First baby, 36 weeks, has not engaged - C-section?

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At my 36 week midwife appointment the baby's head was completely free, the midwife was actually able to move his head around. He is facing downwards but his head doesn't seem to be showing any signs of engaging. The midwife mentioned that this could be because his head is big, because he is in a funny position, or possibly because my pelvis is small (I have always suspected I might have problems with this!). He is measuring a week ahead.

Midwife said it is unusual that he hasn't started engaging by now as it is my first baby. She said that if he had not engaged by my 38 week appointment then she would send me to have a scan to see what the problem is, and I got the impression that this might involve scheduling an elective C-section if he is seen not to be progressing into position.

Does anyone have any experience with this? Did you end up having a C-section or are there other options?

I am doing my birthing ball stuff and walking a lot to try to encourage him down there. Pelvis is in agony most of the time because his entire weight is on it rather than in it. His body seems to be generally diagonal so I am not confident he will actually shift before 38 weeks. And if he does engage, I assume I will know about it as I will feel it in there, surely?!

My ds did not engage until I went into labour, I remember being worried about it and speaking to a midwife. She laughed and said "a couple of nice painful contractions will get him into position". Oddly reassuring and completely accurate as it happens.

Not saying it will be the same for you, but maybe try not to jump to conclusions and wait to see what they say after your scan.

No, you won't necessarily know (late pregnancy is IME a series of generally weird sensations...). But you've got two weeks. Give it a chance (I know this is easy to say and harder to do!) and then see what happens.

I don't, in all honesty, think there is all that much you can do yourself. I've looked at the research (I write about pregnancy from time to time) and the evidence for positioning isn't that strong.

Good luck!

The only other thing I'd say is that an elective C-section, if it does come to that, is a pretty safe and straighforward option.

I had no idea when any of mine were engaged. Lack of engagement isn't an issue even with a first baby afaik as long as baby is in a good position to engage when labour is progressing. What may be an issue is if your baby turns breech - or tranverse (across your tummy) because whilst you can vaginally birth a breech you can't do so with a tranverse lie baby. Try not to worry though - loads of time yet for things to change.

Thanks so much for these comments, this was exactly what I hoped to hear!

Will keep doing what I'm doing, and keep an open mind. Then if it comes to having to be scanned and booked in for C-section I will deal with it then. Hopefully he is just in a funny position and will shift but if not it is not the end of the world. I don't mind how he comes as long as he gets here healthy!

mine was not engaged til labour but midwives never seemed to think it was much of a problem?

Your MW is wrong. It is not at all unusual for babies not to engage right up until the start of labour. There is absolutely no reason at this stage for you to be worrying about a c-section.

I had pretty much the same experience and had a straight forward birth, no CS.

I am pretty sure I felt DD's head engaging in the car on the way to hospital, I thought she would arrive in the car park but when we got inside and I was examined I was only 8 or 9 cms dilated so I think that must have been what it was.

I was annoyed with the midwife at the time as there was a student there as well and I felt she was only saying it to create a bit of drama for the student. From your experience I can see that it might be a standard thing to say though.

I don't want to detract from all of the positive comments, hopefully it will all be fine for you! However I would make sure that you get this followed up if he doesn't engage... my DS never engaged and I did end up with an EMCS for suspected pelvic disproportion. I think this is really really rare, but I would much rather have had an elective section rather than a real emergency at the pushing stage. Not engaging with first babies is an indicator for this, and nobody bothered when my DS wasn't engaged at my 41 week check, but in restrospect I wish I'd made more of a fuss (although obviously it doesn't necessarily mean that there is a problem).

I didn't think it was a problem either, I thought the head could engage at any point right up until during labour. She gave me the impression that the fact that he hadn't engaged at this stage was unusual because it is my first pregnancy, but I'm not sure I agree with that - potentially he still has six weeks to get his head in there (but please don't let it be that long - I don't know how much longer I can do the whole beached geriatric thing :()!

Not going to worry too much for now!

DS (my first) never engaged and it was never mentioned as a problem to me. I had an ELCS at 39+1 for totally unrelated reason so never know if he would have engaged eventually. My second never engaged either but again was ELCS by choice.

GrumpyFish, thanks for the comment. I have decided already that if it gets to the stage where I am scanned and the outcome is that it is a problem with the size of my pelvis (as opposed to positioning etc, which can potentially change) then I would rather have an elective section than attempt to birth him naturally with the possibility of it failing and having to have an emergency section. I feel it would be physically healthier for me to do that, rather than putting my body through all that trauma only to then have the added trauma of an EMCS anyway. Obviously I would prefer to attempt a natural birth, but we'll see what happens. I have a very small pelvis proportionally and I have always been concerned that this may not put me in good stead for a natural birth, but I will see how it goes over the next few weeks and whether there will be the need for me to make this decision! Thanks again for the informative and useful comment. :)

My DS also never engaged - and he was born vaginally. He did end up in a slightly odd position, looking up rather than down which caused a few issues but they got him out with a ventouse - don't know whether related or not. But in any case my midwife was never concerned re: the lack of engagement and yours still has quite a few weeks to drop in.

Some say labour can be slower to get started as no baby's head putting pressure on the cervix but I went into labour on my due date so not the case for me.

My first baby wasn't engaged at my 38wk midwife appointment (she said I was unlikely to go into labour anythime soon) and then 3 days later my waters went and was scanned at the hospital to show he was then engaged. It did end up as an emcs but it was fine.