Exercises to get your baby to turn head down

When did your baby start rolling over? This is not an idle question, which young mothers often ask each other - the skill of turning over is very necessary in order to learn to crawl. It can be mastered after the child learns to lie on his stomach. If your baby does not try to roll over onto his stomach by 3 months, you need to help him with this.

Babies usually begin to master turning from back to stomach at 3 months. As a rule, by 4 months, most are already able to independently and purposefully roll over from back to stomach in full.

However, we must understand: in order for a child to learn this movement and begin to roll over, he must be able and willing to simply lie on his stomach. You also need to create an incentive for the desire to roll over. For example, toys should not hang from above the head, but lie to the side, etc.

Why is the baby in the wrong position?

The reasons for the incorrect positioning of the baby can be both medical (in this case, all attempts to turn it over may be in vain, so a decision on a caesarean section will definitely be made before the birth), or related to the lifestyle of the pregnant woman:

1. Most often, this is caused by the habit of sleeping in one position, which can cause internal organs to shift under their own weight and blood to stagnate. If you can’t get rid of this habit, then you can change several positions before going to bed, and only then lie down in your favorite one.
2. You should also not go to bed too late. This can cause both overwork and sleeping in one position.
3. Wrong diet, especially eating before bed. The opinion that pregnant women can eat anything is wrong, especially at night. There should not be heavy and questionable food in the diet of the expectant mother.
4. A sedentary lifestyle, although excessive physical activity to which the mother is not accustomed, also negatively affects the position of the fetus.

As for medical reasons, they may be related to the anatomical features of the woman’s structure (for example, she may have a narrow pelvis), the tone of the uterus or its relaxation (if there have been many pregnancies before).

Features of breech presentation

Breech presentation of the fetus is a variant of its location in the uterus. In this case, the pelvic end of the fetus is presented to the entrance to the woman’s pelvis. This position of the child is observed in 5% of cases. In this case, there are several options for breech presentation:

• gluteal - in this position of the fetus, the buttocks are adjacent to the entrance to the small pelvis, while the legs are located along the body;
• mixed gluteal - the fetal legs are bent at the hip and knee joints;
• foot - can be complete (both legs are present), incomplete (one leg), knee.

By determining the type of presentation, the doctor can create a birth plan.

Breech presentation of the fetus

Breech presentation of the fetus in the womb is a position in which the baby’s butt and legs are facing the exit from the uterus, and the head is looking at the bottom of the genital organ, that is, it is at the top. It occurs infrequently - only 2.5–5.3% of cases.

The baby in the womb can be in three positions: head, transverse (horizontal), pelvic. And if the head is the norm, then the transverse and pelvic are pathological.

The fetus in the uterus can be in one of three positions: cephalic, pelvic, horizontal.
Throughout pregnancy, the baby is in the amniotic fluid, so it can change its position. However, normally by 22–24 weeks it turns head down. If this does not happen, then experts unanimously say that there is no reason to worry. Presentation before 35 weeks is considered unstable and can change repeatedly. But still, in order to facilitate the coup, experts advise resorting to a number of measures.

Classification of breech presentation

Experts distinguish several types of pelvic position:

• the child lies with his buttocks down, his legs are bent at the hip joints, straightened at the knees and located parallel to the body (breech or true presentation);
• the baby lies with his legs down, that is, during childbirth, his feet will be the first to appear from the birth canal (foot full presentation);
• the child lies with one leg down, and the other is bent at the knee and pressed to the body (leg incomplete presentation);
• the child lies with his buttocks and legs down, which are bent at the hips and knees (mixed presentation).

In 60–68% of cases, true presentation occurs. Mixed, according to statistics, occurs in 20–25% of births, and foot birth is observed least often. Moreover, a breech presentation during childbirth can change its appearance from complete, for example, to incomplete or vice versa.

Breech presentation can be breech, mixed, full or incomplete.

How to determine the position of the fetus?

Knowing that this problem exists, and constantly doing special exercises, it will be useful for a pregnant woman to know how to determine the position of the fetus to make sure that the baby has turned over before delivery. This can be done using the following criteria:

• tremors felt in the upper abdomen indicate cephalic facial presentation;
• with an occipital presentation, shocks are felt in the back, while the back is clearly palpable;
• if the expectant mother feels blows in the lower abdomen, it means that the baby is positioned head up.

