The thing about pregnancy is that it comes with its own unique language. You wouldn't be the first expectant mother to feel like she needs to take a dictionary along to her appointments!
For instance: "your baby's head has engaged". Which simply means your baby’s head has moved down to the pelvis - the right position for birth.
First babies tend to engage early - anywhere from 34 weeks. Second or subsequent babies tend to engage when labour starts. Your baby may even move in and out of the pelvis as you near labour.
Your baby’s head engaging is not a predictor of when labour will start.
How can I tell if my baby’s head is engaged?
In your third trimester, you may experience a feeling of being 'full up' and find it more difficult than usual to breathe deeply. This is thanks to your baby competing for space with your lungs and stomach. As you near your due date and your baby’s head drops (or engages), you may feel these symptoms ease, or feel a heaviness in your pelvis.
It is important to remember that, as with every part of pregnancy, this may not be experienced by every mother.
"When your baby's head drops," says Tina Perridge, Midwife at Private Midwives, "You may notice that there is a little more space at the top of the uterus making breathing somewhat easier, while there may be slightly more pressure down below making long walks less attractive and visits to the bathroom more frequent."
Mum kate3 on our forum describes how it felt for her: "Your ribs will be free at last and you can breathe better... you can also feel baby pushing down very low. I wouldn't describe it as pain (unless I sneeze or cough) but it is uncomfortable. I do sometimes get shooting pains when I move too quickly coz of it. You tend to waddle a lot more. It's a real heavy feeling. You're also more likely to need the loo a lot more than before, too."
And RedHead85 says, "I've been getting the same sensation since Sunday (on the same day, my mum and my nan commented that my bump was looking lower). Feels like there's a heavy pressure down there! At first, I thought it might be constipation (sorry, TMI) but everything's fine on that front."
When should I expect my baby’s head to engage?
"With a first baby, this might start at around 36-37 weeks," says midwife Tina Perridge. "While for some women expecting a second baby, it may not occur until just before labour. Either way, it is a gradual process."
It is important to remember, though, that your baby’s head engaging has no bearing on when labour will start.
"Many women find that the baby's head doesn’t engage until they are actually in labour, and the power of the contractions helps to push the baby’s head deeper into the pelvis. Once the head is well down and engaged you may feel that your bump has ‘dropped’ and looks lower in appearance," says midwife Anne Richley
What does my midwife mean by 2/5 or 3/5 engaged?
Your midwife records your baby's head engagement in measurements of fifths. If you read 5/5 or 4/5, this means that the head is not engaged yet. Notes of 3/5, 2/5 or less means your baby's head is engaged. That’s because - at 3/5ths - the widest part of your baby’s head is in your pelvis.
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Midwives measure it because when they see that your baby can make it to 3/5ths engaged, there’s a good chance that your baby will arrive without much difficulty. But please don’t worry if you never see 3/5ths on your notes. As we mentioned, your baby may not engage until right before birth.
"The phrase 2/5 or 3/5 engaged simply records the baby’s progress and descent into the pelvis," says midwife Tina Perridge. "Some practitioners may record 2/5 or 3/5 palpable which means that 2/5 or 3/5 of the baby’s head is felt above the pelvis.
"It is worth remembering that few babies descend further than 2/5 palpable before labour because the head is felt at the front of the pelvis and the pubic bone is quite shallow at this point."
On our forum, natmarie says, "In my notes it has an explanation of engagement which reads: engagement is how deep the presenting part - eg the baby's head - is below the brim of the pelvis, it is measured by the proportion which can still be felt through the abdomen, in fifths. 5/5 = free, 4/5 = sitting on the pelvic brim, 3/5 = lower but most is still above the brim, 2/5 = engaged, as most is below the brim and 1/5 or 0/5 = deeply engaged, as hardly still palpable from above. In first time mothers, engagement tends to happen in the last weeks of pregnancy, in subsequent pregnancies, it may occur later, or not until labour has commenced."
What can I do to make my baby’s head engage sooner?
Your baby’s head is more likely to engage if they are in an anterior position, rather than ‘back to back’. Anterior means, says Tina, "his/her back is slightly towards your front." This position, she says, "Allows the baby to curl up comfortably and to tuck his/her head which, in turn, facilitates engagement.
"To help with this, it is a good idea to be active - walk, swim, use the all fours position, kneel and lean forward to help gravity to rotate your baby. Try to avoid reclining back on a soft sofa."
Mums on our forum advise the same, nicki100’s midwife advised her to "spend time on my hands and knees”. She adds, "As if I'm not uncomfortable enough!"
And Feebs76 says, "Apparently sitting on a birthing ball with your legs astride and rocking from side-to-side is meant to help - although it's all in baby's hands as to how co-operative he/she is going to be!"
Once my baby’s head is engaged, how long before I go into labour?
It is worth remembering that, just because the baby’s head is engaged, it doesn't mean that you will definitely go into labour soon. So when will labour start? "Unfortunately, nobody can answer that." Says Tina. "Some babies like to confuse us by popping out and repositioning themselves. So just try to relax and wait for your labour (and your baby) to take its course."
On our forum, mums experienced the same, "My baby engaged early and I thought she would come early, but I'm still here at 39+2," reported princess4aday.
WoWbabies says, "DS was 2/5ths from 33 weeks, he never engaged any further and didn't arrive until 40+6."
GlitterBug09 reports a similar experience, "My dd started to engage at 35 weeks, by 39 weeks she was fully engaged but I didn't give birth until 41 weeks!"
Factors that can affect when your baby's head engages include...
- If your baby is in a posterior position - his back to your back - it may be harder for him to engage.
- If your baby has lots of room to move he is less likely to engage. He might be enjoying swimming in lots of amniotic fluid!
- The shape of your pelvis or position of the placenta.
- If you are expecting a big baby it is more likely that your baby's head will engage when contractions begin.
About Tina Perridge
Tina is based in London and has been a midwife for 21 years, with a keen interest in postnatal care and breastfeeding. She became a midwife after having her fourth child and realising what a difference continuity of care and support can make to a woman’s experience. She is a midwife for Private Midwives, the leading provider of private midwifery services.
About Anne Richley
Anne Richley is a community midwife and a regular contributor to Made for Mums.
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