Until 32 weeks the baby swims freely in the womb, and only at the end of pregnancy should he take a headache. The cause of the wrong position of the fetus can be high activity of the baby, hydramnios or hypochondria, various anomalies of the development of the uterus and so on. By the end of pregnancy a woman in all ways should try to "turn" her little girl. To date, there are many different techniques and exercises. However, even if all the methods were unsuccessful - you should not worry. One way or another you will give birth to your baby - you can not get away anywhere.
The stubborn babies in the womb have always been. On the pelvic presentation our grandmothers learned already during the birth, and nothing - gave birth. Then there were various benefits and pelvic presentation began to be considered pathology, and the births themselves resolved exclusively by the method of cesarean section. Fortunately, the fashion for cesarean passes, and every woman has the right and the opportunity for natural vaginal birth. No, you do not think that we are categorically against the caesarean section. Nobody doubts the advantages of this method of delivery, but it should be used only in extreme justified cases.
Pelvic presentation is by no means the main indicator for cesarean section, although it has its own peculiarities with natural delivery.
Definitely, if at 37-38 week of pregnancy the baby has not turned over, then you will be hospitalized in the obstetric hospital 2 weeks before the expected day of childbirth. Here, and only now, the question of the mode of delivery will finally be decided. Prepare yourself for the fact that you will be examined by the full program, by many specialists and by all means.
Here are the main criteria by which to evaluate the possibility of giving birth to a baby yourself or surgically.
- Age. Although it is customary in our time to give birth to children at any age (medical contraindications practically do not exist), however, doctors say that giving birth to all children is up to 35 years. And if you are 35 or more, you are pregnant for the first time, and the baby sits in your stomach on the pope, then most likely you "prokeserat." There are several reasons for this: the presence of chronic diseases, for example, is almost always an indication for a caesarean section; the course of a late pregnancy can be complicated by late gestosis, edema, elevated blood pressure and other complications. The risk of natural delivery during pelvic presentation of the fetus increases several times. It's unlikely that you and your doctor will want to risk in this case.
- The course of pregnancy. If this pregnancy has been taking place with many complications, then it is possible to appoint a cesarean section, regardless of the presentation of the fetus. Severe gestosis, hypoxia of the fetus, placental insufficiency, overdistension of the head, and if the pelvic presentation is added to all this, then an operation is unequivocally necessary. Do cesarean also with multiple pregnancies, if the first baby in the "wrong" presentation. When choosing the delivery of cash pregnancy are taken into account and previous pregnancies. The final decision is influenced by the presence of abortions, the outcome of previous births. For successful delivery by natural means, the most favorable picture is when the birth is second, and the previous ones had a positive outcome vaginally.
- The state of health of the reproductive organs. For favorable delivery in a natural way, the condition of the cervix is ??important. At an obstetrical survey the maturity is estimated. Ready for delivery, the cervix is ??soft, located in the center of the small pelvis, shortened to 2 centimeters. If on the uterus there is a scar from the previous cesarean section, then with pelvic presentation, a repeated surgical intervention is necessary, because with natural births, the risk of rupture of the uterus along the seam will increase. Indications for cesarean section are also anomalies of development and tumors of the uterus.
- The size of the pelvis. The anatomically narrow pelvis, even with the "normal" position of the fetus, is an indicator for cesarean section. In pelvic presentation on the eve of the forthcoming births, an assessment of the size of the bony pelvis of the woman in childbirth is performed using X-ray neoplasmometry. This method of investigation makes it possible to accurately determine the size and shape of the small pelvis.
- Fruit. If your karapuz sits on the pope, and even weighs more than 3, 5 kg, then you yourself can not give birth to him. A large fetus with pelvic presentation is a direct indication for surgery. The most favorable for natural delivery is the body weight of the fetus from two to three and a half kilograms. Also, when choosing the method of delivery, the condition of the fetus is taken into account. Signs of chronic hypoxia, The shortage of oxygen can aggravate prolonged births naturally.
- Pelvic presentation of the fetus. There are several types of this position of the fetus. Pure gluteal (legs of the baby are stretched up and pressed to the trunk, and the buttocks are attached to the entrance to the small pelvis), a mixed gluteus (the buttocks and the feet of the fetus lie) and the foot. Foot predlozhdenie is considered the most unfavorable and with natural childbirth In this case, various complications are possible: fall of the handle or leg of the baby, loop of the cord, asphyxia.
- Head position. Surgical delivery is indicated by excessive extension of the head, as during vaginal delivery during the passage of the head there can be serious complications: trauma of the brain, cervical spine and other birth injuries.
Caesarean section is also prescribed if there is no effect on births. Well, the persistent desire of a pregnant woman to give birth "under anesthesia" plays almost the main role in choosing the method of delivery of a "sedentary" fetus.
The flow of breech delivery
If, nevertheless, for all indications you can successfully give birth to your baby yourself, then your main task will be psychologically adjusted to difficult births, gain strength, patience and stock up knowledge about the course of labor in pelvic presentation.
As with any natural birth, you expect contractions, attempts and birth of the placenta. However, with pelvic presentation at each stage, there are some nuances that both the parturient woman and naturally the medical staff should take into account.
At this stage of childbirth, the woman in labor is to lie on the side where the frontal back is facing. Otherwise, the probability of complications is high: anomalies of labor, premature discharge of amniotic fluid, prolapse of the fetal limbs and umbilical cord loops, fetal asphyxia, prolonged delivery. In the period of labor, physicians assess the heart activity of the baby and contractions of the uterus. You can enter painkillers and antispasmodics. However, many doctors oppose such methods and adhere to the natural course of labor ("without hands"). It is also possible during this period to prevent the development of fetal hypoxia.
Ejection of the fetus
In pelvic presentation, the baby appears in such an order: birth to the navel, birth from the navel to the lower edge of the blade angle, the birth of the shoulder girdle and handles, the birth of the head. At each stage, specialists monitor the condition of the fetus and the woman in labor. It is important to follow the doctor's instructions to avoid possible consequences. Usually, when the buttocks are erupted, the doctor cuts the perineum. This is done in order to reduce the inevitable discontinuities at the birth of the head and thereby reduce the likelihood of birth injuries. The incision is most often from the center of the perineum to the side.
Obstetrical care may be needed after the birth of the fetus to the level of the navel, because during this period the head presses the umbilical cord. The birth should end within 10 minutes, and if this does not happen, the fetus may die from suffocation. The consequences of oxygen starvation are very unpleasant.
With weak attempts to give birth, intravenously drip oxytocin, which stimulates uterine contractions. To prevent spasm of the cervix, spasmolytic agents (papaverine, no-shpu) are also administered.
The birth of the placenta at birth with pelvic presentation is no different from the births with the "normal" position of the fetus. In this period, special attention is paid to the pulse, blood pressure, the condition of the mother's bladder, monitor the amount of blood discharge from the uterus. The likelihood of early postpartum bleeding is large enough, so for the prevention of injections, which reduce the walls of the uterus.
Recently, more and more doctors are insisting on childbirth without any interventions. Even with this type of delivery, they refuse to "push out" the baby by using stimulant drugs. Birth should occur by progressive movement, and not by stretching, they argue.
Usually the "buttock" babies are no different from their peers. After birth, such babies require consultation of a neurologist. Possible disorders of the nervous system and hip dysplasia. With timely diagnosis and treatment, these problems can be eliminated.
No matter how your baby is sitting in the belly - do not worry about childbirth. After all, your confidence and positive - the basis for successful delivery. Good luck!