A lot of women want to know how likely it is that a baby will stay head down, or vertex, if it is discovered prior to that point that they were vertex at some point. And the good news is that statistics are in your favor if this is the case for you. Research has shown that at 28 weeks, 25% of babies are breech, or head up, in the abdomen. That is just because they’re smaller and so they have more freedom to move around. But most of them start to figure out that they need to be head down as the pregnancy progresses. And at 32 weeks, 7-14% are breech, and at 37 weeks, or full term, only 3% of babies are breech. So it’s likely for women that the baby will be in the right positions, but there is of course the unlucky 3% that still have a breech baby at that point and the likelihood of them staying in the position that they are in largely depends on what baby it is for you. Because on your first baby the uterus isn’t very stretchy and once the baby plants themselves in a certain position whether that is vertex or breech, they don’t have as much ability to move around in the uterus. But after you’ve already had kids before the uterus is more stretchy and its easier for the baby to move around and they could very well change position from day to day. I’ve seen that happen as a labor and delivery nurse I had a patient who once who was head down at their 37 week appointment, head up at their 38 week appointment, and so when they came in for their 39 week appointment and the baby was head down the doctor hurried and sent her over to the hospital for an induction. And of course we verified again, we did an ultrasound the baby was head down, and as labor progressed things were going well and then I went to go check her at some point and there was no presenting part in the pelvis and so it made me suspicious that the baby had flipped again and we went and got the ultrasound machine and indeed the baby was breech. But this was her 5th baby, and so that can happen after you’ve had more children. Towards the end of the third trimester you’ll notice that at your prenatal appointments the doctor may do what’s called Leopold’s Maneuver which is where they grab really low on the pelvis just above the pubic bone and they’re trying to feel the baby’s head and then they follow the spine up your abdomen and then there should be a little bum resting underneath your ribs, but sometimes they feel a head or suspect that the head is in a different location and if this is the case then they do an ultrasound to verify the baby’s position. A breech presentation may also be suspected when the doctor checks the woman’s cervix and when you check the cervix you can feel what’s on the other side of the cervix, if it’s dilated at all, and hopefully it’s a head on the other side. But if it doesn’t feel like a hard head, or if its suspicious in any way then the doctor, then again the doctor will perform and ultrasound and see what position the baby is in. And if the baby is still in the wrong position when it comes time to deliver then they talk with the woman about options for delivery. These options may include, if the woman’s a candidate, an external cephalic version, where the doctor tries to rotate the baby from the outside. Or it may just be a C-section because a baby cannot safely be delivered in the breech position vaginally. If you have more specific questions about your circumstances talk with your OB provider and they’ll be able to give you tailored information and advice about what to expect. And if you have more questions in the future for me feel free to ask them on our Facebook page at facebook.com/intermountainmoms and recommend us to your friends and family to.

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