Positions When Is Hard to Hear the Baby Heartbeat in Womb

one Measure the mother's womb
- 1.1 How to measure the womb
  - i.ane.1 To measure using the finger method
  - 1.1.2 To measure using a soft tape measure out
- 1.2 If the size of the womb is not what you expected
  - one.2.one The due date you got by counting from the last monthly bleeding is wrong
  - 1.2.ii The womb is growing too quickly
  - one.two.3 The womb is growing too slowly
two Observe the position of the infant
- 2.1 Feeling the female parent'south belly
  - 2.ane.1 Is the baby vertical?
  - 2.1.ii Is the baby facing the mother's front or her back?
  - 2.1.iii Is the baby head downwardly or bottom down?
- two.two Listening to the baby's heartbeat
  - 2.ii.one Find the baby's heartbeat
  - two.two.2 Notice the infant's position past listening to the heartbeat
  - ii.ii.three Check how fast the baby's heart beats
- 2.3 What to do if you detect warning signs
  - 2.3.one Baby is breech
  - 2.3.2 Baby is sideways
  - two.3.three Twins

Measure the female parent's womb

HEALTHY SIGNS

The size of the womb matches the due appointment.
The womb grows virtually 2 finger widths every month.

WARNING SIGNS

The size of the womb does non friction match the due date the first time you check.
The womb grows more or less than ii finger widths every month.

When y'all mensurate the womb, you check to see where the top of the womb is. This will show y'all 3 things:

How many months the adult female is pregnant now.
The probable due date. If you were able to effigy out the due date from the mother's terminal monthly bleeding, measuring the womb tin can help yous see if this due date is probably correct. If you were unable to effigy out her due engagement from her monthly bleeding, measuring the womb can help you figure out a probable due date. This should be done during the first checkup.
How fast the baby is growing. At each checkup, measure the womb to see if the babe is growing at a normal rate. If it is growing very fast or very slow, in that location may exist a trouble.

How to measure the womb

As the baby grows within the womb, yous can feel the womb abound bigger in the female parent's abdomen. The top of the womb moves most 2 finger widths higher each calendar month. At 3 months, the top of the womb is commonly simply above the mother's pubic os (where her pubic pilus begins). At about 5 months, the top of the womb is unremarkably correct at the mother's bellybutton. At eight½ to nine months, the acme of the womb is almost up to the mother's ribs. Babies may drop lower in the weeks only earlier nascency.

To experience the womb, have the mother prevarication on her back with some support under her head and knees. Your affect should exist firm simply gentle.

Notice the elevation of the womb.

womb
Walk your fingers upwardly the side of the belly	Find the top of the womb (it feels like a difficult ball nether the skin.)	You tin feel the peak by curving into the belly

To mensurate using the finger method

8½-9 months

9 MONTHS!

7½-8 months

6½-7 months

5½-6 months

4½-five months

iii½-iv months

2½-iii months

If the top of the womb is beneath the umbilicus, measure out how many fingers beneath the umbilicus information technology is. If the acme of the womb is to a higher place the bellybutton, measure out how many fingers higher up the belly button it is. Then come across how many months significant the woman is now by comparing the number of fingers with this moving picture (each line is near the width of ii fingers).

Write downwards what yous find, with a picture or with numbers.
To draw a pic: Make a circle for the mother'due south belly, a dot for her umbilicus, and a curved line for the top of the womb. Then draw the number of fingers the acme of the womb is to a higher place or below the bellybutton. For example:

This drawing means that the top of the womb is 2 fingers below* the bellybutton.*	bellybutton top of the womb	This drawing ways that the top of the womb is 3 fingers to a higher place* the navel.*
This woman is about iv½ months pregnant.		This woman is most vi½ months pregnant

To employ numbers: Write downward the number of fingers you used to measure the womb. Put a "+" sign in front end of the number if the top of the womb is above the omphalus. Put a "–" sign in front of the number if the top of the womb is below the bellybutton. The example in a higher place on the left would be – 2. The one on the right would exist +three.

The superlative of the womb is 4 fingers above your umbilicus — only where information technology should be at vii months!

Effigy out (or double check) the due date. For example, if measuring the top of the womb tells you that the adult female is seven months pregnant, you lot tin can await that the infant volition be built-in in about ii months. If you accept already figured out her due date using her last monthly bleeding, bank check to encounter if the two dates are about the aforementioned. See information on if the two dates are not well-nigh the same.

To measure using a soft tape measure

You can apply this method when the womb grows as
high as the woman'due south belly button.

Lay a cloth or paper measuring tape on the mother'due south belly, holding the 0 on the record at the peak of the pubic bone. Follow the bend of her womb up and hold the tape at the elevation of her womb.

Write downward the number of centimeters from the top of
the pubic os to the top of the womb.
Doctors, nurses, and many midwives are taught to count pregnancy past weeks instead of months. They start counting at the first day of the last monthly bleeding, even though the woman probably got pregnant two weeks later. Counting this way makes most pregnancies 40 weeks long.
During the second half of pregnancy, the womb measures close in centimeters to the number of weeks that the woman has been pregnant. For example, if it has been 24 weeks since her last monthly bleeding, the womb will usually measure 22 to 26 centimeters. The womb should abound about 1 centimeter every week, or iv centimeters every month.

If the size of the womb is not what you expected

If you are measuring correctly and yous do not discover the elevation of the womb where you expect it, it could mean 3 dissimilar things:

The due appointment y'all got by counting from the last monthly bleeding could be wrong.
The womb could be growing too fast.
The womb could be growing besides slowly.

