The birth of a baby has so many possibilities in terms of positions that it is impossible to predict what mood your baby will be in at the time when the doctors say the word ‘Push!’.
Usually, the baby comes down the birth canal face-down, back if the head facing the mother’s belly and chin tucked in against the chest. This is called flexed or vertex presentation and allows a smooth birthing, where the smallest position of the baby’s head passes first through the birth canal. However, as unpredictable is the labor and delivery, so is the baby.
What Happens In Brow Presentation?
In the case of brow presentation, the baby does not tuck its chin against its head—apparently, this leaves them facing up as the head and neck is extended backward. Due to this posture, there is lesser space available for their head to pass through, increasing the chances of a C-section.
Can The Presentation Be Diagnosed Before Birth?
Not really, it is difficult to determine the baby’s presentation until the labor is in full swing. However, ultrasound scans can be used to keep an eye on the position of the baby. The vaginal examination doesn’t allow much detection apart from the facial features.
How Often Does Brow Presentation Happen?
Brow presentation is a rare phenomenon and is observed in only 1 in 1400 births. More than half of such babies who are in such a position during the early labor decide otherwise and tuck their heads only to make the labor normal as any other.
The rest half of babies move their heads a little backward in such a way that they tend to emerge face first, which can also result in a normal delivery.
Though brow presentation happens rarely, your doctor might recommend an immediate c-section if the labor doesn’t progress or the baby seems to be in distress.
What Are The Causes Behind It?
There are a number of reasons that increase the risk of a brow presentation.
1. An abnormal shape and size of the pelvis can have an effect on the baby’s positioning. For instance, a contracted pelvis, which is abnormally small in size could increase the risks.
2. Low amniotic fluid can also create a hindrance for the baby to be in the flexed or vertex presentation for birth.
3. Babies born prematurely or with a lower birth weight are at a higher risk of getting in a brow presentation.
4. Multiple pregnancies can lead to shifting in position of the baby in an unfavorable way.
5. Macrosomia or a baby larger than the usual size can increase the risk since they tend to extend the head backward instead of tucking it towards their chests.
6. Brow presentation can also occur in the case of cephalopelvic disproportion (CPD), wherein the mother’s pelvis is not in proportion to the baby’s head.
6. In rare cases, when the umbilical cord wraps around the baby’s neck, the tucking in of the chin isn’t possible, leading to brow presentation.
7. Laxity of the uterine wall may put the baby at a disadvantage when they try to tuck their chin, causing brow presentation.
How Can Brow Presentation Be Avoided?
In most cases, the labor progress could halt for a longer time, causing fetal distress, thus, resulting in a c-section. However, there are two ways in which your doctor could change the course of a stalled labor after the cervix gets dilated completely.
1. Manual Rotation: This way the doctor inserts his hand into the vagina and tries to manually flex the baby’s head.
2. Ventouse Or Vacuum Assisted Vaginal Delivery: Here the doctor uses ventouse to flex the baby head as the mother tries to push the baby during a contraction.
There are various factors, which decide if these two methods can make things easier for the baby and the mother. The last resort is to opt for a c-section.
A mother who had a brow presentation earlier doesn’t necessarily have to face it in subsequent pregnancies. Also, it is a rare condition—your doctor will offer you the right advise on promoting a proper positioning of the baby in the womb.