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When should the fetus come in a head-down position?

Q: I am 30 weeks pregnant now. My doctor says that my baby's head is on the top, when it should be down by this time. What should I do? What exactly does she mean by that?

A:As pregnancy advances most babies take up their final position for delivery. In over 90% this is with the head pointing downwards. In the remaining 10% of babies, the position is with the buttocks or feet pointing towards the birth canal or in a sideways position with the head in either the right or the left flank. This taking up of the final position may take place anytime between 28-40 weeks and occasionally even in labour. Since unusual positions require greater supervision in labour and often need a Cesarean Section delivery, the doctor follows the evaluation of the baby's position carefully in each check up. It is often worth waiting upto the time when you go into labour to assess the possibility of a normal delivery. Mal-positions, as the unusual positions of the baby are called, are usually not due to any cause. Sometimes they are a consequence of a malformation of the mothers uterus, a low lying placenta, fibroids and also in twins.

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