You can also find out about fetal presentation by the heartbeat. This can be done using a stethoscope while lying on the bed. You need to start listening from the lower abdomen, gradually moving upward. It is recommended to apply the stethoscope to the side of the abdomen. A muffled tone may indicate breech presentation (this may also indicate oligohydramnios and placental insufficiency, so consultation with a doctor is required).

In this case, you need to know at what week the child is in the wrong position, since the doctor will make a decision about a caesarean section or performing special gymnastics.

Other ways to change fetal position

There are many other ways to help your baby take the correct position in the womb:

1. Suggestion. If you talk out loud to the baby 2-3 times a day, convincing him to roll over, there is a high probability that sooner or later he will take the optimal position for successful delivery. In this case, it is advisable to stroke the belly, as if pointing the baby in the right direction.
2. Visualization. The expectant mother should imagine as often as possible that her baby is in the correct intrauterine position.
3. Application of a light signal. You can try shining a flashlight or lamp into the lower abdomen. An inquisitive baby will be interested in the light coming from outside and will turn over to see what is happening in the illuminated part of mom's tummy.
4. Use of classical music. According to many doctors, children respond vividly to soothing sounds. If you apply headphones that play relaxing music to the lower abdomen, the fetus will turn over to the side from which it is coming in order to better hear the pleasant music.
5. Contrast compresses. You can stimulate the baby to take the correct position by applying a cloth moistened with cool water to the upper part of the uterus, and warm water to the lower part.

What to do. General recommendations

If the doctor discovered the breech presentation of the fetus before the 34th week of pregnancy, then there is no need to worry, since the baby can still turn over before birth. If desired, he can be helped, but only if there are no medical reasons (the entanglement of the umbilical cord or the position of the placenta preventing the baby from turning into a cephalic presentation). Regardless of the reason, the expectant mother needs to change her habits:

• change your diet, include more vegetables and fruits;
• walk more often, move more, but do not overdo it;
• do special exercises that help the baby turn over;
• get enough sleep, try to change your position while sleeping.

In this case, it is recommended to talk with the child and persuade him.

Causes of fetal malposition

Why does the fetus in the uterine cavity take an incorrect position? The following factors contribute to this:

• the pelvis of the expectant mother is too narrow;
• increased or decreased uterine tone;
• short umbilical cord;
• the position of the placenta preventing the embryo from turning over;
• a woman's constant posture while sleeping throughout the night;
• lack of motor activity of the expectant mother or, conversely, excessive physical activity;
• frequent stress;
• eating plenty of food before bed;
• excess or insufficient volume of amniotic fluid;
• multiple pregnancy.

When is exercise needed?

Breech presentation of the fetus can be dangerous for the child and mother only during childbirth. Because of this, the risk of birth trauma, complications of the birth process, and even the death of the child increases.

Exercises need to be done so that the child turns over and lies head down, but they are not always effective, so they are prescribed only as an auxiliary method. After 35 weeks, doctors consider breech presentation a fait accompli, so in most cases a decision is made to perform a caesarean section. Therefore, you need to start performing special gymnastics at 30-31 weeks.

You must first coordinate the exercises with your doctor, and also make sure that there are no complications during pregnancy.

Exercise restrictions

Inversion exercises cannot always be performed by a woman. Contraindications to gymnastics are:

• placenta previa, i.e. it closes the lumen in the uterus, so there is no point in turning the baby into the correct position, since a caesarean section cannot be avoided;
• risk of miscarriage;
• individual restrictions depending on the characteristics of the pregnancy and the patient’s condition.

It is recommended to first consult with your doctor about the possibility of performing exercises. If necessary, the complex can be adjusted.



Natural birth or caesarean section

With a breech presentation, delivery is possible either naturally or by caesarean section. The way in which the baby is born depends on a number of factors:

• weeks of pregnancy;
• woman’s age and number of births in the past;
• expected weight of the child;
• types of breech presentation (breech, leg or mixed);
• position of the fetal head;
• degree of maturity of the cervix;
• the presence or absence of hypoxia and its degree;
• pelvic size of the expectant mother.

The doctor evaluates all the listed parameters and only then makes a decision. In this case, a caesarean section is indicated for everyone, without exception, in the following cases:

• narrow pelvis;
• post-term pregnancy;
• cervical immaturity;
• fetal weight more than 4 kg;
• strong extension of the child's head.

Despite the possibility of birth through the birth canal, such a birth is dangerous with a number of complications, so a cesarean section is often performed in case of breech presentation.

