How Many Weeks in the Pregnancy Does the Baby Turn His Head Dowwards
Can You Flip a Breech Baby in the Womb?
The internet abounds with strategies for turning a infant caput downward, but only 1 is more than constructive than doing zip at all.
This story was originally published on Nov. 6, 2019 in NYT Parenting.
When I was about 35 weeks pregnant, I propped my blueish-and-white ironing board against the seat of my couch. And then — assisted by my spouse, several cushions and a video tutorial — I clambered onto my dorsum on the board, feet on the burrow, head toward the floor, hoping the uncomfortable angle would convince my unborn child to do a 180-degree turn inside my uterus so that her head was facing down.
The position was based on my chiropractor's proffer to turn breech babies — who are situated in the womb and then that their feet, buttocks or limbs are facing the cervix instead of their head. While this position is not recommended by physicians, it isn't frowned-upon either. My doctor just suggested I use a sturdy board and avoid falls.
Virtually babies settle into a caput-down position between 35 and 37 weeks of pregnancy, so that their head emerges beginning during a vaginal nascence. But in approximately 4 percent of pregnancies, the baby remains in the breech position; and equally they grow, flipping into a head-down position inside the confines of the womb becomes tricky.
[Larn what to expect during the three stages of labor .]
In 2000, researchers compared the breech birth experiences of nearly ii,100 women beyond 26 countries, and found that — while delivering a breech babe vaginally wasn't dangerous for mothers — those babies had a significantly higher risk of dying or complications compared with those who were born via planned C-section. Unlike those born headfirst, a breech baby has higher odds of getting its head stuck in the birth canal during labor.
"Pinch of the head during delivery can also cause trauma to the brain, haemorrhage in the brain or cord prolapse leading to death," said Dr. Christine Greves, M.D., an ob-gyn at the Orlando Health Winnie Palmer Infirmary for Women and Babies in Florida.
That 2000 study led the American College of Obstetricians and Gynecologists and other groups of clinicians to recommend that women with breech babies deliver them via a scheduled cesarean.
Merely as with any surgery, C-sections can come up with potential complications; and studies performed abroad suggest that nigh women prefer to deliver vaginally. But will breech-babe-flipping strategies you lot may have read about online or heard virtually in parenting circles — such as contorting yourself into uncomfortable poses or lying upside downward on an ironing board — actually piece of work? Here, some of the most common strategies expecting parents utilize to flip breech babies in the womb; and why only one actually holds water.
Transmission manipulation
Fetuses bladder every which way throughout most of a pregnancy. Only as they pack on pounds in the third trimester, their movements grow more restricted — and they're less likely to flip over completely, regardless of which position they're in. "It's only effectually the 35-week mark that we'll tell a woman their baby is breech," said Dr. Susan Lareau, M.D., an ob-gyn and assistant professor of obstetrics, gynecology and reproductive sciences at the University of Pittsburgh. "At that bespeak, nosotros nowadays them with the options of an external cephalic version or a scheduled C-section."
An external cephalic version is a procedure where a trained clinician pushes on the surface of a pregnant belly to manipulate the baby into a head-downward position before birth. It'southward performed in a hospital, and the infant's heartbeat is tracked throughout for signs of distress.
In 2018, a retrospective study of nearly three,000 women with breech babies found that an East.C.V. successfully flipped babies in about half the 2,614 patients who attempted it, and 85 percent of them went on to deliver vaginally with few complications. A 2015 Cochrane systematic review of viii studies also found that the method was effective since more than than half of the 1,308 attempts succeeded. "When you review the medical literature, the only affair that's been demonstrated to truly work is the external cephalic version," said Dr. Greves.
Complications are rare, though women accept said that the process can feel uncomfortable or somewhat painful. Some clinics give women an epidural or other pain medication earlier performing an E.C.V. In less than 5 percent of cases — typically if it'due south a 2d pregnancy — the baby will flip back to their breech position later the procedure.
