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Posterior baby, head not engaged 38 w into 3rd pregnancy

(71 Posts)
LillaC Sun 14-Nov-10 13:07:16

I'm 38+1 with my 3rd baby. On Fri MW told me baby's moved from having had his back to my left to being completely back-to-back. She was also concerned that the head is only 4/5ths and free and has been for the past 3 weeks.

I'm delivering privately with MW-led care and their policy with mums who've given birth before is to offer a sweep at 39 w - which I would take, it worked wonders with no 2. But MW said if the head hadn't engaged more by then, they would not offer the sweep as it wouldn't do anything. I thought it was common for the head not to engage until in labour in subsequent pregnancies? But MW said that's only 2nd babies and that 3rd time the head should be engaged by now.

MW also said that if baby is posterior and not engaged by 40, I would need to see a consultant to find out why, if there was any reason the head could not fit. She didn't go on to talk about what the consultant might recommend.

I'm trying to work out how to look at this and whether I should be worried. I've had two vaginal deliveries without any issues re position of baby or head engaging but I guess each pregnancy is different!

I've read up about back-to-back labours and they don't sound great! But I guess I will just have an epidural...

I'm doing all I can to encourage baby to move like sitting on a birthing ball, walking lots, being on all 4, sleeping on my left but not sure any of it is working!

Any advice, comments? Similar experiences?

kitten30 Sun 14-Nov-10 16:30:21

Hi I am also due on the 27th Nov and am 38 weeks plus one.

This thread I started may offer some advice -a-back-to-back-OP-position-Labour-Birth-for-first -baby

I currently have a UTI so in no rush to get him out as in agony with it although it hasnt shown on a dipstick test so the doctors wont give me anything yet until lab results come back.

Good Luck in getting him to turn.

LillaC Sun 14-Nov-10 19:32:04

Thanks - I did read your thread which was helpful. But I was also interested in difference with third labour in terms of whether head is supposed to engage early or in labour etc.

I hope you feel better soon and good luck to you!

Myself can't wait to get this baby out - third pregnancy has been really hard, not at all as enjoyable as the first two. I think my body has had enough!

kitten30 Sun 14-Nov-10 23:11:04

Mine is only my first and I am on my fourth UTI and its been awful! I hope the next one isnt so awful. I think if its a third baby they can just engage right before labour, at least your baby can still turn if he isnt engaged! My worry is my little one is pretty much fully engaged as he was 3/5 in the pelvis at 35 weeks. Oh well fingers crossed for us both.

LillaC Mon 15-Nov-10 10:01:17

Kitten - I'm sorry to hear your pregnancy has been so hard. My first two pregnancies were really good, this one a bit harder on my body but I still probably shouldn't complain.

LillaC Mon 15-Nov-10 10:06:52

Sorry I wasn't finished!

But you haven't got long to go no matter what happens and the baby will come out one way or another. Just try to have an open mind! I had my mind set on a natural birth with my first one but things didn't go according to plan at all and I had to be induced, have an epidural and ventouse! But both me and my daughter were fine and that's the most important thing!

I also thought that third babies could engage right before labour but then I don't understand how the sweep works as she said they wouldn't do a sweep if the head wasn't engaged. I had a sweep a 40w with no 2 and she was born the next morning but I can't remember whether the head was engaged or not when they did the sweep.

Sarahlou8 Mon 15-Nov-10 11:07:44

Hi, My baby is 3 weeks old. She was back to back from 27 weeks onwards and just would not shift, I had an anterior placenta (where it's on the front) so she was just more comfortable where she was.
She didn't engage at all until 38 weeks and then not fully until I was in labour. After an 18 hour labour, which was slowed down considerably by her position, she decided to turn at the last minute and was born normally with just a shot of meptid and gas & air.

I would strongly recommend trying to hold off an epidural if you can, and stay mobile. i never thought my baby would turn - but she did. There is very little chance of a baby turning if you are immobile during labour.

this is my 3rd baby too, the previous two were positioned much better!

All is not lost! try not to worry xx

LillaC Mon 15-Nov-10 12:52:54

Thanks Sarahlou8 - that's interesting to hear. And I'm glad everything went well in the end! Although 18 hour labour sounds tough - not sure I could hold out that long in pain without the epidural. Although my hospital do mobile epidurals that let you stay on your feet - we'll see. I managed no 2 with just gas & air but that labour took only a few hours!

