Quick ? about baby positioning — The Bump
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Quick ? about baby positioning

During labor, can a doctor accurately check baby positioning (not just breech) accurately without u/s?  Never got very far with DS, so don't know completely how that works during the process.  Is it something most practitioners do as routine, or something you'd have to ask about?
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Re: Quick ? about baby positioning

  • Theoretically, they can tell the position by feeling the fontanels on the baby's head or by feeling the body parts in your belly, but in reality I think that can be difficult to do.  U/s can be used to tell the baby's position during labor and it has less room for practitioner error, from my understanding.

    It seems like a lot of doctors don't really check the baby's position or they can't do it accurately.  I know that was certainly the case in my labor.  It's like some of them assume that if the baby is head down, you'll be able to push it out lying on your back, or you'll just have a c/s. 

    I wanted to make sure that would not be the case this time so I asked my doctor right off the bat about how he would handle a malposition.  He talked about things like changing my position for both labor and pushing, manually rotating the baby with forceps if needed, and just letting me have more time to push.

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  • I agree with PP.  Theoretically they can feel and tell how baby is positioned, but it is sort of a guessing game.  I mean they can be wrong too.  I know when I was in labor with DD, no one checked her position (although the midwife did mention something about if she had she would have tried to move her hand since I pushed her out with her hand next to her head).

    I think I'd ask about it if you are concerned.

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  • Technically they can, as PP poster said. When I went with a client who was having back labor, I asked the nurse if she could tell at all if the baby was OP. That was the major issue with DD, so it will always be at the back of my mind at births. Anyway, she said,"no, they don't look for that, they are just concerned about whether or not the baby is head down." It pissed me off since I think I had signs of an OP baby that they should have noticed and could have checked, it just confirmed to me that they don't care, when proper positioning could help take care of so many issues.
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  • imageSoxChamps:
    Technically they can, as PP poster said. When I went with a client who was having back labor, I asked the nurse if she could tell at all if the baby was OP. That was the major issue with DD, so it will always be at the back of my mind at births. Anyway, she said,"no, they don't look for that, they are just concerned about whether or not the baby is head down." It pissed me off since I think I had signs of an OP baby that they should have noticed and could have checked, it just confirmed to me that they don't care, when proper positioning could help take care of so many issues.

    Ugh exactly.  I think fetal positioning should be an important part of what OBs pay attention to during labor.  There are studies showing that the cesarean and morbidity rates from OP position can be significantly reduced when OBs recognize the signs of OP position and manually rotate the baby.  I have also read somewhere that OP position is the factor behind 12% of cesareans for labor dystocia.  But the mindset in L&D wards seems to be if the baby is head down, it's all the same and if they don't come out easily, we'll just section.

    I had very obvious signs of a malpositioned baby and my OB didn't figure it out until she cut me open.  My husband remembers hearing her say "oh well that explains it!"  Gee, maybe you could have done your job and figured that one out before you sliced my abdomen open and scarred my uterus.  Thanks.

    (Yes I'm bitter) 

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  • When I went to the hospital to have my son I wasn't sure about being in labor at that point but I was very uncomfortable and having contractions. The nurse checked my cervix and all that and when she checked again she said something was different and she thought the baby had turned breech. She sounded pretty sure of herself but got an u/s machine to check her suspisions. she was right.

    I think they can tell how baby is positioned for the most part and if they have any question they would do a quick u/s.

  • imagejessicaeakright:

    When I went to the hospital to have my son I wasn't sure about being in labor at that point but I was very uncomfortable and having contractions. The nurse checked my cervix and all that and when she checked again she said something was different and she thought the baby had turned breech. She sounded pretty sure of herself but got an u/s machine to check her suspisions. she was right.

    I think they can tell how baby is positioned for the most part and if they have any question they would do a quick u/s.

    I'm guessing it's a lot easier to tell the difference between breech and vertex presentation than it is to tell whether a vertex baby is anterior vs. posterior, asynclitic, face presentation, etc.  

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  • imageiris427:
    imagejessicaeakright:

    When I went to the hospital to have my son I wasn't sure about being in labor at that point but I was very uncomfortable and having contractions. The nurse checked my cervix and all that and when she checked again she said something was different and she thought the baby had turned breech. She sounded pretty sure of herself but got an u/s machine to check her suspisions. she was right.

    I think they can tell how baby is positioned for the most part and if they have any question they would do a quick u/s.

    I'm guessing it's a lot easier to tell the difference between breech and vertex presentation than it is to tell whether a vertex baby is anterior vs. posterior, asynclitic, face presentation, etc.  

    totally agree!  A butt is soft and a head is hard.  feet or fingers are pretty obvious too I would think, but a head feels like a head and I think it is probably harder to tell exactly what position the baby is in.  I have a girlfriend who was told her baby was OP.  She had a c/s and baby was anterior.

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  • I don't believe so. I was told that DD was in "launch position", head down and ready to go, from the time I was 35 weeks till the end. I was being seen twice a week due to an excessive amount of BH contractions.

    I went into labor naturally, labored for 8 hours, then when the doctor shift change happened at 8 am and they checked me, they poked her right in the butt because she was breech. They had to rush me into a c-section because I was already very close to delivery. The risks of c-section weren't explained to me, I was given no time to prepare, and I had a horrible reaction to the medication they gave me to stop my contractions. It also turns out she was breech for weeks, and it had given her hip dysplasia (which is fine now, but still, there's nothing like having to strap your newborn into a brace every day for 3 months, her screaming every single time because she hated it so much).

    I was seen by 6 different doctors in the last weeks of my pregnancy, and they all told me the same "launch position" line. Next pregnancy, I am demanding an ultrasound in my last trimester to check position. No more taking chances.

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