Pelvic birth: what it is, how it is done and risks

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Pelvic birth happens when the baby is born in the opposite position to the usual, because it is sitting inside the belly during birth. This causes the baby’s feet or buttocks to come out first than the head.

This type of delivery can be done when the baby does not turn upside down towards the end of the pregnancy, which usually happens around 36 weeks of pregnancy. If the baby is not turned upside down between the 36th and 38th week of pregnancy, the obstetrician can perform an external cephalic version, which consists of turning the baby through specific maneuvers in the pregnant woman’s belly. Check out how the external cephalic version maneuvers are performed.

However, if even with the maneuvers the baby does not turn and all conditions are met, breech delivery can be performed safely. Even so, there are some cases, such as when the baby is very heavy or premature, or when the woman’s state of health does not allow it, in which a cesarean section may be necessary.

when is indicated

Pelvic delivery can be indicated whenever the baby is in a sitting position at the end of pregnancy, and there are no contraindications to performing a vaginal delivery See in which situations a cesarean section is indicated instead of vaginal delivery.

However, this type of delivery should only be performed by an experienced medical team, including an obstetrician, neonatologist, anesthesiologist and obstetric nurse, and performed in a hospital environment, so that there are conditions that allow an emergency cesarean section, if necessary.

How is breech delivery performed?

Pelvic delivery should always be done in the hospital, but there are different techniques that the obstetrician can perform:

  • Spontaneous breech delivery: in this type of delivery, the obstetrician does not perform any manipulation technique on the baby, and usually occurs in very premature deliveries;
  • Assisted breech birth: it is the most common type of vaginal breech delivery, in which the baby comes out spontaneously to the navel and then the obstetrician performs maneuvers to help the baby’s arms and head come out;
  • Total pelvic extraction: in this type of breech birth, the obstetrician performs maneuvers from the beginning to remove the baby’s feet first and then the rest of the body. Generally, this type of technique is used in twin births, to remove the second twin baby, which did not reach the cephalic position before birth.

During breech delivery, the baby’s heartbeat should be monitored every 5 minutes, and electronic fetal monitoring can also be performed if necessary. See how the fetal heartbeat is monitored.

How to know if the baby is sitting up

To know if the baby is sitting up or has turned upside down, the doctor may look at the shape of the belly and do an ultrasound around the 35th week.

In addition, the pregnant woman can also perceive when the baby turns upside down, through some signs such as feeling the baby’s legs in the chest or having more urge to urinate, for example, due to greater compression of the bladder. Look for other signs that your baby has turned upside down.

‘Cause baby don’t turn your head down

The baby can be in different positions throughout the pregnancy, however, around the 36th week, it is common for it to be upside down, since from this stage of pregnancy, the baby is already at a size that can make it difficult to change position.

Some of the causes that can make it difficult for the baby to turn upside down in late pregnancy are:

  • Existence of previous pregnancies;
  • twin pregnancy;
  • Too much or too little amniotic fluid, which makes the baby unable to move, or can move very easily;
  • Changes in the shape of the uterus;
  • Presence of uterine myoma;
  • placenta previa.

Placenta previa occurs when the placenta is positioned in a way that covers the inner opening of the cervix. Learn more about placenta previa and how to identify it.

Possible risks of breech delivery

A breech birth is more risky than a normal birth, because there is a possibility that the baby could become stuck in the birth canal or the umbilical cord could become twisted or compressed during delivery, which could lead to reduced oxygen supply, increasing the risk of damage to the body. brain.

In addition, there is also a risk of the shoulders and head getting caught in the bones of the mother’s pelvis, and there is an increased risk of injury to the legs, arms, and may even result in broken or dislocated bones in the baby.

Is it safer to have a cesarean or breech delivery?

Like breech delivery, cesarean section also presents some risks for the baby and the mother, such as infections, bleeding or damage to the organs around the uterus, for example.

Therefore, it is very important for the obstetrician to assess the situation, taking into account the mother’s health status and preferences, as well as the baby’s characteristics, in order to determine the most appropriate method.

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