Positions of the baby in pregnancy

Patient

Q: Hi, i am 36 weeks and my midwife worries i may have a breech baby, she is sending me for a scan to make sure but i am very sacred as it is my first baby and i do not know aht to do what to expect. what other options are there to deliver the baby other that caesarian.

Doctor

A:   In a routine pregnancy, we prefer the baby to come out "head first".  An ultrasound can show us the current position of the baby and will likely be repeated to see if the position changes.
A "feet first" position has the risk of strangulation on the umbilical cord for the baby and a scheduled cesarean is usually advised.
A "breech" position is one where the baby is lying sideways and may come out bum first.  This is a very complicated delivery with many risks to the baby and mother.  If a followup ultrasound reveals the baby has not moved from the breach position, a schedule cesarean is the safest option.  Your other option would be to attempt a vaginal delivery and then have an emergency cesarean if the vaginal delivery is unsuccessful but this again is very risky and I do not know of any physicians who would recommend this. I also do not know of any midwifes who would attempt this outside a hospital setting with full monitoring.

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