Did you go into labour naturally? I think my MW was suggesting that the awkward position makes it harder for the head to engage and that it's only the pressure of the head that dilates the cervix and progresses the labour.

whoodoo Mon 15-Nov-10 14:02:28

I had my third 7 months ago. First was back to back and that wasm't fun labour (section in end). When I went in with 3rd in labour they told me he was suspected b2b and I freaked but senior MW resassured me that turning on third even in labour was very possible cos of all the room you have - unlike with baby 1.

Also DS3 didn't engage till last minute. Asked for sweep at 39 weeks cos of so many false starts (typical baby No. 3 labour for me) but as he wasn't engaged she refused cos of risk of cord prolapse. Cos of ongoing false starts, they took pity and at 39+6 got examined by two MWs in room. When they were both happy he was a bit engaged they gave me a sweep and he came the next day on his due date.

I know how dreadful the waiting is but try not to rush him. If you've delivered fine vaginally before what's to say this will be any different this time. Just get on that ball or start scrubbing the floors to get him turned.

LillaC Mon 15-Nov-10 14:22:39

Whoodoo - thanks for that, that's really helpful. It also sounds pretty much like what they've told me re the sweep. They also said that if my waters break I have to call/come in straight away because of the risk for cord prolapse.

I'm sitting on the birth ball every evening, will definitely be scrubbing the floors on all fours next! Also seeing my osteo this week, he's specialised in pregnancies so maybe he can do something re positioning!

Everyone seems to agree that 3rd labours are unpredictable, very annoying with false starts, especially when you've got 2 little ones at home to care for!

I'll let you know how it goes!

whoodoo Mon 15-Nov-10 14:34:31

yep i had a week of false starts mainly starting just as the wee ones had gone to bed and then resulting in nothing by the morning - drove me mental. Once he did start coming he came in 4 hours though.

kitten30 Mon 15-Nov-10 15:25:47

Yes my midwife said the same to me regarding pressure on the cervix. She said that if he wasnt back to back he probably would have been born by now due to the contractions I keep having. I woke up last night at five am and was having string contractions until 9am. Made DH stay home from work but by 9.20 it just stopped! I have no idea what is going on but I think the baby wants out but cant trigger the labour.

LillaC Mon 15-Nov-10 16:50:09

Kitten30 - your baby is probably trying really hard to get things going!

Poor you, you must be exhausted! At least I haven't had any contractions apart from some BH. Has the MW said what they will do if you go to 40w and its not progressing? Because of Christmas, school events etc I really want mine to be born by or before the 27th!

kitten30 Mon 15-Nov-10 17:01:20

No I havent spoken to the midwife about it but I already have a hospital appointment for the first week in December if I have not had him by then, to talk about induction. To be honest I cant see it getting to that. I have felt sick and been gagging a lot today so I honestly think this week is looking promising. My mother gets the train here tomorrow so I am glad it didnt happen last night really as I want her at the birth and she would have been really upset to have missed it by one day. I dont want the 27th either, the further away from xmas the better, not just for me but him too. My birthday is a week before xmas day and I always hated it as a kid double

LillaC Tue 16-Nov-10 09:56:57

Kitten30 - sounds like things might be happening for you then! Very exciting! It was truly magical when DD1 was born. I remember my DH and I would spend hours just looking at her in amazement in the first few weeks!

No signs of anything going on for me. I'm really active all day walking up and down the hill doing the school run etc so I would be surprised if I go past my due date but then again, everyone says 3rd babies are unpredictable! It's mentally frustrating this waiting game isn't it! But I have to accept that maybe the little boy isn't ready to come out just yet! Have a MW app on Fri so we'll see what they say, perhaps I have to see a consultant too.

Do you know what you're having by the way?

kitten30 Tue 16-Nov-10 10:42:42

Yes it is a boy. I had another terrible night last night and I am just so fed up because I cant handle this pain any more. I think it may be his position being back to back (I dont know as its my first baby) but the pressure on my back passage (sorry tmi) is excruciating and I am throwing up as it is so bad. I dont really know what to do. I am dreading labour as I imagine this same pain is only going to intensify. I am desperate for it to be over now.

LillaC Tue 16-Nov-10 11:02:59

I'm so sorry you are in so much pain - does taking a hot bath, using a wheat cushion help? Have you spoken to MW/hospital? It sounds like it's the start of your labour, I read on these threads that some women don't have regular contractions with posterior babies.

