Engagement of the foetal head is one of the earliest signs of impending labour. It can occur about 37 weeks into pregnancy and should not be ignored. So, what do you need to know about it? This article discusses everything you must learn about the engagement of the foetal head.
Table of Contents
Engagement of the Foetal Head
Prenatal care is an important part of a healthy pregnancy. It’s also a time to discuss the birth process so that both mother and child are prepared for what’s ahead. In this post, we’ll discuss the foetal head’s engagement.
Engagement refers to the point at which a baby’s head is engaged in the pelvis. This happens when the diameter of the head is no longer larger than that of the pelvis. Before this point, labour can be induced—but after it, it’s not recommended because it could lead to complications like tearing or excessive bleeding.
The engagement process can take anywhere from one day to two weeks (or more!), depending on how low your cervix has descended already and how much room there is left in your pelvis for the baby’s head to fit through comfortably without causing any damage to either party involved.
Terms Denoting Engagement of the Foetal Head
The following terms are used to describe the engagement of the foetal head:
-
Early engagement
It describes when the foetal head has moved into the pelvis at 36 weeks of pregnancy. The head will be engaged in the pelvis if it fits through the os or opening of the cervix. This can cause discomfort as it requires dilation of the cervix, but it also indicates that labour will begin soon.
The head cannot be felt by palpation before this point, and many women do not feel any pain until after their water breaks and are close to delivery.
-
Late engagement
Late engagement of the foetal head occurs when the head has not yet engaged but is very close to doing so. This term is used in obstetrics to describe a state when an unborn baby’s head is close to engaging in the mother’s pelvis.
It is a normal process that occurs during pregnancy but can cause problems if it does not occur naturally.
-
Complete engagement
In this condition, the circumference of the foetal head is equal to or greater than that of the maternal pelvis. This means that the baby’s head has descended into the pelvis and is ready to be born.
-
Crowning
This is the most common term to describe foetal head engagement. It describes the position in which part or all of the foetal head is visible in a vaginal examination.
-
Station
The station refers to how far down the presenting part is about a horizontal line from the mother’s pubic symphysis to her sacral promontory. The station is normally determined by palpating the presenting part through the abdominal wall and then comparing it with that same point on an obstetric model (called Barton’s Rule).
Doctors may also use ultrasound for this purpose, but it can be difficult in cases where there is a lot of amniotic fluid around the baby’s head or if there are twins.
-
Shoulder Presentation
The shoulder presentation occurs when only one shoulder is visible on an abdominal exam, while both shoulders are visible below it on an upright view on ultrasound. Shoulder presentations are at risk for complications like shoulder dystocia, so care should be taken when treating these cases.
Pregnant woman feeling the engagement of foetal head
When Does the Head Become Engaged
The head becomes engaged when the cervix is completely dilated or opened up.
It can happen at any point during labour, but it’s usually somewhere between 4 centimetres and 10 centimetres.
Once you reach this stage, the baby will start to descend into the birth canal and engage its head in the pelvic cavity. This causes women to feel pressure in their lower back and pelvis as they enter active labour.
The Route of Engagement of the Foetal Head
The route of engagement of the foetal head is a critical factor in determining the mode of delivery. The route of engagement refers to the direction in which the foetal head enters the pelvis.
A normal engagement route is when the head’s occiput (back) enters first, followed by the brow and chin.
The direction in which a baby’s head enters the pelvis during labour can be challenging to predict because it varies widely between women and babies. Some babies rotate during labour so that they enter with their face first!
How a baby’s head enters the pelvis can impact how soon she will be born and whether she will need assistance from forceps or vacuum extraction techniques.
If a baby’s head is engaged, but her shoulders are not yet engaged (a condition known as shoulder dystocia), she may not be able to pass through your pelvic bones and forceps or vacuum extraction may be required to assist her out of your body.
Causes of Lack of Engagement of the Foetal Head
There are several causes for lack of engagement of the foetal head, including:
- Foetal malposition: In this case, the baby’s head is positioned so it cannot be delivered in the pelvis without intervention.
