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Calling all midwives - baby is due in 3 weeks and head hasn't yet engaged(17 Posts)
Hi all midwives, perhaps one of you is around and can answer a query of a friend of mine.
Her baby is due in 3 weeks time and the head has not yet engaged, so they are talking about doing a caesarean.
I was a little startled by this, as I thought 3 weeks was still plenty of time to go for the baby to engage, and she's very upset about it and doesn't want a caesarean unless it's a medical necessity.
Are they worrying her unduly? Should the head have engaged by now? (I can't remember!)
Is it her first pregnancy? I think second and subsequent pregnancies engage later, but I'm not professionally qualified, so don't listen to me! Hope she's OK and baby's here in the way she wants very soon.
I'm not a MW either but it sounds a bit radical to me. Is there a problem with the size of her pelvis compared to estimated size of baby? That seems to me a valid reason to advise CS. As HM says second and subsequents often engage later as the space has been 'stretched' by the first baby
It's her first pregnancy, she's quite tall (about 5 ft 8) and doesn't look like she hasn't got any hips (without wishing to be rude)!
More info - the baby is in the oblique position (whatever that is).
I used to be a midwife (3 years ago now so may not be up to date).
If the baby is lying in an oblique position the liklihjood is that the head won't be able to engage or deliver - that's not to say that the baby won't move and become properly head down - even if n ot engaged. About 5-10% of first babies don't engage (mine was one of them) and there are various reasons for this - not all a problem. However, an oblique lie means that the baby is lying in a diagonal type position and the head is pointing towards the hip rather then downwards towards the pelvis. Unless this position changes the liklihood is that she'll need a caesarean as the baby won't be able to deliver vaginally.
As I say - he/she may move yet but I imagine if she doesn't show signs of the baby doing so soon they'll recommend a section. It might be worth her negotiating a plan such as - give the baby until such and such a date and if he/she hasn't moved then they can schedule a section.
PS: I ended up with a section for a large baby and unengaged head + failed induction - it was nowhere near as bad as I thought it would be and the staff were great - made it as special as possible for us.
Thanks for that Amanda, and everyone else who responded.
I've spoken to friend now and she's calmed down a bit, has decided that it's just a matter of waiting - she can't find out what the chances are of the baby moving off the bone where he's caught (apparantly) and engaging properly and would like to know that if anyone knows it.
Bit of a bummer having to have a caesarean though. Totally unexpected at this stage, she's had such a straightforward, problem-free pregnancy.
my little love (who still hasn't appeared I might add!), was oblique 4 weeks before i was due (overdue now!) and head hadn't engaged.
By 3 weeks head was a teeny tiny bit engaged... then the next week was back out again!
Am now almost fully engaged!
So, it IS possible that her baby will wriggle about some and get in the right place... so tell her not to worry too much!
I DID do a bit of foetal positioning stuff... but not a hell of a lot... spent some time watching tv straddling a chair and leaning forward... couldn't say it was that that encouraged baby to get in the right place though! but might be worth a try!
Have asked on a UK Midwifery message board to see if anyone there knows the chances. But by starlovers post it sounds possible the baby could still move.
Hi - has your friend had her baby yet? What happened? I am 38 weeks pregnant (first baby) and the head was slightly engaged for the first time when I saw my midwife this week. It has been head down but not engaged before when I see her and I think it has been moving around inbetween times (oblique, transverse, breech). Couldn't someone try to move your friend's baby to head down like they do with breeches?
I am going to see a chiropractor next week to see what is going on with my pelvis to stop my baby engaging. Would love to know what happened with your friend though - I am convinced I am going to have a caesarean because of all this
Caligula, I am in exactly the same situation. Due in less than 3 weeks now and the babies head is sitting on my pelvic bone somehow and not going into the pelvis at all. the doctor has been concerned for a while that my pelvis may not be big enough for the babies head which would mean that a caesarian would be the only option. I don't remember the rest of what has been said. If at 28+ weeks its still not going down then he says we really have to decide what to do - i.e. if to go into labour and risk an emergency c/s or if to plan a c/s. I have spoken to a couple of midwives - including Mears who posts on this site. I'll find the link for you.
Before the doctor mentioned there may be a problem the thought that I may have to have a c/s hadn't entered my mind at all. Now i have had enough warning and time to think about it and realise that the only important thing is that me & baby are safe and no damage is done during labour. If there is really clearly a problem then I am thinking about whether or not putting myself and baby through the trauma of trying for a natural birth would be pointless.
Good luck to your friend!
I've had 3 babies - and none of them engaged until I was in labour. Never any mention of C-sections (only time possible Section came up was when No 2 was breech until late on) - but no-one seemed concerned about the "non-engagement".
Here is that thread!
I've just re-read it and Mears said not to worry until 40-41 weeks! Seems that anything can happen between now and then, but I think its nice to be informed and prepare myself for anything.
I just realised this was an old thread!
Nettie - I guess you are due a few days before me (I'm due on 12th March). I'm interested to know how you get on and what they say to you.
You don't post on the 'Due March' thread on the Ante-natal bit do you? I usually give updates of what is going on there.
Hi thanks for your replies - I am new today so haven't found the March thread yet. The link to the other thread was a comfort - I don't think there is an imediate problem - my midwife says that what is important is what happens in labour. Lots of sitting on my birth ball at the moment.
My first baby was transverse until some time in 39th week, when he turned head down.Like your friend i was told i would have to have a Cs as baby would not turn after week 38. I was also told he was a small baby but he was 8lb6oz. Ventous delivery.
My first was emergency cs and I was told my pelvis was to small for his head and he was OC position (I am 4ft 11). I am 37wks on no 2 and head is still not engaged but hospital is not considering a elective section (different hospital) They want a trial labour, but I dont want another emergency cs after another labour. Am I mad to try to convince them. First was 6pounds 8. This one is bigger they say. I am feeling a little panicky. Any advice would be great.
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