Odd Presentation - Advice?

chloe2326 · 01-06-2010, 05:46 PM

Hi everyone - I haven't posted on here for a very long time because I've been taking something of a hiatus from the birth world. But recently I've partnered up with a crisis pregnancy center in my area, and today I got my first client in almost 2 years!

This mama is one week from her due date with her 3rd baby and baby hasn't dropped. Also she is carrying extremely high - when baby kicks she says her breasts jump. Additionally she has enormous pain and pressure between her legs that makes walking difficult. She is getting her prenatal care from the local public clinic, but sees a different Dr. everytime and says that each one has a different take on what's going on in her belly. From what she knows baby is high and "stretched out."

This late in pregnancy I've never heard of a baby being stretched out - has anyone else? Any input would be really helpful.

Mama is complaining of a lot of considerable pain both in her upper back and between her legs. Any suggestions for ways to help with the discomfort? She has also asked for ways to encourage the baby to drop - I suggested squatting...any other thoughts?

Thanks for all of your help!!

amymaew · 01-06-2010, 06:16 PM

later babies don't necessarily drop before the onset of labor. She could try some pelvic rocks.

doulafava · 01-06-2010, 06:20 PM

I don't really "believe" in chiropractic,

but I suggest it sometimes for wierd positioning. If nothing else, the placebo effect can be really powerful and effective. I do think chiros can help a woman relax muscles and other tissue in the pelvis that maybe can help a baby get in the right position - especially one that is in a really funky position like that.

Someone who is trained to help pregnant women and trained in the Webster Technique is best.

Otherwise, swimming, yoga, meditation, patience, progressive relaxation and abdominal sifting all come to mind for a high baby in that kind of position. Squatting is good too, but my guess is that baby is not engaged because there is some other positional or anatomical issue. Have they ruled out a bicornate uterus or something like that?

raeben · 01-06-2010, 07:05 PM

first babies are the only ones who are expected to drop. second, third, etc, very often don't - it's not a positioning problem, its an expectation problem.

the leg and back pain can indicate that mom's pelvis isn't aligned well - i had similar problems with my second pregnancy and found chiropractic care to be infinitely helpful - and not placebo helpful but "oh, my pubic arch is back where it should be and now i can walk agin" helpful. the chiro should be icpa trained/certified. the webster technique is not an indicator that someone is trained to work on pregnant women but it is one of the manuvers that icpa chiros are trained to do well on mamas.

a big daily dose of a high quality liquid calcium/magnesium supplement might help with the leg thing also.

Kayla · 01-06-2010, 11:24 PM

Is baby postieior? I wonder because you said her breasts jump when baby kicks, my 4th (posterior till transition) baby did this too. Could that keep baby high? Or baby could just not be curling up. The first birth I ever atended baby never did go into the "fetal" position, even as a newborn baby girl never did curl up, wanted to be perfectly srtaight with hands swaddled down at her sides, it really was somehting to watch, lol.

Crowmama · 01-07-2010, 08:00 AM

Spinning Babies!!! It has helped any number of my moms with non progressing lies...

chloe2326 · 01-07-2010, 08:51 AM

Thanks so much for all of your input. Part of the problem is that the mother herself is unclear about position the baby is in so its sort difficult to generate suggestions. I'm not certain if baby is posterior, because she herself doesn't know.

The chiropractic suggestion sounds great, but I don't know of any chiropractors who would be willing to do pratically pro bono work since my client has extremely limited funds.

I've recommended some squats and relaxation/visualization. Also some lunges by taking stairs two at a time. Mama is so exhausted and stressed out I think she's probably carrying her muscles quite tightly. In the absence of family to help with childcare, I'm also looking into some state childcare options for her 3 yr old to help her get a few extra hours of sleep. It can only help right?

Kayla - could you tell me more about the delivery where the baby never went into fetal position? That's the part I'd never really heard of before. Do remember what was helpful for the mother during that preganancy/delivery? Anything pointers would be so very helpful!!

