Being pregnant is a fun and scary time for many moms. During this time, the mom’s body expands and practices for labor as the baby grows. It is truly a wondrous time. Even so, to have a “normal” birth there are things that have to happen, in a certain order and in a certain way. Sometimes things will not go as planned and we have to make allowances to deal with the issues when they arise, such as how the baby presents during the birth. When a laboring mom arrives to the labor and delivery of the hospital, she hopes that all will go as planned. She hopes her body and her baby will do all the things necessary to help deliver a healthy baby. However, if the baby does not present just the right way, it can require the use of forceps or vacuum suction or even a cesarean to deliver the baby safely. Below are descriptions of the different presentations.
Normal and Occiput Posterior Presentation of Baby
If everything goes as planned, the baby will present with the back of their head facing up. This helps the body to be in the best position as the childbirth process progresses. Normally the baby will rotate to be in this position, with his face down, and his little chin touching his chest. If the baby is facing in the other direction, with his face up, called occipital posterior. This makes it a little more difficult during the birth; because the baby will be putting more pressure on the back and spine in particular, causing intense back pain.
Malpresentation of the Head
If the baby turns the correct way, he can still miss-present if he does not pull his chin down to his chest. When the baby looks “up” and his chin stretches away from his chest, this is malpresentation of the head. This means the largest part of the head is coming through first, making it more difficult to stretch the birth canal and deliver. When this happens doctors grab the forceps to help pull the head on out. Forceps is a large clamp-like instrument, which slides on either side of the baby’s head to help pull the baby out of the birth canal.
Breech Presentation and Transverse Lie
If the baby is lying in any way other than head down, he is either breech or transverse. There are three different types of breech presentation, the complete breech, the footling breech, and the frank breech. Complete breech means the baby is sitting with his bottom on top of the cervix. The feet are right there too, so you attempt a vaginal delivery, the feet or a foot and bottom or the bottom would present first. A footling breech means the feet or foot presents first. A frank breech happens when the bottom presents first, and the feet are up around the baby’s head. The transverse lie means the baby is lying sideways, a vaginal birth is impossible with the transverse lie presentation. A vaginal birth is possible with the breech presentations, however they are dangerous, and many women opt to have a cesarean instead.
