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Baby does not turn head down. Why is the baby in the wrong position? Let's make a revolution! Breech exercises

At the beginning of pregnancy, the embryo is located in the uterus with its head up, that is, as if “sitting on the priest”. Normally, by a maximum of 36 weeks of gestation, it should roll over. If this does not happen, then they talk about breech presentation. Sometimes the baby rolls over just before birth.

The position of the baby in the uterus, head down, is best for his birth. Since the head is the widest part of the fetus, it is better if it is born first, and then the rest of the body.

Breech presentation itself is not dangerous, but creates additional problems during childbirth. The probability of prolapse of the umbilical cord, leg or handle of the fetus increases, the birth of the head is difficult, which can even get stuck in the birth canal.

Types of breech presentation

  • Gluteal - the legs of the child are bent at the hips and pressed to the body, the knees are straight, the lowest part is the buttocks. Occurs in 65% of cases, most favorable for natural childbirth.
  • Gluteal leg: hips and knees bent, legs crossed. Occurs in 25% of cases.
  • Foot - one or both legs are extended at the thigh. Occurs in 10% of cases.

Childbirth in breech presentation is considered dangerous and risky by obstetricians, so they try to make such mothers. Only under very favorable circumstances can the doctor decide to give birth naturally, but even in this case, the operating room must always be ready.

Why does the child not want to roll over?

Visible causes of breech presentation can be:

  • premature birth before 36 weeks, since at this time the baby has not often rolled over;
  • , and : often one twin is in the head presentation, and the other in the pelvic;
  • oligohydramnios or polyhydramnios: in the first case, the fetus has too little space to roll over, in the second, on the contrary, there is a lot of space, and it tumbles back and forth;
  • problems with the uterus: fibroids, abnormal structure - prevent the baby from turning head down;
  • stretched and weakened by previous pregnancies uterine muscles;
  • problems and anomalies in a child, such as malformations, Down syndrome, anencephaly, hydrocephalus, etc.

In many cases, in healthy mothers and babies, the cause of breech presentation remains unknown.

Signs of breech presentation

Sometimes experienced and sensitive mothers can determine that the baby has already turned over by his movements in the uterus. The legs begin to rest against the very top of the abdomen, under the ribs and diaphragm, and the hiccups shift down.

An experienced doctor can make a conclusion after examining and probing the abdomen, but in most cases the diagnosis is made only after ultrasound. At the same time, it is important to examine the uteroplacental blood flow with the help and check if there is an entanglement of the umbilical cord.

In some cases it may be necessary amnioscopy- examination of the fetus through a tube inserted into the cervix. This method is unsafe, it can lead to damage to the membranes and premature rupture of amniotic fluid. Therefore, it is resorted to only in extreme cases, when the health or life of the child may be in danger.

Features of children with breech presentation

These children are at high risk. During childbirth, they more often (but by no means always !!!) suffer from a lack of oxygen ( hypoxia) up to its complete absence ( asphyxia).

Due to the non-standard position in the birth canal, they are more likely to receive a birth injury, and therefore, neurological disorders. Such children are more prone to dysplasia (displacement) and congenital dislocation of the hip joints.

In order to identify possible violations at the earliest possible time, they are recommended to do an ultrasound of the brain, an ultrasound of the hip joints and internal organs, as well as a study of cerebral blood flow after childbirth.

Although breech presentation (buttocks down) is common throughout pregnancy, approximately three percent (3%) of babies remain in this position for the rest of their term. Such cases are called breech presentation and are at an increased risk of developing certain problems, such as hip dysplasia and oxygen starvation of the brain during childbirth. Various methods are used to naturally rotate a breech presentation baby into a birthing position (known as cephalic presentation). To rotate a breech baby, follow the guidelines below (with the consent of your doctor) from 30 weeks of pregnancy onwards.

Steps

Part 1

Application of exercises (from 30 to 37 weeks)

    Try leaning back. The posterior tilt is the most widely used exercise for breech presentation fetal rotation. It helps the baby pick up his chin (known as flexion), which is the first step in turning over.

