Video: Meine Schwangerschaft in Eigenregie 24. SSW
Hello, this is Sarah Schmid with a new video. I'm in week no. 24, baby has grown as babies do and my belly as well. That's what it looks like right now. A lovely little bump already. Baby is kicking diligently. Has his times when he is active and when he is sleeping. You can almost set the clock after him. Otherwise nothing extraordinary has happened over the past four weeks. Not concerning my pregnancy at least. But my sister had her baby. Her first child. For two weeks I rent a holiday appartment close to her and went there with all the kids to support her the first time after birth. At least that were my plans. She wanted to give birth only attended by her husband.
She had seen a midwife for prenatal care, but declined ultrasound and blood testing and now was planning a birth with her husband. Now things do not always happen the way you imagined. When I got there–I arrived at her estimated due date–nothing had happened yet. A few days later birth started with her waters breaking. Her midwife of course said: Go to the hospital. We knew what would happen in the hospital: There they are quickly with giving antibiotics and a cesaeran – if contractions don't start. And her contractions didn't start. Not after one day, some contractions after two days and some more after three days. Then she had a night with strong contractions but…. no baby still although she thought: It should come this way now. In the morning she called me–three days after her membranes ruptured and one night with strong contractions.
I went there and checked how the baby was actually lying. We quickly found out that the baby was not lying so well which explained the premature rupture of membranes, the contractions not really starting etc. So we started gymnastics, doing all kind of exercises to help the baby turn in a better position. Finally–after a few hours–baby moved down. Everything went quit slowly, she was tired…..finally started pushing which also took hours. In the evening I became too tired myself, asked my mother to take over. Anyway, nine hours pushing, then they went to the hospital. One more hour pushing there and finally the baby was out. Supported by pitocin and directed pushing lying on her back. Push push push! But….she made it. Without cesarean. Under all other circumstances they would have sectioned her.
Had she gone to the hospital directly after her waters broke, she would have had the cesarean. You can be quite sure about that. That's why we were glad that things went like they did, even those this birth was not something you would call a nice birth. I learned a few things though. First: If your waters break you have several options. Of course you can go directly to the hospital, risking to get your IV antibiotics and a cesarean after 24 hours if the baby does not want to come on its own, with other words if contractions don't start properly. If contractions start–perfect. But going to the hospital with ruptured membranes and without contractions almost guarantees a cesarean. There is always a fear of infection–but, this also has to be considered in relative terms. As long as you don't get vaginal exams and are at home in your own bacterial enviroment, the risk is not high.
And you should watch for signs of infection of course, like a fever. Another fear connected to waters breaking is cord prolaps, especially if the baby is not properly engaged in the pelvis. Her baby had his head in the pelvis. But even if the head is not engaged: When the baby is head down and term, it is very unlikely that the cord gets trapped when the waters break. Because if the waters break, head and body descend much faster than the cord which is relatively light in comparison. So not much chance for the cord to quickly slip between. This usually just does not happen. In Germany they even recommend to lay down at once and call the ambulance. In other countries this approach is completely unknown. There is no scientific study that demonstrates the advantage of one approach to the other. So you can just continue as you normally would and wait for contractions to start as long as you feel fine especially if you plan for a natural birth. Fetal position is another issue. My sister's baby, when I felt for it, was lying like this: I've got the baby doll of my daughter here. It is not really clean but just imagine this to be vernix or something like this.
Anyway, her baby was in this position: Head in the pelvis….like this…..and back to the left. This is actually a good starting position for birth, but…. for an easy birth the baby has to turn its back slightly to the front. Because, in the front the pelvis is formed like a slide, so that the baby can nicely tuck his head and….slip into the pelvis. If the baby's head points to the side or the back, in these areas the pelvis is not formed so nicely. What happens is, that the baby often does not tuck his head from this position but enters the pelvis deflexed. Not like this but….like this which makes the perimeter, with which the head has to come through the pelvis, much greater compared to when the head is tucked and the so called occiput comes first. Which means: long and exhausting labor that often ends with a cesarean. That's why we tried to get the baby in a better position using all kinds of exercises which is rather difficult when the membranes have already ruptured. The waters are like a cushion under the baby's head, making it easier for him to turn. The head was already very deep in the pelvis.
…it's not so easy then. When the waters are still intact and the head is higher, it's easier to make the baby turn in a better position. So head down alone does not necessarily mean easy labor but it is important where the back of the head and back are. These should point to the front or slightly to the front. This would be a good position. As a starting position before birth this is common and not bad, but it should turn a bit during birth, to easily enter the pelvis. This way is not so good. It's also called stargazer, because when the baby is born this way–head turns oblique into the pelvic inlet, then turning forward again– when it comes out, it will be looking up to the stars….if you are birthing on your back. As I said, there are exercises you can do. You can find these exercises in my book….
which I may present to you once more–English and German version. I describe these exercises with nice pictures to it. There is a website, in English, too: spinningbabies.com There they explain in an understandable way, what you can do in which situation to help the baby turn. And in my book I explain how you can feel for your baby's position yourself. I think this is very important. Women learn how to feel their breasts to early detect breast cancer but they don't learn how to determine how the baby is lying although this is not difficult. In the last four pregnancies, where I did not go to antenatal visits and later gave birth unassisted, I taught this to myself: to feel how the baby is positioned. It's not hard. You just keep attention to where are the kicks–legs and feet–and the smaller movement–hands– You can feel for the hard, long part–the back, on the other side it is soft. If the baby's back points to the back, you feel a lot of movement on the front, around the navel because arms and legs are in the front. So there are ways to determine the baby's position yourself and do something before birth if necessary.
I'm in the 24th week right now. It is not yet so easy to feel the baby's position for me but this is not relevant at the moment anyway, only later in the last weeks, then it is important that the baby is lying in a good position for birth. Before it is not so important and that's why I don't feel much around except when I feel for it. But right now I don't. That's what I wanted to share with you today. Over the next weeks the baby will keep growing and we'll see what I share with you the next time. Till then, bye!.