• Fetal position and unassisted homebirth

    Date: 2010.12.20 | Category: Unassisted Childbirth | Tags: ,,

    For families who are planning an unassisted homebirth, their unborn baby’s position in utero becomes increasingly important during the last few weeks of pregnancy. Vertex or head down, and anterior (face facing the spine) is the optimal position for birth. Other possibilities include vertex but posterior (face towards the belly), which can make for a longer and more difficult labor, or frank or footling breech. If your baby is in a stubborn transverse lie, which is sideways, vaginal birth will not be possible. Whatever the position of your baby, knowing about it before labor starts, and during labor, will provide extremely useful information.

    During the last few months of pregnancy, most women will be able to palpate their baby and make out its position. Whether you will be successful or not depends on a few factors – the position of your uterus, your body shape, and your size. And of course, whether you know what you are looking for. Usually, ultrasounds are not needed to be able to work out your baby’s position. Most midwives are able to determine fetal position by examining and feeling (palpating) the outside of the uterus. Most mothers can do this just as well, with a little practice.

    When you are trying to work out what your baby’s position is, keep in mind that the bum and the head can feel rather similar. Both are large and fairly hard surfaces. If you think you can feel the head right there in your pelvis, and assume the baby is vertex, think twice and consider that it could be your baby’s bum, too. Besides the two large surfaces – your baby’s head and bum – taking into account where you have been feeling kicks and punches is very informative too.

    Finally, listening to your baby’s heart beat with a Doppler or fetoscope  will  tell you more than just what your baby’s heart rate is – it will also tell you approximately where the heart is located. That will give you further clues about the baby’s position. Visualizing your baby in your womb, and feeling around for its position several times daily, will help you get get information.

    Babies move around all the time, and although many settle in to a final position for birth in the last few weeks of pregnancy, that is certainly not true for all of them. If your baby is transverse late in pregnancy, he or she might still turn. The same goes for breech and vertex babies.