    Perform knee to chest exercise. This exercise uses gravity to force the baby to roll over into the correct birthing position.

    Perform a forward bend over (exercise "mom upside down"). This exercise is similar to the knee-to-chest exercise, but a little more extreme.

    Go to the pool. Swimming and doing squats and flips in the pool can help your baby roll over into a head-down position on their own. Try these exercises in the pool:

    • Squat to the bottom of the pool at depth, then push off and pull your arms up as if you are tearing the surface of the water.
    • Just by swimming in the pool, you can encourage your baby to move (and this can make you feel really good during the last weeks of pregnancy). The front crawl and breaststroke are said to be particularly effective for this purpose.
    • Perform front and rear flips at depth. This will relax the muscles and make it easier for the baby to roll over on their own. If you are good at balance, you can try getting into a handstand position and holding it for as long as you can hold your breath.
    • Dive in. Dive into the pool while gently supporting the baby's head in the pelvic area. It is believed that weightlessness and the rapid movement of water help the child roll over on their own.

  1. Pay close attention to your posture. In addition to doing special exercises that encourage the baby to roll over, it is important to pay attention to your posture in everyday life, as this affects the movement of the baby.

    • To clarify, correct posture provides the maximum available space in the uterus, so that the baby can independently turn into the correct position. For perfect posture, follow these guidelines:
    • Stand straight with your chin parallel to the floor.
    • Relax your shoulders. If you stand up straight and hold your chin properly, your shoulders will straighten out naturally. Don't take them back.
    • Pull in your belly. Don't stand with your belly out.
    • Pull up your buttocks. The center of gravity should be on your hips.
    • Put your feet right. Stand with your feet hip-width apart and evenly distribute your weight on them.

    Part 2

    Application of alternative methods (from 30 to 37 weeks)

    1. Apply hot and cold. Applying something cold to the top of the womb and something warm to the bottom of the womb can encourage your baby to move away from feeling cold towards warm, rolling over into the correct position.

      • To do this, place an ice pack or a pack of frozen vegetables on top of your belly, near your baby's head. Hopefully baby will start to shy away from the cold and turn around to find a warmer, more comfortable position.
      • Using an ice pack in the tub with the lower abdomen submerged in hot water is a great way to apply this technique, as the baby will gravitate towards the heat. Alternatively, you can place a heat pack or heating pad on the lower half of your abdomen.
      • This method of heat and cold is completely safe, so you can use it as often as you like and for as long as you like. Many women prefer to use heat or cold packs on their belly while doing a posterior tilt.

    2. Use sound to make the baby turn around. There are a couple of different ways to use the sound, relying on the child addressing the sound and thus assuming the correct position.

      • One popular way is to play music to your baby by placing headphones on the lower abdomen. You can download online music specially created for unborn and newborn babies, from light classical music to lullaby versions of your favorite soothing melodies.
      • Alternatively, your partner could put their mouth on your lower abdomen and talk to your baby, making him move towards the sound of his voice. It's also a good way for your spouse to bond with the baby.

    3. Consult a chiropractor experienced in the Webster Method. The Webster Intrauterine Pressure Method - or simply the Webster Technique - was developed to restore normal pelvic balance and function, and is believed to help turn the baby into the correct position on its own.

      Consider the cauterization method. Moxibustion is a traditional Chinese method that uses the burning of herbs to stimulate acupressure points.

    4. Try suggestion. Some women have successfully rotated a breech baby with the help of a trained hypnotist.

      • Hypnotherapy typically uses a two-pronged approach to turning the fetus. First, the mother will be put into a state of deep relaxation. This will help relax the pelvic muscles and expand the lower part of the uterus, helping the baby turn.
      • Second, the mother will be made to use a visualization technique to visualize the baby rolling over in the correct way.
      • Ask your primary care physician for the name and number of a trusted hypnotherapist in your area.

22.02.2012 15:07

The position of the child in the uterus with the buttocks or legs down after 34 weeks of pregnancy, which occurs in 5% of the total number of births, is called pelvic and is now considered a certain deviation from the normal course of pregnancy and childbirth.

