Overdue with an OP baby and a few questions

[OyOfMidWorld]

I'm currently 40+7 with DC2. Baby is OP and not engaged at all. As far as I can tell baby is actually side on rather than classically OP. It feels like the spine is down my left hand side and I can feel limbs across the front of my bump and on the right hand side.

When I was expecting DS1 he was engaged for weeks before I delivered him, this one has been engaged (at around 35 weeks) but is now free. I know this 'disengaging' is common with second babies but I'm really concerned that the position will prevent the baby from engaging. I'm trying so many different things to move the baby into the correct position but nothing is working.

MW has booked me in for a sweep tomorrow but I'm not convinced of the point of it if the baby is in, what feels to me, an undeliverable position. On several occasions I've felt what feels like the babies head pushing down to the side of my pelvis, rather than the centre. I have an induction booked for Sunday, would I be able to request a scan on the baby's position before they start? I can't stand the idea of labouring for hours and ending up with an EMCS, I'd rather just go straight for a section if the baby is in such a bad position.

Sorry for length, any advice gratefully received.

Yes you can insist on a scan. Dd1 was almost an undiagnosed breech - I had a scan at 38 weeks for reduced movements and they discovered it then. I requested a late scan with each subsequent pregnancy and they were very happy to do them. Insist on an appointment being made or having done when you see you me tomorrow.

The baby could move while you are in labour. Lots of time on your hands and knees would help.

My worry with induction would be that it would start you on the path to an epidural because of a long slow labour etc. If you are not mobile and in forward leaning positions during labour the baby is less likely to turn and make a c-section/instrumental birth more likely.

Have you seen this website: www.spinningbabies.com/.

Thanks, I've seen Spinning Babies and have been trying to spend as much time as I can leaning forwards and on all fours but to no avail. The baby definitely isn't in a 'classic' OP position so I'm not even sure if those would help me to move my side on monkey.

I'm getting so stressed and worried about the prospect of a long, intervention loaded induction for the reasons you describe Wizard and very concerned that, if I am induced, the baby may not be able to turn or engage. If that is a likely scenario I'd rather just have a section.

I will speak to the MW tomorrow and ask about the baby's position. I really don't feel like there is much prospect of this baby budging on their own at the moment. I have no pressure in the centre of my pelvis at all which just seems bizarre at this advanced stage of pregnancy and after having 5-6 weeks of it with DS1.

Both of mine were oddly positioned (DD was LOA rather than ROA, which can make some difference apparently, after several hours pushing and a transfer to hospital with DS I overheard the MW say to a dr that she 'suspected the baby was transverse' and he too was found to be positioned oddly but not transverse!)

Both were forceps births as they didn't come down properly (probably due to shit positioning) and DD was a horrid 17 hour induction. Had I been told she wasn't in the expected position I wouldn't have consented to induction.

Thanks Flisspaps, can I ask if you would have requested an ELCS instead of the induction? or more time to attempt turning her yourself?

With DD, I'd have just gone home, although the induction was 'just' for getting to 40+15 and my heart wasn't in it anyway. With hindsight a CS would probably have been preferable for my pelvic floor (forceps, 3a tear, manual placenta removal).

I assume I didn't labour naturally because she was poorly positioned so there wasn't sufficient pressure on my cervix; with DS he was fucking massive so was probably pushing on my cervix despite being off to the side.

This is all guesswork of course, they could have been perfectly positioned and still have needed the salad tongs, but it was the case with both that a VE during 2nd stage showed the head wasn't coming down straight.

I would not have consented to induction had I known DD1 was malpositioned. All the MW did was mutter "this baby has changed position" to herself and as a naive 1st timer I didn't do anything....and ended up with hellish induction and Keillands forceps delivery (she was in deep transverse arrest - effectively where an OP baby tries to get round the right way during labour and gets stuck, she still has the scar to prove it ). I WISH I'd have refused induction until she repositioned, I had DD2 by ELCS because of the 1st nightmare and do sometimes wonder 'what would have been' if I'd have taken control at the beginning with DD1.

I was induced at 40+11 with DS1 who was posterior - I didn't know until afterwards when I saw my notes that he was OP and this was apparently because I had an anterior placenta. Spent the entire labour wired up on a bed due to syntocin drip. Was on my hands and knees for bloody weeks beforehand to no avail. Was told that he was never likely to turn due to placenta. Finally born 40+15 by EMCS after getting to 10cm but baby not descending/Deep Transverse Arrest, foetal distress, a week in SCBU. If I had known then what I know now etc. etc. I would have done all I could to have had a CS without the endless, pointless, exhausting labouring for me and my son.

my last spent sometime side-on on both sides - i did some positioning on all fours (leaning on a birthing ball with my laptop on the floor to MN, e.g.) and inversions (just 20 seconds - not more!) to shift him round - these worked but as he had plenty of space to shift about he shifted back - still, in early labour he turned fast enough from the side-on position he was in at the time.

My first was fully OP and never turned - but was born that way.

if you don't want induction you can ask for monitoring instead - and term goes to +14 anyway so you could just ask to hold off until +14 rather than +12.

have a read here of the NICE guidelines

Both my dc were induced and both were OP, dd was forceps and ds was anterior placenta. I spent weeks on all fours cleaning thd hall and kitchen floor, both born in Jan do nesting went into overdri e with all thd wet shoes .