Have a glass of wine my MW told me when I started my first labour - but maybe a bit early in the day for that

Hang in there, you can cope with so much more than you think!

kitten30 Tue 16-Nov-10 11:15:25

Yes actually I think that is what I will do..go and sit in the bath for an hour to ease things off. Yes that is a good point about the contractions, I had read that and forgotten. God I never knew pregnancy was this hard towards the end! The last 7 days or so have been awful. Yes too early for wine, besides I have to pick my mother up from the train station at 3pm so god knows how I am going to manage that. May have to tell her to get a taxi.

LillaC Tue 16-Nov-10 16:08:13

Kitten- hope you're feeling better and that your mum has arrived and can support you! Best of luck! Maybe you could have that glass of wine now...

planner26 Tue 16-Nov-10 17:49:39

Sorry to barge in on your thread but reading it is similar situation to me (though it is my first). Am currently 38+5 and baby is back to back. Got so much pressure on my back (and back passage - nice!) especially at night when I lie down just can't wait for this to be over now. Did really want a natural birth and had a rigorous birth plan but decided to just go with the flow now and see what happens.

Hope you are feeling better kitten - if it makes you feel better I haven't slept through the night for a couple of weeks now!

Am jealous of you being active Lilla as my SPD has got so bad now can't manage walking around for more than ten mins or so. Am trying the exercise ball thing too though!

Best of luck girls, hope it all goes ok for you. It's reassuring to feel like I'm not the only one in this position!

LillaC Tue 16-Nov-10 18:40:51

Planner26 - it really sounds horrendous with the pressure on the back and back passage! I've got some back ache but not so bad maybe it's because the head hasn't dropped yet? Once the head is engaged there's probably a lot more pressure!

I have no choice but being active, with 2 little ones at home! But it makes me feel better I think.

Good luck to you too!

kitten30 Tue 16-Nov-10 23:07:50

oh ladies we are all in the same boat. Planner are you getting the awful shooting pains in your rectum if you need a bowel movement? I was dreading that during labour it may be that pain but a friend told me that she had a back to back and that pain wasnt really part of the labour..phew!

Whoever goes first needs to report back to share how they got on... mum is here now and so I feel like DH can have a break too as he has had to do everything round the house as well as work full time so I feel a bit sorry for him. At least now he can sit down a bit more.

planner26 Wed 17-Nov-10 07:12:00

No shooting pains here, just waking up a few times in the night with bad aching pain as if someone has kicked me in the bowel area (if that is possible?!). Also (tmi) but when I needs to go I really need to go!

Saw my GP friend last night, who said that she didn't even think baby had engaged yet - brilliant. Keep reading how baby engages about 4 weeks before in first babies....hmmm am 39 weeks tomorrow. MW is about as useful as a dishcloth. Really didn't want to be induced.

Did get out my Juju Sundin book 'Birth Skills', there's a really good chapter about posterior labour/birth that relaxed me a bit at my usual 6am panic!

Aarrggh just want this to be over and have my lovely little one! Am absolutely bricking it about horror stories about bad tears/ episiotomies and forcep births!

kitten30 Wed 17-Nov-10 15:18:16

I am waking in the night too with back pain and contractions and it goes on for about two or three hours..then BANG stops and nothing. I am going to be drained at this rate.

I am sure mine is fully engaged now ..will know for sure as seeing MW tomorrow.

What does your book say about OP labour? I am totally shitting myself re all the awful stories and when I tell people he is back to back..the reaction says it all :-(

planner26 Wed 17-Nov-10 16:47:05

Same here - even my GP friends gave me a 'oh my God poor you' look and then said that birth was so bad she would have to meet someone really really nice to even consider having kids with! Nice!

The book is good, it keeps saying 'don't panic, be proactive' but also to give it a go without epi when labour starts and stay mobile as it is at this stage a lot of babies turn. She is a physio is Australia and both her babies were born posterior. She also says that epidurals are used for more than pain relief in posterior labours - she says that often babies turn once mum is more relaxed.

She cites big studies in Sydney and Canada that showed that doing 'all fours' excercise in late pregnancy had no impact on the baby position at that point. She says that is most efficient to get into all fours position during a contraction when labour starts as 'it is not until the uterine contractions start to warm up that the muscular fibres have any influence on the baby'. She also says only get into these positions during contractions as you may tire yourself out needlessly otherwise. She also says that bouncing on a fit ball is not good.

There are also two chapters on pushing and crowning (she gives advice for those who have had epidurals too and can't feel a lot). If you can get hold of the book I really would recommend it.

Let us know how you get on at MW!

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