I must say that until 1985, breech presentation was considered physiological and childbirth in the vast majority of such cases was carried out through the natural birth canal. However, statistics show that the percentage of complications during childbirth in the breech presentation is higher, so today in Ukraine this position of the baby is one of the indications for a caesarean section.

Breech presentation is divided into gluteal And foot .

Buttock, in turn, is either purely gluteal(in which the buttocks are presented to the entrance to the small pelvis, the legs, bent at the hip joints and unbent at the knee, are extended along the body), or mixed gluteal(when the buttocks are facing the entrance to the mother's pelvis along with the legs bent at the hip and knee joints).

Among the foot presentation, there are full foot(in which both legs are presented, slightly extended at the hip and knee joints), incomplete foot(when one leg is presented, unbent at the hip and knee joints, the other is bent at the hip joint and lies higher) and knee(in which the bent knees of the child are presented).

Causes of breech presentation:

Reduced tone of the uterus (in this case, the ability of the uterus to change the position of the fetus in response to irritation of its walls is reduced).
- increased fetal mobility in polyhydramnios, premature pregnancy, multiple pregnancy;
- narrow pelvis, placenta previa (its location on the path of the fetus moving along the birth canal), too large size of the fetal head;
- oligohydramnios, anomalies in the development of the uterus (this limits the mobility of the fetus in the uterus).

If we consider pregnancy not only from a physiological or medical point of view, then among the reasons for the breech presentation of the child is the subconscious desire of one or both parents to have, for example, a son at the time when the daughter is due to be born (or vice versa). The child, of course, feels the experiences of the parents and does not want to be born without meeting their expectations. In addition, in this way the baby gives parents a sign of their disagreement with their decision. For example, about the place of his birth.

How to turn the baby in head presentation?

1. Independently or with the help of a husband who directs the thoughts of his beloved in the right direction. Mom closes her eyes, sitting comfortably or lying down, goes inside herself and asks the child how he feels and why he does not roll over. A woman concentrates as much as possible on the child and her own experiences, pronouncing her thoughts aloud - perhaps she is afraid of the prospect of childbirth in a breech presentation or caesarean section? Relaxing and allowing yourself to share your experiences, you can “persuade” the baby to roll over, “explaining” to the baby that it will be better for both him and his mother.

2. It is known that being in the womb, the child is able to respond to manifestations of maternal tenderness, for example, clinging to her hands from the inside. Through tactile contact, the mother establishes a connection with the unborn baby. It is important to communicate with the baby in this way for about 10-20 minutes daily at the same time of day, and after a week or two you can bring the baby to the desired position, teaching him to move after his mother's hands.

3. You can also use the baby's natural curiosity. To do this, the included flashlight is leaned against the mother's tummy in the place where the child's head is, and then, while talking, they slowly hold the flashlight to the side and down, dragging the baby along. This also includes sound methods, when, for example, a bell is attached to mother's clothes at the very bottom of the tummy. And while the woman is busy with household chores, the sound of the bell entices the baby to roll over into the head presentation.

4. Acupuncture is quite safe for pregnant women, provided that the sessions are conducted by an experienced specialist. Influence on certain meridians can also contribute to the coup of the baby.

5. You can help the child roll over into head presentation with the help of exercise:

The inverted headstand and birch poses are considered one of the most effective, however, they are only suitable for trained women.

- "Half-bridge": lying on your back, bend your knees and raise your pelvis by 30-40 cm. You can grab your ankles with your hands or, if it's hard, throw your legs over your husband's shoulders. Some people find it more comfortable to put pillows under their lower backs. The knees, pelvis and head should be on the same line. You need to stay in this position for 10-15 minutes. In this position, the child has space for movement - it is likely that the baby will take advantage of this. Exercise is performed at least 2 times a day on an empty stomach.

