The vertex position. A technical term that describes when a baby is delivered headfirst. The vertex position is the ideal position when you are getting ready for labor. But it’s not always the case.
Usually, weeks before you give birth, the baby moves in a position with its head above your vagina. Sometimes, their feet, bottom, or bottom, and feet remain in this area, which is known as breech. There are a few other ways the baby can position themselves, if not in the vertex position. This does not always require a cesarean, but you will have to discuss the best and safest way to deliver with your doctor.
Breech position is when a baby enters the birth canal with the buttocks or feet first, rather than the head. This prevents the cervix (opening to the uterus) from dilating effectively and can lead to the umbilical cord becoming pinched or compressed. Breech position only occurs in approximately 3-4% of deliveries and is more likely in premature births or multiple babies. While breech babies can be delivered vaginally, studies have found that vaginal deliveries are around three times more likely to result in serious harm to the baby than cesarean sections. Therefore, in most cases in the US, breech babies are delivered by c-section. Your doctor can diagnose a breech presentation either by a physical exam or ultrasound.
Shoulder first is rare and occurs in less than 1% of deliveries. This is when the baby lies sideways in the uterus, rather than head down or buttocks/feet down. If labor begins with the baby in this position, the shoulder becomes wedged in the pelvis, and the delivery usually does not progress. Almost all babies with shoulder presentation will need to be delivered by cesarean section. Shoulder presentation, like breech presentation, is more common in premature babies or the setting of multiple gestations.
External cephalic version (ECV)
ECV is one way to turn a baby from breech position to head-down position while it’s still in the uterus. It involves the doctor applying pressure to your stomach to turn the baby from the outside. Sometimes, an ultrasound is used to help this turn.
Many women who have normal pregnancies can have ECV. You should not have ECV if you have other complications and talk to your doctor if you are comfortable pursuing this option.
No matter what position the baby decides to be in, be sure to have an honest discussion with your doctor about getting the baby in the safest place best for you to deliver and get the little one into the arms of your intended parents.
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