An E.C.V. may not be an choice for some, especially if you have depression amniotic fluid levels, an anterior placenta (where the placenta attaches to the front wall of the uterus, which can arrive hard for a medico to feel and manipulate the infant), a history of abnormal bleeding or other pregnancy complications, such as pre-eclampsia.
Acupuncture and moxibustion
I spent several evenings watching Netflix Originals while waving a burning, cigar-similar stick of moxa, a traditional herb, over my baby toes. The herb (likewise called mugwort or Folium Artemisiae argyi) is used in traditional Chinese medicine to warm specific trigger points on the body, such equally one on the outside of the trivial toe. This handling is often used in conjunction with acupuncture on these trigger points.
According to Judith Schlaeger, Ph.D., a certified nurse-midwife and banana professor of nursing at the Academy of Illinois in Chicago, traditional medicine principles say that activating this spot using fine needles (acupuncture), pressing on it with thumbs or rollers (acupressure) or warming it (a practice chosen moxibustion) is thought to improve free energy menstruation and apportionment to the uterine muscles.
But no solid research has confirmed whether any of these practices work, as most such studies have been designed inconsistently and are small. Some, for instance, apply different kinds of moxa, others combine the herbal treatment with acupuncture, or use inconsistent control groups or women in varying stages of pregnancy.
"There's no consistent protocol that's been determined to exist effective," Dr. Schlaeger said, who published a review of 16 randomized clinical trials on moxibustion for breech babies in 2018.
That existence said, in that location are few side effects and it's cheap, co-ordinate to Dr. Schlaeger. "More often than not speaking, there's no reason non to try it."
Chiropractic manipulation and massage
Some chiropractors offer a combination of gentle abdominal massage and adjustments to the lower back to encourage a baby to turn. The moves are known every bit the Webster technique, and are thought to act past easing tension in the uterine ligaments or muscles that may exist restricting a baby's movements in the womb. But only a scattering of case studies describing individual patients' experiences report success or failure. In one case, the Webster technique failed to aid a 23-year-old outset-time mom, perhaps considering she had low levels of amniotic fluids. If you're thinking of trying such techniques, co-ordinate to the study authors, check with your doctor offset.
Postural adjustments
In addition to reclining on my trusty ironing board (a position known every bit the breech tilt), I skillful pelvic tilts (where you prevarication on the floor with a wedge-shaped pillow under your hips) and the open knee-chest position (where yous residue on your elbows and knees and bring your head to the flooring, kind of like a down dog on your knees).
A 2012 Cochrane review of six studies, one of the most recent reviews on the topic, compared the outcomes of 417 women with breech babies and plant that postural adjustments did little to flip their fetuses. But two of the studies, which were published in 1987 and 1999, showed a minor potential benefit of the human knee-chest position and pelvic tilts — but the 170 women included in these studies began exercises as early as 30 weeks into their pregnancy, and so it's possible that even if they hadn't done such exercises, their babies would have flipped into the correct position on their own.
While none of these postural techniques are likely to harm you or your baby, Dr. Lareau said, you should e'er consult with your doctor before trying whatever kind of manipulation. And you definitely shouldn't effort to perform a cephalic version at home. But making (fifty-fifty unsuccessful) efforts can help you feel more in control of your trunk.
"Almost of united states of america, myself included, want to feel similar nosotros're doing something about an issue," Dr. Lareau said. "Simply I exercise always want women to sympathise that if it doesn't work, it'due south not because they didn't practice it correct or they're a failure. It'southward just that the exercises are not that effective."
As for me, the ironing board technique, moxa and chiropractic care weren't enough to coax my baby to flip. And my ob-gyn determined that I wasn't a candidate for an E.C.5. because I had low amniotic fluids. In the end, my daughter was built-in via a scheduled C-section. But weeks of endeavour and discussing the outcomes helped me feel confident (both as a patient and equally a parent) that the surgery was the right move.
[Read about how to abet for yourself in the delivery room.]
Jyoti Madhusoodanan, Ph.D., is a science journalist and mom to a toddler.
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Source: https://www.nytimes.com/2020/04/15/parenting/pregnancy/breech-baby-turning.html
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