Normally, the chin of the fetus in the womb should be pressed to the chest, and if excessive extension of the head is established during breech presentation, then natural childbirth is contraindicated

Complex

Exercises for turning the fetus during breech presentation were developed by obstetricians and gynecologists. The complex is approved by the Association of Doctors. It includes key exercises to promote fetal rotation. The advantage of such gymnastics is that it can be performed both as a prophylaxis for breech presentation and as preparation for childbirth.

"Pendulum"

The exercise is performed in a lying position. Any flat, hard surface is suitable for this (a sofa and bed are not suitable).

Lying on your back, you need to bend your knees and then spread them wide, while making sure that your feet do not leave the floor. Place your hands along your body.

In order for the baby to roll over, you need to lift your pelvis while taking a deep breath. Stay in the new position for a little while, and then smoothly return to the starting position, while exhaling. Now you need to take a few breaths and exhales, and only then repeat the exercise.

Number of repetitions – 7-10.

"Cypress"

It is based on low-intensity Kegel exercises. To perform, you need to lie on a mat on the floor, bend your legs at the knees, spread them, and press your feet. As you inhale, stretch your legs. Then, without exhaling, squeeze your buttocks and tense your perineal muscles. As you exhale, the body must be relaxed and returned to its original position. Repeat 7-10 more times.

"Cat"

This exercise is most popular among pregnant women. It must be performed on the floor. You need to kneel down and take a cat pose, i.e. arch your back and slightly raise your pelvis. You cannot lift your palms off the floor. Additionally, you need to ensure that your knees are in the same vertical line with your hips.

Inhaling, you need to throw your head up and lift your pelvis. As you exhale, try to curl up into a ball, for which you need to round your back and lower your tailbone and head. All movements should be as smooth as possible. The number of repetitions is about 10.

"Bridge"

This exercise is the most effective (15%), and requires virtually no effort. The exercise should be performed during the period of maximum activity of the child.

Place pillows or other similar devices on the floor so that when lying down, the pelvis is 20-30 cm above the floor. The legs can be placed on a chair. You need to spend 10-15 minutes in this position, without straining or performing special movements.

“Sailboat”

Starting position – standing on the floor. Feet are shoulder-width apart, arms extended along the body. As you inhale, raise your arms and place them so that your palms are turned toward the floor. Then stand on your toes, trying to round your chest. As you exhale, return to the starting position.

This exercise is part of a breathing exercises complex, so it can be repeated several times throughout the exercise (for example, at the beginning and end).

Dikan's method

You can turn a baby in a breech presentation using the Dikan method. The method is based on periodically turning the body over and changing position. To perform the exercises, you need to lie on the floor and turn over from one side to the other every 10 minutes, while your legs should be bent at the knees (for convenience, you can hold them with your hands).

You need to perform the exercises on an empty stomach to prevent the feeling of nausea. During such gymnastics, you can watch a movie.

To improve performance, it is recommended to do at least 4 approaches per day.

Fomicheva complex

If the baby is lying incorrectly in the womb, then a complex developed by obstetrician V. Fomicheva will help turn him over at 32-36 weeks. The basis of the complex are slopes. They need to be done forward and backward, while doing this you need to bend your lower back. Additionally you need to do:

• turns;
• lifting the pelvis, as in the “Pendulum” exercise, but the support should be on the back of the head and feet.

Each exercise from this complex must be repeated at least 5 times.

Brukhina's technique

This complex is indicated in case of uneven uterine tone. If the child does not roll over, then you need to perform the following exercises (this must be done in a knee-elbow position):

1. Inhale slowly 6 times and then exhale slowly.
2. As you inhale, lower your torso down, and as you exhale, return to the starting position (number of repetitions – 5).
3. First, raise your straightened leg, then take it to the side, touch it to the floor, and then return it to its original position. Do the same with the other leg. Repeat the exercise 4 times.
4. Do the “Cat” exercise.
5. Perform a Kegel exercise, which involves alternately tensing and relaxing the muscles of the vagina and anus.

Ways to turn a fetus at different stages

Since for a successful birth the fetus must move head first, various methods are used to help turn the baby from a breech presentation to a cephalic presentation.

Special gymnastics

Special gymnastics is a set of actions aimed at relaxing the muscles of the uterus, which promotes fetal rotation. The simplest include gymnastics according to Dikan and exercises for raising the pelvis, but there are other methods, for example, according to E. V. Bryukhina or V. V. Fomicheva and others.