Thanks again everyone!

peacefulbabydoula · 01-07-2010, 08:59 AM

Ok..I had this problem with my last pregnancy.Turned out the cord was wrapped around him(his body,leg ect).Sometimes,there is a REASON why baby isn't dropping.My little one didn't until labor started.I had 2 hours of labor and baby came flying out five minutes after mw got there.She goes.."ok felicia,wait a second we have a cord" and me..having four previous births i don't push,i wait for the contraction to do it..said..I CANT WAIT" because I wasn't pushing,and he pretty much came flying right at her past the cord lol.I was SO frustrated because she kept talking about how baby didnt drop yet,and i was 3 days past my due date..i walked and walked and lunged and squatted.Talked to my mentor later on(a midwife with 300+ births under her belt) and said that its very common for women with cord issues)so..dont over stress her!There is a reason why her body isnt..if i had to guess i would say a cord issue! Every time she checked me baby was VERY ballotable(and i checked myself too)

TO Doula · 01-07-2010, 10:29 AM

Movement is always good, but squatting may not be especially so - it opens the pelvic outlet, but simultaneously *narrows* the inlet. If you've got a model pelvis, try it. Or just try it with your own body. You're squooshing the hipbones closer together at the top when you squat. So, it can actually be harder for a baby to drop that way.

I love Spinning Babies, too. Have her take a look at the belly sifting page. And yes, I'd be suggesting chiropractic, too. Is there a college near you? That can be a way to get low cost service. The students are supervised, so it's quite safe.

Kayla · 01-07-2010, 11:14 AM

Quote:

Originally Posted by chloe2326

Kayla - could you tell me more about the delivery where the baby never went into fetal position? That's the part I'd never really heard of before. Do remember what was helpful for the mother during that preganancy/delivery? Anything pointers would be so very helpful!!

Thanks again everyone!

I am still friends with her actually, baby girl is almost 2. She was head down, just never drew in her legs, and had her arms down by her side the whole pregnancy, we thought baby was just carried really high, but she was just stretched out, and her feet were up as high as could get. It was very amusing watching her contract, her belly would go really long, and almost flat in the middle instead of balling up and having a high spot. Did't pose any problems in labor exactly, just an odd look to her belly. But she did end up with a section, she was an attempted VBAC, and her Dr got a bit antsy, she caved, but I don't think he really was giving her a fair shot anyway. The biggest complaint in pregnancy from is was not getting any relief in her ribs, she would tuck her foot and just keep it there. We tried pelvic tilts, alot of different things on Spinning babies, nothing worked. But neigher was anything considered a complication either, just mom was really uncomfortable, but most are at that point in pregnancy.

DoulaMegz · 01-07-2010, 01:00 PM

I second Chiropractic care and spinning babies and strongly caution AGAINST SQUATTING! This narrows the pelvic inlet and if the baby is cramped, this will not help repositioning. I say knee chest for at least 30 minutes, then pelvic rocking, hip checks, etc several times a day.

raeben · 01-07-2010, 03:11 PM

yes, in prenatal yoga, they strongly discourage the mamas from squatting positions in the last month suggesting that this may even hurt the baby if it is engaged in the pelvis - if mama is squatting a lot maybe the wise baby is staying extra high to avoid injury.

i still maintain that 3rd babies shouldn't be expected (or forced) to drop.

helpinghands · 01-07-2010, 07:41 PM

I just had a client who was a first time mom... drawing close to 41 weeks and baby stayed high, cervix didn't prepare for labor, etc. and I was really racking my brain trying to figure out WHY. Baby appeared a bit peely/wrinkly when born by cesarean after a very long induction attempt...22 inches long, ...long, lean, beautiful baby girl. I wish I knew why some babies stayed high. I know that as Doulas we are not medical providers, but I think that fetal positioning and other things can be helpful...but sometimes...I am just stumped. If there was an answer easily accessible that could help another mom go through their experience a bit easier b/c of wisdom gleaned, it would sure help the world make a bit more sense. I hope some more will chime in w/ ideas.

chloe2326 · 01-08-2010, 08:44 AM

Okey dokes - I have another meeting with client today. I'll advise against the squatting and suggest continuing with knee chest and pelvic rocking, and looking into chiropractic care. Also some shoulder exercises because she is carrying her back tension quite high.

Personally I'm not as concerned with whether the baby drops etc, but more trying to help mom feel some relief from her discomfort. Of course it's great to encourage right positioning, but I feel like it's not my place to get over-invested in repositioning baby.

Thank you all so much for all of your help! I'll let you know how it all turns out