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Pelvic delivery occurs when the baby is born in the opposite position than usual, which happens when the baby is in a sitting position, and does not turn upside down at the end of pregnancy, which is expected.
If all the necessary conditions are met, pelvic delivery can be performed safely, but in some cases, such as when the baby is very heavy or premature, or when the mother's health does not allow it, it may be necessary to perform a cesarean section.
Because the baby doesn't turn his head down
The baby may be in different positions throughout the pregnancy. However, around the 35th week, it should be presented upside down, since from that stage of pregnancy, it is already a size that can make it difficult to change position. Some of the causes that can prevent the baby from turning upside down in late pregnancy are:
- Existence of previous pregnancies;
- Twin pregnancy;
- Excessive or insufficient amniotic fluid, which causes the baby to be unable to move, or to move very easily;
- Changes in the morphology of the uterus;
- Placenta prev.
The placenta previa happens when the placenta is positioned in a way that covers the internal opening of the cervix. Learn more about the placenta previa and how to identify it.
How to tell if your baby is sitting
To find out if the baby is sitting or turned upside down, the doctor can observe the shape of the belly and do an ultrasound, around the 35th week. In addition, the pregnant woman may also be able to 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 bladder compression. See other signs that the baby has turned upside down.
If the baby has not yet turned upside down, the doctor may try to turn him over manually, using a maneuver called the external cephalic version (VCE). If, through this method, it is not possible to turn the baby upside down, the doctor should talk to the mother about pelvic delivery or suggest a cesarean, which will depend on several health factors of the mother and the baby's weight.
Also see what exercises you can do at home to help your baby fit.
How the External Cephalic Version (VCE) is made
The External Cephalic Version consists of a maneuver used by the obstetrician, between the 36th and 38th weeks of gestation, when the baby has not yet turned upside down. This maneuver is performed manually by the doctor, who places his hands on the pregnant woman's belly, slowly turning the baby to the correct position. During this procedure, the baby is monitored in order to avoid complications.
What are the risks of pelvic delivery
Pelvic delivery presents more risks than a normal delivery, because there is a possibility that the baby will be trapped in the vaginal canal, which may lead to a decrease in the oxygen supply by the placenta. In addition, there is also a risk that the baby's shoulders and head will become trapped in the bones of the mother's pelvis.
Is it safer to have a cesarean section or a pelvic birth?
As with pelvic delivery, cesarean sections also present some risks for the baby and the mother, such as infections, bleeding or injuries to organs around the uterus, for example. Therefore, an assessment of the situation by the obstetrician is very important, 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.
Most obstetricians recommend a cesarean section for babies in a pelvic position, especially for premature babies, because they are small and more fragile, and have a relatively larger head in proportion to their body, making it difficult for them to pass through if the baby is on his head. up.
Created by: Tua Saúde Editorial Team
Bibliography>
- BERHAN, Y et. al .. The risks of planned vaginal breech delivery versus planned caesarean section for term breech birth: a meta-analysis including observational studies. The British Journal of Obstetrics and Gynecology. Vol. 123. 1.ed; 49-57, 2015
- THE AMERICAN COLLEGE OF OBSTETRICIANS AND GYNECOLOGISTS. If Your Baby Is Breech. Available in: . Accessed on 06 Aug 2020