- "Pose of the cat": get on all fours, back straight. We bend the back (the cat is “kind”) while inhaling, hold our breath for 10 seconds, then with an exhalation we round the back, lowering our head (the cat is “evil”) and again hold our breath for 10 seconds. Repeat exercise 5 times.

Rolling from side to side on a hard surface. The pregnant woman lies on the floor for 3 to 10 minutes on one side, then the same amount on the other side and comes back. Such turns should be performed before meals 2-3 times a day for approximately 40-60 minutes. It is recommended to sleep on the side where the head is displaced.

The effectiveness of such exercises, according to various estimates, is about 75%.

Another option for an effective exercise for turning a child into head presentation can be viewed here:

External (obstetric) coup of the fetus

Sometimes exercise doesn't work. In this case, it is sometimes recommended to make a prophylactic external rotation, which is carried out at a gestational age of 34-37 weeks in an obstetric hospital. Before turning, the mother is injected with agents that relax the uterus. The task of the doctor is to turn the child over, pressing on his head and pelvis through the mother's abdomen. The rotation is carried out under ultrasound control. The doctor makes a maximum of 3-4 attempts.

This is not an easy procedure, and it is not suitable for every pregnant woman. There are many contraindications to external rotation:

  • scar on the uterus;
  • the threat of termination of pregnancy;
  • obesity;
  • the age of the primipara is more than 30 years;
  • infertility or miscarriage in history;
  • preeclampsia (toxicosis);
  • placenta previa;
  • anomalies in the development of the uterus;
  • entanglement of the umbilical cord;
  • oligohydramnios or polyhydramnios;
  • narrow pelvis;
  • severe extragenital diseases of the mother;
  • pregnancy with the help of assisted reproductive technologies.

External rotation is a procedure fraught with a number of complications, including placental abruption, premature birth, deterioration of the fetus. External rotation is effective in about 65% of cases, after which almost all births occur through the natural birth canal. But in general, due to the large number of contraindications and possible complications, external rotation in Ukraine is very rare. Although in other countries this is a more common practice.
If it is not possible to turn the baby into head presentation at 38 weeks, you will be offered hospitalization and a planned caesarean section at 39 weeks of gestation. However, there are cases when the baby, for unknown reasons, rolls over a day or two before birth, and you should not take away this opportunity from him: the scalpel will not run away anywhere.

With the onset of labor, upon admission to the hospital, the general condition of the pregnant woman and the fetus is assessed, and, taking into account the course and outcome of previous pregnancies, the method of delivery is selected and a plan for the upcoming birth is drawn up.

If you are healthy, you have good labor activity (strong contractions with a clear interval), a medium-sized (up to 3500 g) fetus in the breech presentation, then an experienced doctor will try to take a natural birth, which often goes quite successfully. If there is a large fetus, weakness of labor, entanglement of the umbilical cord and other complications, then we will talk about caesarean section.

Which caesarean section is better: planned (before labor) or emergency (during childbirth)? It is believed that the second is preferable, since the child is born when he is ready for this (physiologically mature), and the woman recovers better and faster after childbirth.

And remember: many negative consequences of a not very successful birth are healed by your love and care for the child!

For 9 months, the baby grows inside the uterus. Every day it gets bigger. At first, the baby moves freely in the uterus, changes position many times a day. But as the space for movement grows, there is less and less space left, it is already much more difficult to roll over. On an ultrasound scan performed at 27-29 weeks, the doctor establishes the presentation of the fetus, that is, its position in the woman's abdomen.

By nature, it is arranged in such a way that by the end of pregnancy the child is located in the uterus with his head down, towards the birth canal. In 95% of cases, children take the correct position. This makes it easier to move through the birth canal. The head, larger in comparison with the body, facing down, is born first and opens the way for the body. This is the most comfortable natural position.

In 5% of cases, pregnant women are diagnosed with breech or transverse presentation. That is, the fetus does not turn over to the correct position. Childbirth in this case can be very difficult, sometimes for this reason they resort to a caesarean section. Today, much attention is paid to this problem. There is a special gymnastics - exercises to help the child roll over head down.

