Bubs may not engage - may need c-section

[Fee]

I had an OB appointment yesterday afternoon.

He felt my tummy ... he is concerned that the baby may not engage / fit through my pelvis. He's going to check again in 2 weeks time. He said he doesn't want me to worry but he just wants me to be aware that I may need a c-section.

He said that it feels like the baby's head is just resting on my pelvis but that the head won't fit/drop down into my pelvis (if that makes sense).

But there's no use worrying yet. All may be good in two weeks. We'll just have to wait and see.

Does anyone have any info on babies not engaging? I assume if I need a c-section then one would be booked in. That is, I won't even get to go into labour???

[Melbo]

Fee, there is still time for the baby to engage so don't feel you have to make this decision now. In any case, you are only 34 weeks.

There is info on the site about this sort of problem. There is a thread in the Ask Professional Support Panel forum on Cephalopelvic Disproportion but I don't think you can access it unless you are Platinum. I hope Kelly or one of the other mods might be able to help with some info ...

Anyway, there is plenty of time for you to make this choice so don't feel pressured by anyone. And yes, if you need or decide to have a c/section, they will book a time for you and you will not be going into labour.

Hope baby engages very soon.

Mel

[Coolabahdee]

Fee, You are only 34 weeks, I would do some research darl, get all the information and have the extra ultrasounds (In a few weeks time)to determine if you are one of the very few who have this problem. I would give it a few more good weeks before making any decisions, I have had 4 babies and very shortly will be having my fifth and none of my babies have ever engaged until active labour. I have birthed them all vaginally.
The actual number of women who have CPD is very small, yet there seems to be an increase in women having unneccessary C/S. Call me cynical but check your OB's C/S rate. OB's seem to be lining their pockets with this one and have a very neat date book as well.
I to hope Kelly or one of the mods sees this and reply's to you, this site has some really good information about this. Of course if you are one of those very few women good luck with everything.

[dani141]

I ended up with an "emergancy" ceaser. Jett wouldn't engage fully either.
I kept trying for a natural birth but after 3 1/2 hoursof pushing when they had decided enough is enough and took me for the ceaser.
I look back now and think nothing of it as I have a healthy boy, so as the other girls have said you have time, try and if you have to take the ceaser option but go natural first.

[BellyBelly]

A comment on the CPD (cephalo-pelvic disproportion or baby too big, pelvis too small) - many doulas and midwives have witnessed this diagnosis only for mum to go and have a caesar to find a posterior baby. Many babies, including first babies do not engage until labour - it is common and normal. So don't let it frighten you. Your pelvis in labour will swing like the gates and I cannot see how he can make a judgement right now on how your labour will go and if your baby will fit. I mean seriously, a 34 weeker with a head that appears to be in the wrong spot / too big etc? Puhleeeeease.

Research optimal fetal positioning, the spinning babies website is great and to help get baby in a good position there are a few things you can do. Don't slouch - sit with your hips above your bum, so if this means sitting on a cushion or sitting at the edge of a seat rather than back into it, this will help. Spend 15 minutes a day leaning over a fitball or similar while kneeling forward (cushions under knees might help!). Malpositioning can be such a huge deal with babies not engaging, apparently 'fitting' and things like that. That's why I am such an advocate of active birth. There are lots of things, but I can't believe an Ob is telling a mum-to-be with a 34 weeker about possibly needing a caesar already?! You can always get a second opinion, even ask a few midwives what they think, and look up / read about active labour. Squatting when pushing can open your pelvis an extra 30% - something that is rarely utilised because most women are birthing flat on their backs on the bed as this is what they think has to be done. I know plenty of Obs who have induced women with supposed big babies, only to find baby being born as a 6lber or nothing near huge and unbirthable from a vagina...

Be strong, believe in yourself, your body and your baby. You were born to do this.

[Liz]

Tallon didn't engage until labour either.. at least I don't think so! Coz I had my visit with the OB the day before, and he didn't say anything about the baby making it's way down.

I understand that very few people have CPD and it varies with each baby and each birth. I'm surprised he's picking this up so early, as your pelvis hasn't even started to open up to TRY and get the baby out! I always thought it was something you don't find out until labour! Even if your first baby doesn't fit, your subsequent bubs possibly could.

