When will I have a position check? What happens at the position check? What are the possible outcomes of a position check?
What is a position check?
As the name suggests, during this check we look at how the baby is positioned in the womb by performing an ultrasound. Prior to the birth we would like to know whether the baby is positioned head down or buttocks down. As the buttocks down position will have consequences for the birth. An ultrasound will provide an answer during your pregnancy and allows you time to consider how you would like to give birth. Midwives will always check your belly during pregnancy and try to determine the position of the baby. However, this is subject to human error and it can be difficult to feel the baby’s position this way. This is why we perform a position check on all clients, even when we are already pretty certain about the baby’s position.
When to have a position check
It is best to schedule a position check between 35 and 36 weeks of pregnancy, because this is the period when babies usually cease turning spontaneously. Around 30 weeks, 25% of babies are breech, i.e. with the buttocks down. Around 35-36 weeks, 3% of babies remain breech. So many babies will return to the cephalic position (head down) before 35 weeks without intervention. So performing a position check much earlier than 35 weeks has little use. After 36 weeks, approx. 10% of breech babies will still turn by themselves, reducing chances even more.
Breech, what now?
When the baby appears breech around 35 weeks, several options will be discussed with you. The first option is to schedule an external version. During an external version, we attempt to manually turn the baby from breech to the cephalic position. However, this is not always successful. If this is your first pregnancy, the success rate lies between 30 and 40%. With a subsequent pregnancy, this lies between 60 and 70%. To have an external version, we will refer you to Focus. You may come across 3 of our Breedstraat midwives at Focus, as they are also external version experts.
An external version poses little risk. There is a 5-7% chance that the procedure will affect the baby’s heartbeat; the heart rate will then lower. This effect is usually temporary. In 2 in 1000 cases, the heartbeat does not go back to normal and an emergency caesarean is required.
If the external version procedure is unsuccessful or you do not wish to have one, we will refer you to the gynaecologist. We do this because a breech birth poses a higher risk than a cephalic position birth (head down). There is an increased chance that a caesarean section will be needed, it is also more likely that the baby needs admitting to a paediatric ward after the birth. You can of course choose a caesarean section as your first option if the baby is breech. However, this choice carries an increased risk to the mother and any subsequent pregnancies.
Do you have questions about the position check or want to know when to book? Please contact midwifery practice Breedstraat! Use our simple registration form to register at our practice: Go to the registration form.