Causes of malposition of the fetus

Instinctively, the child takes the correct position by about 36 weeks. If it doesn't, then something is blocking it. The reasons may be:

  • Narrow pelvis of a woman.
  • Uterine tone, high tension.
  • Excessive relaxation of the muscles of the uterus, for example, due to many pregnancies. In view of this, the fetus has a lot of room to move.
  • The length of the umbilical cord and/or the position of the placenta is such that the baby cannot physically roll over. No manipulation can force the fetus to change its position.
  • The habit of a pregnant woman to sleep in one position from evening to morning every night. The child instinctively finds a comfortable position for him and gets used to it. He sleeps with his mother, practically not moving, all night. If this happens 6-8 weeks before delivery, when it is already difficult to change position, the fetus remains in its usual position, often upside down.
  • Wrong nutrition. If a pregnant woman eats a lot at night (especially for fatty, protein foods), the fetus may feel so bad that it will turn its head up.
  • Insufficient mobility of the expectant mother.
  • Strong feelings, stress.

If the baby is not positioned correctly before 34 weeks, there is no need to worry. He still has enough time to roll over easily. But even after 34 weeks, it is quite possible to help the fetus change its position.

If the ultrasound revealed the entanglement of the baby with the umbilical cord or the position of the placenta, which does not allow the child to change position, there is no need to even try to do something. Most likely, in order not to harm the little one, the doctor will recommend a caesarean section. You should not be afraid of this. Women tend to tolerate surgery quite easily, and newborns avoid the trauma and complications that could occur during natural childbirth due to the head-up position.

With a breech or transverse presentation of the fetus, the expectant mother should, first of all, change her habits:

  • eat right, consume more vegetables and fruits;
  • exercise sufficient physical activity, walk, breathe more air;
  • do special exercises for pregnant women;
  • pay attention to sleep: its duration, posture.

If you have a habit of sleeping in the same position all night, you need to change it. Before rest, you need to lie down in several comfortable positions for at least 5 minutes. Every night you should try to fall asleep in different positions, this will make the child move. In search of comfort, he must take the right position.

Exercises

The coup of the fetus is facilitated by special gymnastics. But you don't have to do anything on your own. First, you need to consult a specialist. There are contraindications for gymnastics:

  • placenta previa (it blocks the exit in the uterus);
  • risk of miscarriage;
  • individual contraindications.

Some exercises are contraindicated for preeclampsia, problems with the heart, liver, kidneys. The doctor will recommend a suitable complex. Before gymnastics, you can not eat for 2 hours. Exercises cause the movement of amniotic fluid, an increase in the activity of the child, and change the tone of the uterus.

Trained women who practiced yoga before pregnancy can resort to yoga to turn the fetus upside down. Here, too, there are nuances. The best result is achieved with the so-called inverted postures, head down. Women who have never practiced yoga should not even try, you can greatly harm yourself and your child.

You can go in for sports after consultation with a specialist under the supervision of an experienced instructor. A special warm-up is also important, which will prepare you for the implementation of the main exercises.

For example, untrained pregnant women are advised to do a half bridge. Lying exercise is performed. Under the lower back, it is necessary to put a pillow, blankets so that the pelvis is about 20 cm above the level of the bed. The shoulders are at the bottom. You need to lie in this position for 20 minutes. You should start with a few minutes, increasing the time every day. Do 3-4 times a day.

This position gives the child some freedom, it becomes easier for him to move in the uterus. Instinctively, he must find the right position - upside down.

If the uterus has an increased tone, doctors recommend performing the exercise by I. F. Dikan. You need to lie on your right side, spend ten minutes on it. Then roll over to the left, and stay on it for the same amount of time. Repeat 4 times. Do the same three more times a day.

If the tone of the uterus is low or normal, the V.V. Fomicheva complex is used. It is quite intense, causes contractions of the abdominal muscles, from which the tone of the uterus grows. It is shortened, which helps to move the child to the desired position.

