most studies don't actually show much efficacy in the twists and turns that are said to help breeches turn, or for that matter helping the baby go from face up to face down. If you are heavier, or are having your first, you are a bit less likely to get the baby to turn.. In a study by Ponkey and now a new study by Desbriere only the numbers of babies and the BMI of the mom were associated with the baby turning from posterior to anterior. Posture wasn't able to help the baby turn. So be comfortable, and do your routine exercises as most likely patience will be on your side, most babies turn on their own.

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