Week 36: Head down or bottom down?
Image: @evieandsarah
Welcome to week 36 of the Happy Parents Happy Baby guide to pregnancy, birth and beyond.
This week we'll be covering:
We hope you enjoy it!
Your baby’s position and what it means for birth
Babies will change position many times during pregnancy, but by 36-37 weeks most will turn head down and stay in that position until birth.
If your baby hasn't moved into the head down position there may be some extra considerations for your birth.
So this week we explain the different positions your baby may be in and what it might mean for you..
Occiput anterior aka 'front to back'
Most babies are born head first, with their chin tucked into their chest and their back against your stomach.
This position is called Occiput Anterior (OA) or 'front to back' and is the most streamlined position for your baby to be born.
Occiput posterior aka 'back to back'
Sometimes babies lie head down with their back against your back.
This position is called Occiput Posterior (OP) or 'back-to-back'. This is of little importance during your pregnancy and most babies in this position are born vaginally. However:
You may have more backache during labour, where your baby is pushing against your spine. Remember all the options we discussed previously about how to make things more comfortable during your labour.
It can make labour longer, especially if your baby's chin is pushed up, which can make its journey through the pelvis less smooth.
It’s important to know that most babies that are back to back will turn to the front to back position during the early stages of labour.
Transverse
Some babies lie sideways across the womb rather than head down.
This is known as transverse lie. If your baby is still in this position at 36 weeks or when labour starts, you will be offered:
A procedure to try to turn your baby to head down, called an ECV (see below)
An elective abdominal / Caesarean birth
Breech aka 'feet first'
Babies lying bottom or feet down rather than head down are referred to as being in breech position. Being breech is common in early pregnancy and by 36–37 weeks of pregnancy, most babies will have moved to be head down. However, 3 or 4 in every 100 remain breech. You can read the Royal College of Obstetricians and Gynaecologists information leaflet here.
Your baby’s development in week 36
Size of a bunch of kale
Weighs on average 2.6kg
Around 47.4cm long
This week your baby is busy building up their fat stores ready for life in the outside world. It is normal for babies to lose some weight in the early days of life so these fat stores provide a buffer until feeding is established and they start gaining weight again.
Most babies by this stage are in the head down position, but if not your midwife will advise you of next steps.
Your baby is shedding the downy ‘lanugo’ hair that once covered it’s body as well as some of the cottage cheese like ‘vernix’ covering the skin. These enter the amniotic fluid and are swallowed by the baby, resulting in meconium being formed in the guts. This is passed as the first black tar-like poo.
Week 36 Checklist
You might like to:
Discuss birth preferences with your birth partner/s if you have one. This will ensure you can be supported in the way you would like to be on the big day. Your birth partner can also be your advocate, communicating your wishes with your health care team so it’s important that they understand what you would like to happen in different scenarios.
Complete a birth preferences document with your healthcare team. You can download the Happy Parents Happy Baby birth preferences template here.
Spotlight on: Carpal tunnel syndrome
Each week we'll be delving into the common symptoms of pregnancy and bringing you top tips for managing them from our team of specialists and parent community.
Carpal tunnel syndrome
Why are my hands and wrists aching?
Carpal tunnel syndrome (CTS) is a common pregnancy symptom and it may affect one or both of your hands. It’s caused by compression of a major nerve (the median nerve) that runs through a tunnel in the wrist known as the carpal tunnel.
Symptoms include:
Tingling sensation or pins and needles
Numbness in your hands, thumb and fingers and sometimes your forearm
Throbbing in the palm of your hand, thumb, fingers and wrist
Cramping
The pain may feel worse at night and first thing in the morning
Redness and skin is hot to touch
Is there treatment for CTS?
There are a few things you can try to ease the pain and, as with many pregnancy symptoms, carpal tunnel syndrome should resolve after you’ve had your baby.
Try to rest your hands and wrists as much as possible.
Avoid repetitive movements such as wringing, squeezing or gripping
Elevate your hands to encourage the drainage of excess fluid, especially before bed
Try alternating cold and warmth on the affected area i.e. use a cold compress and then wrap something warm around your wrist (being careful not to touch your skin). Try this several times a day.
Try some hand and wrist exercises such as making a fist and stretching out your fingers, moving your hand up and down at the wrist, making an O with your thumb and each finger one at a time. Try doing these every hour.
Wear a wrist splint to give you extra support and relieve the pressure on your median nerve. Make sure you put it on before bed. It may take a few weeks for you to notice a difference.
Symptoms commonly go after the baby is born.Always seek help from your healthcare team if you are worried.
Birth story of the week
This week we catch up with Megan from our online course who shares the positive birth of her baby Eliza.
"My pregnancy was plain sailing, up until 37 weeks, when I had a growth scan where we found out that Eliza was breech! After the initial shock and upset, as a C-section was far from my planned hypnobirthing water birth, I referred back to all the information given to us on the HPHB course about Caesarean sections to really help me prepare for my birth. I then used this to help me prepare for the positive birth I wanted.
“We were excited and nervous all at once. The theatre had views of Brighton beach and the South Downs which was just beautiful as the sun was setting. I used my breathing techniques as the doctors prepped. HPHB helped us to understand how many people would be in theatre with us and their roles - if we hadn’t known this, we may have been daunted as it’s more than you think! It also really helped that everyone referred to us by our first names, making us feel at ease straight away.
“We got to play our playlist (which everyone loved!) and before we knew it Eliza was raised above the drapes to greet us! The birth was slow and calm, which included delayed cord clamping, my birth partner cutting the cord and lots of skin to skin while the surgeons finished the procedure. Eliza was so calm the whole time.
“The first moment I saw Eliza I was elated! Nothing can describe the instant love for such a tiny human!”
Treat of the week
If you're planning to breastfeed, the Elvie wearable electric breast pump is a big hit with our graduate community. It's perfect for discreet and hands-free pumping.
Products are based on suggestions from our specialists and community of parents. We may earn commission from shopping links.
Join our community
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Connect with other parents-to-be and learn everything you need to know, by joining our award-winning antenatal classes.
That's all for now...
Thank you so much for joining us!
Have a great week.
Team HPHB x
Information you
can trust
Our articles are based on the latest-evidence based guidelines and scientific research and are written by our team of medical experts.
Coming up
next week
Colostrum harvesting and feeding
Spotlight on: lightning crotch - yes, really!
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