First you should warm up (walk in place, leaning on different parts of the foot). Then it is recommended to do the exercises slowly:

  • From a standing position with legs slightly apart, bend to the left, straighten up, then also to the right, five times. Then the same back and forth. Pay attention that the inclinations are performed on the exhale, straightening - on the inhale.
  • Standing raise your arms to the sides (on inspiration). Exhale and close them in front of you, turning to the right, then repeat the same to the left. Do four sets.
  • Standing near the support, raise the bent leg to the side, without touching the stomach. Five times with each leg.
  • Perform standing. The right leg is on a support (chair), the left leg is on the floor. Inhale, raise your arms to the sides, exhale, turn your upper body and pelvis outward, lean forward. Three times right and left.
  • Leaning on your knees and palms, raise your legs back in turn, five repetitions each.
  • Lying on your side, inhale, bend the upper leg, exhale - unbend. Five reps. Then, from the same position, describe circles with your foot. Do four repetitions.
  • Exercise cat. Leaning on your knees and palms, tilt your head down, while arching your back up, inhale. Perform slowly. Then raise your head, bend your lower back down, exhale. Repeat ten times.
  • Leaning on your knees and palms, straighten your legs, raise the pelvic area up (it turns out the letter "L"). Do five repetitions.
  • Take the half-bridge position. Inhale, tear the lower back off the floor up, exhale, lower. Run four times.

At the end, slowly breathe, calm down.

When the tone of the uterus is uneven, the complex of E. V. Bryukhina is performed twice a day, aimed at relaxing the abdominal muscles. All exercises are done in the knee-elbow position:

  • Inhale slowly, slowly exhale. Repeat six times.
  • Inhale, lower the torso down, bending your arms, exhale, rise up. Perform five repetitions.
  • Straighten your leg, lift it up, take it to the side, down, touch the floor, put it on your knee. Four repetitions with each leg.
  • "Cat". Ten times.
  • Kegel exercises. It is necessary to strain the muscles of the vagina and anus.

In 76% of cases, exercises help turn the child upside down.

Breech presentation refers to the position of the child in the womb with the buttocks or feet down. The doctor can feel this position of the child through the lower part of the uterus. There are two types of pelvic presentation: gluteal and foot.

In the gluteal proposition, the child turns to the entrance to the small pelvis with the buttocks, while his legs are bent at the hip joint and extended along the body. A mixed breech presentation may also occur, in which not only the buttocks, but also the legs are located towards the exit from the uterus.

Foot presentation of the child may be incomplete and complete. With a full breech presentation, both legs of the baby are located at the entrance to the small pelvis. If the presentation is incomplete, then only one leg, unbent at the joints, is located right at the exit from the uterus, and the second, bent at the hip joint, is located above.

Variations in breech presentation depend on the position of the baby in the uterus. If the child turns with bent knees, then a knee breech presentation occurs. Having turned in the uterus across, the child's shoulder is adjacent to the exit from the uterus, creating a brachial presentation.

Causes of breech presentation

The most obvious cause of breech presentation is preterm labor. For up to 36 weeks, the child was not yet ready to be born and therefore.

Also, if the expectant mother is expecting more than one child, but several, the likelihood of breech presentation is very high. Often, one of the twins takes the correct head presentation, but the other may turn around.

A large or small amount of amniotic fluid can provoke a foot or breech presentation. When there is not enough water, the baby becomes too crowded in the uterus and cannot roll over. And in the case when there is a lot of water, he simply begins to swim in them and does not have time to take the necessary position in time.

If the woman's body did not have time to recover from previous births, then the muscles of the uterus may not be able to cope with the movements of the child and will not be able to fix it in the desired position. In 80% of breech presentation, it is very difficult for gynecologists to determine its cause. It occurs in only 5 women out of 100.

Why is breech presentation dangerous?

Modern medicine has proven that there is no serious danger in breech presentation. Of course, natural childbirth is a little more difficult, but this has practically no effect on the health of the mother and child.

The most common danger that occurs with a breech presentation is throwing back the baby's arms. But this happens in the case of improper obstetric benefits. Childbirth should take place as naturally as possible so as not to harm the child.