- Abnormalities in the shape and size of the pelvis (such as bony prominences or narrow pelvic bones)
- Large babies that cannot fit through the birth canal due to their size or shape
Image Source: iStock
How to Avoid Lack of Lack of Engagement of the Foetal Head
Lack of engagement of the foetal head is a common problem in childbirth. The head is not engaged when it is not in the pelvis, instead of being at an angle, with the top of the head pointing towards the mother’s back.
It can be a serious complication that requires immediate medical attention. Still, if you’re experiencing it at home, there are some things you can do to help alleviate your symptoms and ensure a healthy delivery.
Avoid walking around a lot if possible. This will help lower your blood pressure, easing pain in your abdomen and making it easier for your baby to move into position.
Try taking warm baths or showers to relax and relieve pain. You may also want to massage your lower back or abdomen with oil or lotion.
Take deep breaths and try not to panic—it’s natural for anxiety levels to rise when dealing with this issue!
Position of the Foetus
The stage of pregnancy determines the position of the foetus. In the first trimester, the foetus is in a cephalic presentation. This means that it is head down and facing your front. The second trimester typically sees a breech presentation.
This means that your baby’s bottom will be pointing towards your back. In the third trimester, you may see a transverse presentation where your baby will lie sideways in your uterus.
Multiple pregnancies, however, can lead to varying positions of the foetus. When there are two babies in one womb, they will usually be positioned head to head with their backbones against each other.
However, if three or more babies are present, they will be in various positions around each other and against the womb’s walls.
Pregnant woman in pain | Image Source: iStock
Is Baby Turning Head Down Painful
The first evidence of a baby turning head down is often characterised by pain in the mother’s abdomen, back and/or sides. This is because the baby’s head, which has been facing up until this point, is now starting to turn down into her pelvis.
The pressure caused by this movement can cause discomfort for the mother and even make it difficult to walk or sit comfortably.
What Causes Baby Turning Head Down Pain?
Several factors can cause the changing position of your baby’s head:
- The baby’s growth
- Your body’s response to that growth
- And your body’s ability to stretch to accommodate that growth
Can Baby Change Position Once Head Down
The answer is yes. A baby can change position as many times as needed during pregnancy.
A baby’s position is determined by how much space the baby has in the uterus and how well that space is utilised. If there is plenty of room for the baby to move around in the uterus, then it’s likely that he or she will stay in the same position for a while.
However, if there isn’t enough room for him or her to move around comfortably, or if something may be blocking his or her movement path (such as a fibroid), he or she may move into another position.
It’s important to remember that babies don’t have control over where they are positioned at any given time: They just go where they can fit!
ALSO READ:
7 Signs That Labor Is 24 To 48 Hours Away And You Must Get Ready
How To Make A Birth Plan: A Complete and Detailed Guide For Singapore Parents
Pros And Cons of Different Vaginal Birth Positions During Labour
Symptoms of Baby Turning Head Down
- Intense movements in your lower abdomen
- Your belly feels like it’s burning or cramping up
- You have an irresistible urge to pee (even though you haven’t even drank any water yet)
- You’re starting to feel slight contractions every few minutes, but they aren’t painful.
How to Tell if Baby Is Head Down Without Ultrasound
- Your belly button is pointing up. If this happens, it’s a good sign that your baby is head down and ready to come out.
- You’ve been feeling more pressure in your pelvic area lately. This could indicate that the baby has moved into position, which means they’re ready to come out!
- Your back hurts less than it used to. If this happens, it’s a good sign that things are progressing well towards labour and delivery!
Here at theAsianparent Singapore, it’s important for us to give information that is correct, significant, and timely. But this doesn’t serve as an alternative for medical advice or medical treatment. theAsianparent Singapore is not responsible for those that would choose to drink medicines based on information from our website. If you have any doubts, we recommend consulting your doctor for clearer information.