But you should not decide on your own to perform gymnastics to turn the fetus over. A doctor should prescribe and recommend it, and choose a specific method, taking into account the characteristics of the course of pregnancy. In addition, the exercises have a number of contraindications:

• gestosis;
• the likelihood of premature onset of labor;
• location of the placenta above the cervix (previa);
• two or more fetuses in the womb;
• abnormalities in the structure of the uterus;
• infertility, miscarriages and premature births in the past;
• child developmental defects.

Gymnastics according to Dikan

This method is very simple, has no contraindications and is used from the 29th week of pregnancy. It consists in the fact that the expectant mother should lie alternately on one side and the other on a hard surface for ten minutes, changing her body position 3-4 times. You need to perform the exercise every day for 10 days, 4 times a day before meals, and after the fetus turns its head down, sleep mainly on the side where its back is located. The doctor may also prescribe wearing a bandage, which helps secure the child in a cephalic position.

Gymnastics according to Dikan is a very simple way to help the heart turn over to the head position

Raising the pelvis

Raising the lower part of the body above the upper is an effective way to help the fetus assume a cephalic presentation. Experts identify two main exercises that can be used to encourage a child to turn his head down:

1. Lie on your back and place your feet on a chair so that your ankles are on its surface.

   
   When performing the exercise, you first need to lie on your back and raise your legs on a chair

2. Raise your pelvis while keeping your legs on the chair.

   
   With your feet on a chair, you should raise your pelvis

3. Place pillows under your buttocks to support your body at a 45-degree angle.

   
   In conclusion, you need to place pillows under your pelvis and relax

4. Relax and stay in this position for 10–15 minutes.
5. Repeat steps 2-3 times a day.

The second exercise to lift the pelvis is also very simple:

1. Get on all fours.

   
   When performing the exercise, you first need to get on all fours

2. Place one pillow under your knees and a second pillow between your arms.

   
   Then you should put pillows under your knees and between your arms.

3. Lower yourself onto your elbows so that the pillow remains between your hands and your tummy is in the air.

   
   Finally, you need to lower yourself onto your elbows so that your pelvis is raised up

4. Relax and stay in this position for 10–15 minutes.
5. Repeat steps 2-3 times a day.

You can start lifting the pelvis from the 30th week of pregnancy. You need to do the exercises on an empty stomach. If dizziness, pain or other unpleasant sensations appear during exercise, you should stop exercising and consult your doctor for advice.

External rotation of the fetus

External fetal rotation is a manipulation performed by a gynecologist to turn the baby in the womb into a cephalic presentation using light pressure on the abdomen. To carry out the procedure, the doctor feels the child’s head and pelvis with his hands, after which he gently turns his head forward, while shifting the pelvis in the opposite direction. If it is not possible to achieve the desired position in this way, then an attempt is made to turn in the opposite direction (backward forward).

Painkillers may be used to perform external rotation, although this is not necessary for multiparous women. The likelihood of successful completion of the manipulation is higher if drugs are used to relax the muscles of the uterus.

External fetal rotation is performed through the abdominal wall without vaginal intervention.
External fetal rotation is performed at 34–36 weeks. Its success is estimated on average at 50%, that is, turning the child into a cephalic presentation is possible in half of the cases. The manipulation is performed under the control of ultrasound and CTG, so experts consider it safe for the fetus, although in rare cases negative consequences are possible:

• twisting or compression of the umbilical cord, which causes hypoxia. Monitoring a pregnant woman after performing a turn allows you to avoid negative consequences;
• placental abruption;
• breaking of waters and development of labor. This complication is not critical if the rotation occurs at 36 weeks;
• injuries to the fetal shoulder joint after successful completion of the rotation;
• uterine rupture.

There are many speculations about this manipulation that I hear from both patients and medical professionals. Over many years of practice (I have been performing turns since 2001), I have not observed any complications from this manipulation. Although there is a risk of some complications, and this is discussed with the pregnant woman before the manipulation, the risk of such complications is extremely small. This risk is not comparable to the risk from a caesarean section or breech birth.

Rudzevich Alexey Yurievich, Doctor of Medical Sciences, Associate Professor of the Department of Obstetrics and Gynecology of the Faculty of Training and Teaching Staff of the Tyumen State Medical Academy, obstetrician-gynecologist

https://lib.komarovskiy.net/naruzhnyj-akusherskij-povorot.html

Even after successful external rotation of the fetus, a return to breech presentation is possible. This occurs on average in 10% of cases.

