Baby's head not engaged

Hi

My due date is only 5 days away. I saw the OB yesterday and he said the head is still not engaged. He said if the head is not engaged when he sees me again next week he will likely recommend a CS. I accepted that at the time but when I came home and did some reading I found that it isn't uncommon for the head to not be engaged when labour commences, so I wondered why he would suggest a CS when I will only be a day or so over my DD? The baby is slightly smaller than normal, would that be a possible reason? Also then, if I DO go into labour should I ring the hospital sooner rather than later and tell them the baby wasn't engaged at my last visit?

Thanks,
Sammy

I don't know why your ob wants to do a CS, it's common for the head not to be engaged til labour. Tell him that you don't want it and maybe ask his reason for the suggestion. I can't see the baby's size being the reason, unless bub was bigger than normal. My first didn't engage til i was in labour (i was induced). My ob never meantioned a CS so i really don't see why yours would recommend one. Good luck anyway!! Not long to go!

I agree with MummyNelly, it is often the case that a bub won't engage until labour. It doesn't sound like a valid reason to say you have to have a c/s so you have every right to refuse. Perhaps ask him to explain his suggestion further.

Good luck,
Spring xx

I'd agree with the above posts, Sammy! My baby was a week overdue and only engaged a couple of days beforehand. But I've also heard it is not uncommon for baby to wait til labour to engage.
I think most hospies will let you go 10 days over before talking to you about induction... But c/s? I agree that it'd be wise to have a chat to him and find out his reasons. (Could be he's trying to make it more convenient for himself. And that's NO reason to do major abdominal surgery where its not medically necessary, IMO.)
You sound like you're onto it anyway :)

Slightly different perspective...my first daughter also did not engage..I was finallu induced and her head failed to engage even then and ended up having an emergency c/section.

2nd daughter again this happened and I had an elective c/section.

We are having a 3rd daughter on 11 September and have been advised that a c/section is required because of previous c.sections and low and behold the little princess is head down and ready to go...and I have been told that any signs of labour to ring straight away.

Whichever way I wish you the best

Suz

Thanks all. I'm sure to find out at the next visit where I will make him go through it more fully with me. In the end, I guess I will opt for whatever seems the safest way for baby to arrive.

In the meantime I have been walking, doing squats and getting down on all fours as I read this was helpful in encouraging the baby to move to the right position.

I'm surprised at the c/s option too! From what I understand, even if the bub isn't engaged.. it just means a bit more work during labour to get the bub down and out.

My bub didn't engage until the day prelabour started. In fact his head engaging probably started the whole thing! LOL. (that's just my opinion.. there was no sign of him being engaged at any of my OB visits.. but the first day of any discomfort similar to that of the head being engaged was when it all started for me). But there was no suggestion of c/s or anything at all due to him not being engaged. Definitely find out what your OB's reasons are before agreeing to a c/s or induction or anything. Bub's are pretty clever and usually find their way without us needing to interfere :)

All the best!

Hey,
A girlfriend of mine had a baby by c section cos the head was no where near engaged. I think she was about a week over and they just booked her in for a c the next day! They frightened her with tales of the baby lodging on the cord etc, but having had the operation she decided to do a bit more research, and that is quite uncommon (but still a risk).

I was also surprised that they didn't induce or at least wait a week more, but I guess it depends on your OB.

The main thing is that you feel comfortable with your decision. Do your research to find out what are the chances of engagement later, what are the risks, what happens if you are induced, etc. At least if you end up with a C section you will feel informed and more positive about the experience.

Good luck!
PS I hear breast stroke is great to get bubs engaged...

My bubs wasn't engaged either, I was induced & he came along when ready. When he did finally decide to come out it was with head around the wrong way, but with a heap of determination I managed to squeeze him out!!

Out of 4 pg's I have only ever had one baby truly engaged before labour started and not once once has c/s ever been mentioned. I think your ob is putting the horse before the cart on this one and not giving you and bubs enough time. My first baby didn't even engage until labour had started and there was never an issue.

In some instances there can be risks of cord prolapse and I wouldn't want to have an induction if bubs wasn't engaged, but going straight for a c/s isn't the only option either.

While Obs have a wealth of knowledge in birth complications, they can also say whatever they want to say and believe. There is a notorious Ob who tells women there is no such thing as safe VBAC and why have a vaginal birth after IVF when you have gone through so much trouble to get pregnant in the first place.

