Breech babies, disappearing symptoms, and dates
Finding out your baby is breech late in pregnancy can often lead to feelings of anxiety and concern, but there are multiple evidence-backed options for moms who find themselves in this position (no pun intended…).
Welcome to the weekly ZIP - your Zenith Informed Pregnancy!
Read on for a quick zip through 3 of the week’s most popular pregnancy questions, and the evidence behind them. Plus - bonus content on the latest & greatest in the world of pregnancy research.
This week's top pregnancy questions:
1️⃣ My baby is breech - what now?
2️⃣ Pregnancy symptoms disappearing?
3️⃣ What's the evidence behind dates and labor?
My baby is breech - what now?
Between 3-4% of babies are breech at full term, but that still represents many thousands of moms wondering what this means for their carefully-laid birth plan and both their own and their baby’s health during birth. Finding out your baby is breech late in pregnancy can often lead to feelings of anxiety and concern, but there are multiple evidence-backed options for moms who find themselves in this position (no pun intended…).
📚The tl;dr from the evidence: The primary reason a baby being in breech position (feet or bottom down, rather than head down) is that if a baby is delivered feet-first, there’s a higher risk of birth complications, including the baby’s head/shoulders getting stuck, or the umbilical cord being compressed (reducing oxygen to the baby).
As a result, most (~85%+) babies who are breech at full term are delivered via planned C-section, as the evidence shows this to be the safest option in most cases. There are other options: your provider may try to turn the baby before delivery via a procedure called external cephalic version, or ECV, where gentle pressure is applied to the abdomen to try and adjust the baby’s position. ECV is a safe procedure, but only has ~50-60% success rates of moving the baby to a head-down position. Planned vaginal breech birth is also a possibility in some cases, although infrequently, as the data shows that the risk of complications is higher with a planned vaginal delivery than with a planned C-section.
And remember - needing a C-section is not a sign of “failure” in any way, even if you’ve been planning on a vaginal birth. Oftentimes, a C-section is the safest, risk-minimizing way to ensure that your baby arrives safely.
👀Read Penny’s full summary of the evidence for more on breech babies
Pregnancy symptoms disappearing?
The presence of symptoms is the root of most pregnancy questions, like the tried and true “best remedies for morning sickness?” “heartburn relief that actually works?” or even “are crazy vivid dreams normal?” It’s not just the presence of symptoms that leads to questions, though – the equally nerve-wracking and anxiety inducing questions are about the absence of symptoms. “My symptoms went away - is this a bad sign?” “Should I be worried, suddenly no more nausea?” come up frequently, especially towards the end of the first trimester.
📚The tl;dr from the evidence: Often, the absence of symptoms is completely normal - and common for early pregnancy symptoms like nausea and fatigue to clear up as you enter the second trimester. Generally speaking, symptoms can fluctuate across your pregnancy for many reasons, including pregnancy progression, lifestyle changes, diet changes, or stress, so it’s normal that not every day is consistent in terms of the symptoms and severity you experience.
Symptoms very suddenly disappearing early in pregnancy (early/mid first trimester) may be concerning as a signal of a potential miscarriage, particularly if vaginal bleeding or cramping accompanies the loss of symptoms. If you experience this or if you simply feel like something isn’t right, it’s always okay and a good idea to reach out to your OB for reassurance and guidance.
So why does the start of the second trimester often feel so much better symptom-wise than the first? In early pregnancy, the ovary (specifically, the corpus luteum) produces most of the hormones needed to support pregnancy, but right around the end of the first trimester, the placenta becomes the main producer of these hormones. The likely mechanism behind your symptoms disappearing is that your hormone levels actually start to stabilize as the placenta takes over.
👀Read Penny’s full summary of the evidence for more on symptoms going away
What’s the evidence behind dates and labor?
In the third trimester, natural ways to induce or ease labor are always popular questions! Eating dates comes up all the time in this conversation – so is it just a superstition, or is there data behind it? And is eating a date a day enough?
📚The tl;dr from the evidence: There actually have been some studies on this, although many of the studies are small or inherently flawed. While imperfect, they do generally point towards potential benefits of consistent, higher quantities of dates (think ~6 per day consecutively for the last 3-4 weeks of pregnancy) leading to positive labor-related outcomes like an increased likelihood of spontaneous labor and higher cervical ripening.
Why? It’s not conclusive, but the fatty acids found in dates may help increase the body’s levels of prostaglandins (natural substances that help soften the cervix), and dates contain compounds that may mimic or support the action of oxytocin (a key hormone that causes the uterus to contract and helps labor progress).
What dates are not? A surefire way to ‘naturally induce labor,’ so don’t bank on dates as a magical tool when you’re ready (or more than ready!) to begin labor. Even so, dates are filled with great nutrients and vitamins, so there’s little downside to consuming them if you’re so inclined and want to see if there’s benefit for you in your personal labor experience!
👀Read Penny’s full summary of the evidence for more on eating dates and labor
🤓 Zenith's top read of the week
Bonus: what the Zenith team found interesting this week. Think cool pregnancy research or recently published studies, news in pregnancy health and policy, and more!
Don’t call it morning sickness: ‘At times in my pregnancy I wondered if this was death coming for me’ (Abi Stephenson, The Guardian) - Last week, "pregnancy-safe nausea medications?" was a trending question (which we covered in our ZIP - read here if you missed it!) and we were moved by this longform piece on the experience of living through a pregnancy with hyperemesis gravidarum (HG) – or extreme nausea & vomiting of pregnancy.
HG is a brutal condition affecting up to 3% of pregnancies - which may sound small, but in practice is over a hundred thousand women in the US each year. Given that many are familiar with ‘regular’ morning sickness and nausea, but most are not familiar with HG, it’s unfortunately common for proper care and treatment to be delayed, or even absent, without real self-advocacy from women suffering through it. We’re grateful for the publication of experiences like this, as they help shine a light on the severity of the condition, physical and emotional toll it takes on women, and the urgent need for improvements in our understanding of and treatments for HG.
Key excerpt:
“Like the millions of non-royals with HG, I was largely left to fend for myself, never knowing when my condition was considered “bad enough” to trouble a hectic emergency department for IV fluids. No blood tests took place to check for nutritional deficiencies (I couldn’t keep down prenatal vitamins), there were no weigh-ins, no extra check-ins, no counsellors and no special clinic to visit. … If one hasn’t experienced it, it is hard to imagine the physical and psychological impacts of starvation and relentless vomiting – up to 50 times a day, for nine months."