External rotation of the fetus is carried out under mandatory ultrasound and CTG control

Contraindications for external rotation:

• multiple births;
• scar on the uterus;
• dilatation of the cervix;
• threat of miscarriage;
• fetal hypoxia;
• placenta previa;
• pregnancy accompanied by toxicosis, bleeding, gestosis;
• narrow pelvis;
• high or low water;
• large fruit;
• abnormalities of the uterus.

External obstetric rotation - video

In a swimming pool

Exercises for abnormal fetal position can also be performed in the pool. You need to choose one in which the water is not too cold. The most popular exercises for pregnant women are:

• lean on the side of the pool, lift your pelvis and legs several times in a row;
• squat down, and then push off from the bottom and jump;
• backflip into a part of the pool with sufficient depth;
• free swimming, which helps to reduce the tone of the uterus, which gives the baby good conditions for turning over and more space for movement, since the walls of the uterus will not be as rigid as before.

Classes can be held in your own pool or a public one. In the latter case, you can attend special groups for pregnant women, where classes are conducted with an instructor. This specialist will teach you how to breathe correctly and perform basic exercises that will be useful not only for turning the baby over, but also as preparation before childbirth.

Popular options for a coup

Not only exercises for pregnant women will help turn the baby over during breech presentation. Many believe that he can be mentally convinced to do this. The chance that this will help is small, but it is there. To do this, you need to lie down comfortably, relax, turn on quiet, pleasant music, stroke your belly and imagine how the baby turns over. During this you can talk to him.

There are other similar methods:

1. Exposure to sound. You can bring the headphones to the lower abdomen; perhaps the child will try to get to the source of the sound and roll over.
2. Exposure to light. The principle is the same as in the case of sound. At 32 weeks of pregnancy, the baby can already distinguish between light and dark, so he will be able to try to roll over, moving towards the beam of a flashlight.
3. Contrast compresses. A cold compress should be applied to the upper abdomen. It is generally accepted that the child will be uncomfortable in this position, and he will try to roll over to escape the cold.

These methods do not have evidence of effectiveness; they are often used as additional methods, but they certainly will not harm either the child or the expectant mother.

Yoga and inverted asanas also help turn the baby over in the womb. But they can only be performed by trained expectant mothers, since in the absence of skills, you can harm both yourself and the child.

Causes of breech presentation

Head presentation is the normal course of pregnancy. It is in this position that the baby develops normally in the womb. And if the fetus turns its buttocks towards the exit from the uterus, then there are reasons for this, which can be divided into three main groups:

• maternal factors;
• fruit factors;
• placental factors.

Maternal factors

Maternal factors are related to the health and physiology of the mother. These include:

• developmental anomalies of the reproductive organ (one-horned, saddle-shaped, underdeveloped uterus and other pathologies);
• tumors in the uterus or pelvis;
• discrepancy between the fetal head and the woman’s pelvis;
• increased or decreased contractility of the uterine muscles;
• scar on the uterus;
• stress and nervous fatigue.

A woman diagnosed with breech presentation experiences nervous tension and worries about childbirth, which only increases the tone of the uterus and does not contribute to fetal rotation.

Fruit factors

The cause of breech presentation may be the developmental characteristics of the fetus. In such situations, we talk about fruit factors, which include:

• multiple births;
• fetal prematurity;
• abnormalities of the skull;
• malformations of the central nervous system, cardiovascular, urinary and other systems.

With multiple pregnancies, the likelihood of malpresentation increases

Abnormal position is associated with prematurity because preterm labor occurs before 36 weeks. It is likely that the fetus would have time to turn over into the cephalic position, provided that it was born in a timely manner.

Placental factors

Sometimes breech presentation is a consequence of pregnancy. In such cases, we talk about placental factors, which include:

• excess or insufficient amount of amniotic fluid;
• location of the placenta above the cervix (previa);
• short umbilical cord.

How can you tell if your baby has rolled over?

After performing a set of special exercises to make the baby turn over in the stomach, the pregnant woman will definitely want to know about the positive result before going to the doctor. Therefore, she needs to know how to understand that this has happened. This can be done by palpating the abdomen: a rounded bulge should be clearly felt in the upper part - the buttocks of the fetus. You also need to pay attention to the localization of the movements - in the lower part they should be less intense.

Regardless of the stage of pregnancy, there is always a chance that the baby will turn head down. Special exercises, constant conversations and lifestyle changes can prepare a mother and her child for childbirth without negative consequences.