Obs are specialists in birth complications so given their university training, they often look at birth as a complication (not all do). Midwives are trained in normal, physiological childbirth and deal with normal birth. They know, as we know by evidence, that babies can engage anytime, right up until labour without affecting outcomes. The baby knows when it's in the right spot and when it's the right time to engage. If you wanted to change lanes on a freeway, you'd wait before the traffic is safe, then indicate, then perform your manouvre. You wouldn't just change lanes while traffic is whizzing by for the sake of hurrying up - that can be dangerous.

Anyway, don't know how I came up with that analogy but I think it makes sense and I think Obs are just to used to women believing that since the Ob is the expert with training, they must be right. Please inform yourselves ladies - as I always say - they wont remember your birth in years to come but you will.

A bit of an update. I had my OB's appointment today. The baby is still not engaged and we are a day over the delivery date. He is happy to let me go another week and monitor the baby closely if I go into labour to see if it engages, but he has scheduled a CS for next Monday if nothing has happened by then. He is concerned the baby is in an unusual position and can't engage and because I am over 40 he would rather be cautious and recommend the CS. I was happy with his explanation. I am hoping labour starts before then and the baby engages so I can avoid the CS but I can live with one if it means a healthy baby.

All the best SammyP - completely your decision no matter what you do, but one thing I wanted to point out, just for the sake of correctness LOL:

:

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but he has schedule as CS for next Monday if nothing has happened by then.

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He doesn't have to - you have the power to make decsions not him. No matter if you choose to or not, I just want people to know that there is no law that says Obs have to do things by xxx time - it's their own judgement they bring into their work, either way :)

Fingers crossed you go into labour soon - I would really strongly recommend chiro to help get bubby/your pelvis into alignment in case of malposition - email me at info@bellybelly.com.au if you want a name of someone I can recommend - and I also suggest walking and stairs which will help move your pelvis, to help move baby.

Perhaps you could even have a scan to see if baby's head is malpositioned, could save you a c/s if all is looking good. Lots of things you can do for a malaligned baby, I also wouldn't have those waters broken as it will give baby even less manouverability. Check out the spinning babies website too.

Thanks Kelly

I was happy with the discussion with my OB this morning as it was presented to me as advice rather than his attempting to pressure me into something I wasn't keen to do. I have noted that a lot of people feel they are forced into something they don't want when a CS is suggested but I didn't feel this was the case here. My OB was actually quite keen I had a vaginal delivery as it would have helped with some previous problems I experienced.

I had a scan a couple of weeks ago which may be why he has concerns about the head being in the wrong position.

I am wary of chiropractors as one cracked my neck 13 years ago and I have had tinnitus ever since (ringing in the ears). I am using stairs and trying to walk a lot in order to move this baby into the right position. I have also been reading the spinning baby website quite a bit. Here's hoping it all happens before next week. I will let you know.

Sammy

Final Update:

I went into labour three days before the planned CS. When I went to the hospital the baby had still not engaged and I was about 5cm dialated. They rang my OB and he said he was happy for me to continue through to a VB as long as the baby had constant monitoring and they broke my waters and made sure the head engaged correctly when that happened. When they broke my waters the pain I was having increased 10 fold so I didn't really notice what was going on around me but I began to realise the room was filling with people and DH emerged from the bathroom in a white gown (I didn't even notice he left the room). They told me I had to have an emergency CS and I was in theatre in minutes and then told it would be a general as the baby needed to come out straight away. Next time I woke up I was in recovery and someone was thrusting polaroids of DH holding a baby before my eyes. I was apparently in recovery for almost three hours (according to DH) as my blood pressure was very high. I had not had a problem with it before the birth so that surprised me.

I finally met my beautiful daughter about three hours after she was born. DH explained that when my waters broke the heartrate dropped dramatically and they called for an emergency CS straight away. He wasn't allowed into theatre as it was very quick. The cord was wrapped twice around the baby's neck which was why she hadn't moved down to engage. I was very, very fortunate my waters didn't break at home as she would have been in big trouble.

In the end, despite all the drama, I don't feel very traumatised by what happened, I just feel blessed that it all worked out and my daughter is healthy (and now screaming in the background).

Hey SammyP,
I guess these thing happen for a reason hey? I am so glad you got the opportunity to listen to your body, but also ultimately glad that your medical team was there for you and your daughter. After all, that is how it is supposed to be. Congrats on the birth of your baby girl!

Congratulations, Sammy on the birth of your daughter!