Baby in Vertex Position During Labour And Delivery – What It Means

During the last few weeks of pregnancy, most babies get into the right position for the delivery. But then there are some babies who may not get into the vertex position (the head-down position). If a baby is in the breech position, the pregnant woman may try her best to turn the baby into the vertex position, but if the baby doesn’t get into it, a caesarean section is considered to deliver the baby. If you’re pregnant, your doctor must have discussed the vertex position with your baby. If you want to know about the vertex position, read this article.

What Is Vertex Position?

The vertex position is the position, a baby needs to be in when you give birth vaginally. Most babies get into the head down, or vertex position, at around 33– 36 weeks, when you get closer to the delivery date. Even babies who are in the breech position until the last weeks can get into the vertex position last minute. But once the baby is low enough in the pelvis region and is head down, they do not change.

Although the baby’s head can take different and more specific positions during the actual process of delivery, if the baby is in the vertex position in pregnancy, then you have nothing to worry about.

Giving Birth in Vertex Position

As the baby moves through the birth canal during the delivery, they will actually do a lot of turning and twisting to fit through, even though they are head down at the beginning of the delivery. Unlike other mammals, where the babies simply drop straight through because of the wide and straight birth canal, the ratio of the space in the birth canal and the human head is a very tight squeeze.

In order to fit through the birth canal, the baby will have to turn and flex their head in various positions. When the delivery begins, most babies usually get into the vertex position and will move down to the opening of your vagina. You will have to push until the baby’s head is ready to come out. Short breaths can be taken to help the head move out slowly and safely. A slow birth can also help stretch the muscles and skin around the vagina during the delivery.

Are There Any Risks for the Baby in the Vertex Position?

A baby in the cephalic vertex presentation, as it moves through the birth canal, may experience a few complications.

• For instance, babies that are considered to be on the larger side may face difficulties when passing through the birth canal even if they are in the head-down position.
• Babies are considered ‘macrosomic’ when they are over 4500 grams (9 pounds and 4 ounces). ‘Macrosomic’ is simply a medical term for larger babies. These babies, even though they are in the head-down position, are more likely to get their shoulders stuck during delivery.
• Depending on the size and the age of the baby, the doctor will figure out an individualized birth plan for you.

How to Get the Baby into the Vertex Position

There are various exercises an expecting mother can do to help the baby get in the vertex position. Though this does not mean that your baby will definitely get in position, these exercises can increase the possibility. Here are a few exercises to help your baby get in position:

• While you are sitting down, use a cushion or a pillow so your bottom is higher than the knees.
• Once in a while, you can do some front tilts by sitting on a big exercising ball.
• Get on your knees on the floor. Lower your chest down slowly to make sure that the hips are at their highest point for around 15 minutes.

Remember that keeping your hips higher than the knees will help the baby settle easier. However, do not stay in a position for too long, and make sure you move regularly.

Can a Baby Turn From Vertex Position During Delivery?

Some pregnant women, whose baby is already in the correct vertex position, might still be at the risk of giving birth to a baby who turns during the last few minutes.

• Pregnant women with polyhydramnios (extra amniotic fluid) are considered to be at a higher risk for having a baby turn from vertex position to breech at the last minute.
• The breech position is when the baby tries to come out bottom-first, feet-first, or even both.
• At 36 weeks of pregnancy, if your baby has not changed to the vertex position and is still in the breech position, then your healthcare provider might offer you an ECV (external cephalic version).
• This is a procedure in which the doctor tries to turn the baby to a headfirst position by putting pressure on the uterus.
• It is a safe way to change the position of the baby, though you may feel slightly uncomfortable.

ECV will not be done if your water is broken, if the baby has an abnormal heartbeat, if you had recent bleeding from your vagina, or if there is more than one baby inside you. The breech position is rare and it happens only in about 4% of births. If the ECV does not work, then you will either have a vaginal breech birth or a C-section (cesarean section). If this is the case, then you can talk to your healthcare provider about the risk of the baby turning and ask her if anything can be done to make sure your baby stays in the right position until labour.

Ask your healthcare provider if they are confident that the baby inside you is in the right position for delivery. Most doctors usually use their hands to check what position the baby is in. This procedure is known as Leopold’s manoeuvre. Doctors use physical landmarks to feel and understand the position of the baby. But, if the doctors are not able to accurately determine the baby’s position using this procedure, then they will schedule an ultrasound to accurately determine the position.

When you are closer to your delivery date, be sure to have an honest discussion about what position is best for you and your baby with your healthcare provider, no matter what position your baby is in. Your doctor will surely know what is best for your situation and act accordingly.

Also Read:

Stages of Labour & Childbirth
Interventions during Labour and Childbirth
Positions to Try during Labour and Childbirth