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Has my pelvic region expanded?

Q: I recently went to a doctor and he told me that I was 1 cm dilated and the baby's head was well engaged. I have been feeling very uncomfortable. Although the last couple days, I haven't felt as much pressure. After the baby's head is well engaged, is it possible he can back away (retreat) or has my pelvic region expanded?

A:The head stays above the mid plane of the pelvis in most circumstances until some contractions encourage the baby to settle into a birthing position. True engagement is the fixing of the fetal presenting part at the level of the mid pelvis (or at the level of the ischial spines) and this process (also called dropping or lightening) occurs anytime after 36-37 weeks. In multiparous women, the baby does not usually become fully engaged until the woman is in labour. When you start to have contractions every 3 minutes (from the beginning of one contraction to the beginning of the next contraction) at the level of your belly button, and each contraction lasts (remains hard) for, at least, 45 seconds, and this continues for a full hour, one would consider you to be in labour. If you are dilated more than 3-4 cm, you will be admitted to the hospital. Once you dilate up to 5 cm, you should continue to dilate at the rate of 1cm/hour.

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