SmartParents expert, Dr Christopher Chong an ob-gyn at Gleneagles Hospital, notes that how smoothly your vaginal birth will go depends on the three Ps of vaginal birth. The Ps refers to:
* Passage: The size of your pelvic opening. For instance, how narrow your pelvic bones are compared to the size of the foetus or if you have any history of fractures or surgery.
* Power: The intensity of your contractions, which can be enhanced with medication.
* Passenger: The growth and size of your foetus, plus, other factors such as if you’re having multiples.
Another factor is your foetus’ position in the weeks leading up to labour and delivery. This vital consideration, which affects your risk of suffering birth injuries, can also reduce your chances of a successful vaginal birth.
Generally, once bubba’s head emerges from the birth canal, the rest of his body will be quick to follow, shares Dr Chong.
Dr Chong reveals what you can expect if your baby is in a…
Head-First (Cephalic) Position
WHAT? At full term, most babies will be in this position during labour and delivery with their head facing downwards to the pelvic floor. However, variations to this position may also occur during delivery. Some babies may be delivered with their head facing upwards to the ceiling and others with their head turned to the right or left.
HOW DOES IT AFFECT DELIVERY? If your kewpie faces downwards, you shouldn’t have any serious complications. By the way, your baby’s head is the broadest part of his body to clear the birth canal. Generally, once bubba’s head emerges from the birth canal, the rest of his body will be quick to follow, Dr Chong assures.
If your foetus faces upward, you will be advised to get a C-section as it will complicate delivery. “The pushing process during labour will be longer and often result in assisted delivery — requiring a forceps or vacuum. Of course, this means it’ll also be more traumatic to the foetus and mother, resulting in tears.” Dr Chong adds that a vaginal birth is possible only if the foetus is small and the mum’s pelvis is very large.
Besides up or down, your baby’s head may also be turned to the right or left. However, Dr Chong says you don’t need to be concerned or worried — your baby’s head will turn naturally as they make their way out of the birth canal.
Feet-First (Breech) Position
WHAT? Typically caused by health conditions such as a low-lying placenta, a small pelvis or fibroids, a breech baby comes out with his legs folded at the knees and feet near the buttocks first — in a foetal position. Minor variations in this foetal position includes a frank breech — legs sticking straight up, with feet near the head — and footling breech position — one or both of the baby’s feet is pointed downward, being the first part of his body being delivered.
HOW DOES IT AFFECT DELIVERY? The risks of injuries to mother and baby are definitely higher if you decide to proceed with a vaginal birth if your baby is breech. Your kewpie’s body may be delivered first but their head may get stuck. Dr Chong says that the general guide is to do a C-section for breech babies if there’s an emergency such as when your baby’s legs and buttocks are hanging out of the vaginal opening.
The injury risks are similar for footling breech babies, although there’s an 11 per cent chance of an umbilical prolapse occurring, Dr Chong notes. The condition occurs when the umbilical cord falls out before baby or along with your little one, which can cause distress ― this may even be fatal if your baby is delivered immediately.
“Done too late and there’s a lack of space to turn your foetus and the success rates for the procedure will not be good.”
Horizontal (Transverse) Position
WHAT? During the final weeks of your pregnancy, your gynae would have informed you if your baby is lying in a transverse or horizontal position. This means that your bundle’s head is on the right of your body and feet on the left or vice-versa.
HOW DOES IT AFFECT DELIVERY? Your ob-gyn may try to turn your kewpie “manually”, so that he is in the head-first position. However, this procedure is rarely carried out these days as the womb and any delicate membranes may rupture, Dr Chong states. In the worst cases, it can even cause the umbilical cord to coil around your baby’s neck, causing distress.
Time is also of the essence when it comes to turning your baby. Dr Chong cautions that if it’s done too early, it can trigger labour and result in a premature birth. “Done too late and there’s a lack of space to turn your foetus and the success rates for the procedure will not be good.” Because of these risks, your ob-gyn will normally advise you to have a C-section.
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