I'd definitely be pushing for natural labour. Checking his c/s rates is a good idea. It seems so early to be telling you something like that.

Having said that, my OB saw that Tallon was breech early on, and went through the whole "will have to have a c/s if he doesn't turn" speech. Freaked me out a bit.. but of course he turned by the next visit. Perhaps your OB is just telling what he sees at the moment, even tho things can change so much in the next few weeks?

I've heard that not engaging can be a sign of them not fitting in the pelvis.. but it seems many babies don't engage until labour anyway.

*shrug*. Sorry.. none of that probably helped. hehe.

All the best!

[BellyBelly]

Oh and I just wanted to add, that QLD has the highest c-section rate in the whole of Australia, it's something ridiculously high. There is only one place I would recommend giving birth in.

[Alan]

Hi Fee
As Kelly said it is common for the baby not to engage until you are in labour. Also I find it very hard to believe that your OB can work out if your pelvis is big enough for your baby by feeling your tummy

[butterfly_kisses1]

hi
when i had ryan he was engaged and then i got into an argument with his dad (tmi)
wich really stressed me out so ryan dis-engaged himself
and they induced me to try and bring on natural
i was in the unlucky 2% of people that induction doesnt work
about not fitting into the pelvis i dont know anything about that sort of thing
but if it isnt engaged and it can be born naturally they will induce you

[Ambah]

Hi Fee,
My son (1st pregnancy) was not engaged right up until 39 weeks when my waters broke, and then I was induced.
It seemed to have no effect on my labour at all, as he fit through my pelvis fine in the end and I had a vaginal birth.
I have heard of heaps of women whos bubs did not engage until they went into labour, and they did not need C-sections... so try not to be too scared by what your OB is saying... I think its a bit silly for him to be saying so at this early stage too... there is still quite a few weeks left for things to change.

[Fee]

Thanks for everyone's comments. I will be seeing my OB tomorrow - can't wait to hear what he has to say!

My OB hasn't said anything definitely ... he just thinks it could be a problem. Obviously if he continues to believe so, then I'll have to have some further scans etc.

He just said he could feel where bub's head was sitting and it was right on the opening of my pelvis.

[BellyBelly]

Here's a simple medical definition:

Cephalopelvic disproportion is a disparity between the size of the maternal pelvis and the fetal head that precludes vaginal delivery. This condition can rarely be diagnosed in advance.

Maybe your baby is just not in a good position, I would definitely check out optimal fetal positioning like I said and remember that your pelvis will stretch and open wide and your baby's head will mould. Pelvic scans are not ideal for this reason also, it cannot judge how your pelvis will open and baby's head mould - of course anyone will look at it and tell you that baby wont fit while you are flat on your back and not under the influence of labour hormones. The very least he can offer you is a trial of labour, which is common in most other countries - as the above snipet says, it's rare to be diagnosed in advance. Should you be in the small group who do have true CPD, then you can have an emergency ceasar (just means a caesar after labour has started, silly name for it though). Some labour is better for a baby than none, it gives it some preparation for birth. Having said all this perhaps your baby has moved already, but there are things you can do to help shift baby's position. CPD is mostly misdiagnosed when position is a problem, often posterior babies or another mal-position.

[Fee]

Well there is nothing to worry about - my baby has now engaged!!! I'm so relieved.

[Liz]

Congratulations! Grr at these norty drs that give us unnessecary worry. You can relax now and enjoy!

[chocolatecatty]

Ah, my UK friend is 37 weeks next Tues which is classed as full term in England...her bubs is currently breach and so her dr. is talking about a c-section.....feel quite sorry for her but as we're not that close (she's my DH's freinds wife) I don't really feel I can tell her to hang out for another two or three weeks and wait for it to turn.....spech as it's probably full term in her head too...I guess we just have to pray it'll turn!

[BellyBelly]

YAY Fee!!! I am not surprised

Try an reassure your friend that bubs knows what they are doing Many do turn last minute but often we arent given the chance, so she is lucky to be able to have that option to wait. I was born 9 days overdue, was breech but turned on the 8th day overdue. Often I hear they turn a day or so before birth, if they are left to it! Up to 42 weeks is also term so she'll need some good distraction and support to take her mind off things I think!