As the third trimester comes to an end, there can be a great deal of anticipation and focus on whether or not your baby’s head is engaged.
Honestly, it’s best not to get too stressed about whether your little one’s head is or isn’t engaged.
Most midwives will tell you this is not an indicator of how labor might go.
Baby engaged meaning
If your baby’s head is engaged it simply means the head has moved down into the pelvic brim – the right position for birth.
If the baby is in the right position (head down, chin tucked, back to belly) then this is great. If not, encouraging the baby to come out and reposition is ideal.
Baby engaged symptoms
The following signs suggest a baby has probably dropped into the pelvis:
- A lower belly – a woman’s pregnancy bump looks as if it’s sitting lower
- Pelvic pressure or pain
- Easier breathing
- More vaginal discharge
- Frequent need to urinate
- Back pain.
Contact your doctor or midwife if you have any concerns about these symptoms.
When should the baby’s head engage?
Exactly when your baby’s head engages is completely up to your little one. Yes, your first baby may engage sooner than the second or subsequent.
But it doesn’t mean there’s a problem if your baby’s head doesn’t engage before labor starts.
Even for first-time mothers, babies can engage during labor, as early contractions help to bring the head down lower into your pelvis.
Babies know when it’s time to head down the birth canal and engage, and the vast majority will do it when they’re good and ready.
Trust your body and your baby to work in unison when the time is right.
Can you feel the baby engage in the pelvis?
As you near your due date and your baby’s head drops (or engages), you might feel symptoms ease, or feel a heaviness in your pelvis.
Some women notice pressure on the bladder as the head moves down and engages. The belly might feel sore and they might feel aching in the uterus and the spine.
It’s important to remember that, as with every part of pregnancy, this might not be experienced by every mother.
How to engage the baby’s head in the pelvis
Walking on a daily basis, and doing exercise, are great ways to use gravity to encourage your little one down and help the head engage.
The optimal position for the baby to be in for birth is the left occipito-anterior position (LOA). LOA means the baby is entering the pelvis head down, facing the area between the mother’s spine and right hip.
You can encourage baby into LOA by spending some time each day on your hands and knees, using a cushion to protect your knees. Lying on your left side with your top leg in front of your bottom leg, with the hip and knee flexed is also useful. Use a pillow to support your top leg.
Be sure to read Optimal Fetal Positioning – How To Make Birth Easier for more tips about fetal positioning.
You can also seek body therapies such as osteopathic and chiropractic. Chiropractors should have experience in the Webster technique. Acupuncture can also help to get the baby to engage in the optimal position and help labor preparation.
These therapies can help treat tight ligaments across your abdomen and stomach that could cause difficulty for the baby’s head engagement late in pregnancy.
How long can a baby’s head be engaged for?
Generally speaking, first babies tend to engage from about 34 to 36 weeks. Sometimes, however, the baby’s head is engaged only when labor starts.
If your baby hasn’t engaged by the time you go into labor, it’s likely the power of your contractions will soon push him down. Similarly, if your baby’s head engages early, don’t panic. Many babies engage and then bob out of the pelvis repeatedly before settling down.
Does baby still kick when engaged?
Once the head is engaged in your pelvis, the baby will be even less mobile.
As long as you’re feeling the normal pattern of movement, it’s less important what type of movement it is.
Be sure to read Do All Babies Go Quiet Before Labor? for more information.
Baby head engaged chart
When your baby descends into your pelvis, how far the head has descended is measured by the ‘station’, with 0 station being engagement.
When a baby is at 0 station, its head is resting at what is called the ischial spine (sometimes just referred to as ‘spines’) which is the narrowest part of your pelvis.
If the head is above the spines, he is not yet engaged.
In this case, the measurement will be expressed as a negative, or minus, number. For example, if your baby is 5cms above spines, you would be -5; if your baby is 1cm above the spines, then -1.
Once your baby descends past 0 station, a positive, or plus, number is used. For example, if your baby is 1cm below spines, it’s +1, and so on.
Speak with your midwife, doctor or health care provider and they will explain further.
My baby isn’t engaged; does that mean it’s too big for my pelvis?
Not at all. it isn’t possible to know the exact internal shape of your pelvis.
In the small number of cases where the fetus doesn’t engage – even at 41-42 weeks – it’s more likely he has adopted a tricky position in your pelvis, rather than being too big for your pelvis.
Remember, your baby just might not be ready to engage yet.
If you’re concerned about your baby’s size or your pelvis size, here are two great BellyBelly articles for you to read:
Can you induce labor if the baby is not engaged?
Inducing a baby with a high head can be disastrous. It’s not advised to do stretch and sweeps either.
Inductions increase the risk of fetal distress and, therefore, c-sections for the mother.
If the waters are broken with a high head, cord prolapse is a big risk.
This happens when the cord drops below the baby’s head, and the cord can prolapse through the vagina. This is a medical emergency and can have severe consequences for your baby.
A full-term pregnancy is up to 42 weeks. If you and baby are healthy, there’s no reason to schedule an induction.
Letting labor start on its own gives your little one the best chance at being born on the day she or he decides is a perfect time.
Your baby is putting the finishing touches on his ability to cope with the world on the outside, especially in relation to breathing. Every day in your womb counts. Everything you and your little one go through is part of the journey.
Here’s one statistic, to give you an idea of how inductions can affect the outcome for babies who aren’t ready: if a mother is induced and her baby’s head is high, at -5 station, it increases the risk of a c-section by 70-80%.
Will I need a c-section if baby’s head doesn’t engage?
If you just take a ‘wait and see’ approach, there’s a very low chance you will need a c-section. You’re more likely to have a c-section if you’re induced, as mentioned above.
In a very small number of mothers, the fetus will be in a position too tricky to be born vaginally. This can happen whether your baby is engaged or not.
Ideally, if your baby isn’t engaged, your care provider will attempt to move or rotate the baby into a better position.
When contractions begin, and mothers experience discomfort and pain, bouncing on the birthing ball is one of the things that will help with the baby’s head engagement and provide a way to open the pelvic brim even more.
Most women who have babies that aren’t engaged at the time of labor go on to have healthy vaginal births.