I honestly did not know about having a c section because of this? I was offered obs at 28 weeks after dd'z birth but was keen for a good birth to lay any ghost's to rest about it as such.

May have to ask about it at my booking in next week as already havi cold sweats about third induction and face up baby yet a c section such a major op to recover from with three children would I be MADD to think if it.

This is really making me think!!

Please excuse the crazy autocorrects, have had a major eye op and still have three more to go so can't really see what my phone has corrected

I've had 3 op babies. I've been told their position was most likely due to the shape of my womb and pelvis. All 3 have been massively overdue and 2 were induced. My only advice is this; I do think the lack of engagement can b a reason for them being overdue, they're just not putting pressure

Stupid phone. On the right place. But most important of all, stay upright in labour. The 2 I did this with turned in labour and were very easy labours. I had an epidural with my first and ended up pushing lying down. She didn't turn and came out the wrong way up. Ouchy. I don't think there's any need for a scan or c section tbh as I don't think a posterior labour has to be any harder than a Perfectly positioned baby. I think rather that your position in labour is the important factor. Good luck x

i should have said, DS2 came spontaneously at +13 - 60% of babies still inside at +10 arrive in the next three days

i think my plan was to accept monitoring at +14, then hang out a few more days hoping for spontaneous labour - or go straight to C/s if baby wasn't ok rather than buggering about with an induction. However, as it wasn't my first, an induction was quite likely to work.

I would absolutely NOT have a sweep without a scan for placental location.

I am not convinced your baby's head was engaged at 35 weeks.

An unstable lie should be investigated properly.

I really would not be having an induction with a baby that is not engaged.
I know homeopathy is rubbish and woo and has no scientific basis but towards the end of my pregnancy, my son was being akward in positioning and my midwife gave me some homeopathic pills and he had shifted by the next day.
Cannot for the life of me remember what the name was of the remedy though.

Mine is side on (so back to my left, legs to my right) and midwife said that was fine?

I have an anterior placenta...

I do weirdly positioned babies too. Dd was induced at 40+5 because of meconium and DS arrived at 40+14, spontaneously but I took myself in an hour and a half before I was booked for induction.

With DS I had 2 late scans, a size and presentation scan at 36weeks and another at 40+5 when the mw thought the baby was breach. Neither suggested that he was anything other than in a normal position. Mind you, at the time I didn't know dd had been oddly aligned so I didn't ask any pertinent questions. I assumed everything was fine. He also wasn't measured because the ultrasound wasn't working properly.

I'd just make sure that you have as much info as possible to make your decisions. I would have had a much less traumatic birth had I had more info and might have opted for a section...

Thanks very much for all your advice. I'm going along to my MW appointment this afternoon and will go prepared for a full discussion about what is happening.

My baby was positioned EXACTLY as you describe. I went 12 days overdue. Did not contemplate any interference. No sweep, no induction. The plan was that at 14 days I would go for a scan and if they were concerned then I would expect a c/s and if they were unconcerned then I would just carry on.

On the Thurs at 5pm, baby was in the same silly position and free, and I'd had no BH for over a week. 3am I had a contraction that woke me, and then 3:15 and then 3:30. I made myself a bath and lay down in it on my front, - to work with the contractions to ensure the baby got into the right position.

At 6am I finally got out, put TENs machine on, called doula, filled pool. Stayed on my knees leaning forward over the bed or sofa.

Baby born easily, quickly and perfectly positioned at 8:15am in the pool.

Apologies, DD was ROA - LOA is the optimal position. Still trying to scrape together the £ for DS's notes!

Well, I had a very surprising appointment today! The MW I saw is really excellent, I was so pleased when she called me through. I explained all my concerns and she gave me a thorough stomach examination and said that she thought that the baby's head was at brim. The baby is on my left but she said that this is a great position for delivery so we went ahead with the sweep.

When she examined me for the sweep she found that the head was in fact engaged and it was the shoulders she could feel at brim. The sweep was fine and she thinks it may well be successful. My mind is much easier now and I feel so much more relaxed than I did before. I think I'd second guessed myself so much that I really convinced the baby was in a terrible position. Here's hoping for a quick and easy delivery now

Thanks for all your comments and help.

good news :)

Excellent

I had DC2 last week.

Had no idea she was back-to-back till I was in labour and the MWs were debating it in front of me

Towards the end of my pregnancy (I ended up having her at 40+5) I had a funny shape at the bottom of my bump. Turns out it was her shoulder as she was in a sideways position with spine down my left side and limbs to my right.

In labour she turns from this sideways position (sorry I don't know the technical term!) to a full back-to-back one. This was as she was descending the birth canal which was not pleasant!

In the end I pushed her out with just gas & air for pain relief, but my one top tip was that I spent a LONG time standing up or squatting and rocking my hips.

She weighed 9lb 1oz and was born gazing up at the ceiling

At the time I didn't realise what a big deal a baby being back-to-back was, not till I read some threads on here. Honestly I think my ignorance protected me somewhat, as if I'd known all the issues some mums had then I think I might have freaked.