The due date you got by counting from the terminal monthly bleeding is wrong

There are several reasons why a due date figured from the last monthly bleeding could be incorrect. Sometimes women do not remember the engagement of their last monthly haemorrhage correctly. Sometimes a woman misses her bleeding for another reason, and and then gets pregnant afterwards. This woman could actually be less significant than you thought, so the womb is smaller than you look. Or sometimes a woman has a little haemorrhage after she gets pregnant. If you assumed that was her regular monthly bleeding, this adult female volition be ane or 2 months more than pregnant than y'all idea. The womb will exist bigger than yous look.

If the due date does not match the size of the womb at the first visit, make a note. Wait and measure the womb again in ii to 4 weeks. If the womb grows about 1 to two finger widths a month or 1 centimeter a calendar week, the due appointment that you got from feeling the top of the womb is probably correct. The due date you got by figuring from the concluding monthly haemorrhage was probably wrong.

Retrieve: Due dates are not verbal. Women often requite nativity up to 2 or 3 weeks before or after their due date. This is perfectly safety.

The womb is growing too quickly

If the womb grows more than 2 finger widths a month or more than than ane centimeter a week, several unlike causes are possible:

The mother may have twins.Larn how to tell if there are twins.
The female parent may accept diabetes.
The mother may have likewise much water in the womb.
The mother may have a molar pregnancy (a tumor instead of a infant).

Too much h2o in the womb
As well much h2o is non always a problem, but it tin cause the womb to stretch likewise much. Then the womb cannot contract enough to button the baby out or to stop the haemorrhage after the birth. In rare cases information technology can mean that the baby will have birth defects. To see if the female parent has as well much water, try the thump test:

Take a helper put a hand forth the heart of the mother'south belly.

Put one of your hands on one side of the female parent's belly. Thump the other side of her belly with your other hand.

If there is also much h2o inside, you may feel a wave or ripple cross the abdomen from i side to the other. (The helper's paw keeps the wave from traveling through the mother's skin.) If there is likewise much water, get medical advice. It may be safer for the mother to have the birth in a medical center.

Molar pregnancy (tumor)
Sometimes a adult female gets pregnant, but a tumor grows instead of a baby. This is chosen a molar pregnancy.

molar
pregnancy

Other signs of a molar pregnancy are: no heartbeat can be heard, no baby can exist felt, the mother has bad nausea all through pregnancy, and the mother has spotting of blood and tissue (sometimes shaped similar grapes).

If yous see signs of a molar pregnancy, get medical aid as soon equally possible. The tumor can become cancer and kill the woman — sometimes very fast. A doctor can remove the tumor to save the woman.

The womb is growing too slowly

Slow growth can be a sign of one of these problems:

The mother may take loftier claret pressure. High blood pressure tin keep the baby from getting the nutrition it needs to grow well. If y'all cannot check her claret pressure, get medical help.
The mother may accept a poor diet. Find out what the mother has been eating. If she is too poor to become enough good nutrient, attempt to find a manner to help her and her baby. Plenty healthy nutrient can relieve the lives of many mothers and children.
The mother may take likewise little water in the womb. Sometimes there is less water than usual, and everything is still OK. At other times, also niggling water can mean the baby is not normal or will accept bug during the labor. If you recall the female parent has too little h2o, go medical advice.
The female parent may be drinking alcohol, smoking, or using drugs. These can cause a baby to exist small-scale.
The baby may exist dead. Expressionless babies do not grow, so the womb stops getting bigger. If the mother is v months pregnant or more, ask if she has felt the baby move recently. If the baby has not moved for 2 days, something may be wrong.

If the mother is more than seven months pregnant, or if you heard the baby's heartbeat at an before visit, listen for the heartbeat again. If you cannot find it, get medical help. Some medical centers may have equipment to run into if the baby is still alive.

If the infant has died, it is of import for the female parent to give birth before long. She tin can give birth at home, but she may bleed more than other mothers, and is at more take chances for infection. If labor does not kickoff in 2 weeks, go to a medical center where she can get medicine to outset her labor.

Note: When a mother loses a baby, she needs love, care, and understanding. Brand sure she does non go through labor alone. If she gives birth in the hospital, someone should stay there with her during the birth.

Detect the position of the baby

Salubrious SIGNS

There is only one baby in the womb.
The babe is head down at the time of birth.

Alarm SIGNS

The baby is breech (anxiety or bottom downwardly) at the time of nativity.
The baby is sideways at the time of birth.
The mother has twins.

In that location are 2 methods for finding the baby'due south position: feeling the mother's belly, and listening to where the babe's heartbeat is strongest. You lot may demand both to be sure of the position of the baby.

Feeling the mother'southward abdomen

It may be difficult to detect the position of the baby before the sixth or 7th calendar month. Try anyway. What you lot feel may not brand sense now just may make sense the next time yous feel for the babe. Information technology volition be easier to find the position during the last two months of pregnancy. The more y'all practice feeling the position of a baby, the better you will be at it.

To begin, assist the mother lie on her back and give her support under her knees and head. Make sure she is comfortable.

Then feel the mother's belly. You will be checking for 3 things:

Is the baby vertical (up and down)?
Is the infant facing front or back?
Is the baby head down or bottom downwards?

Is the infant vertical?


	vertical: head or bottom downwardly

	sideways: head and bottom on the sides

Almost babies are vertical by the 7th month.

To find out if the baby is vertical, lay one hand flat on each side of the belly. Printing in gently just firmly, get-go with one hand, and then with the other.

Check the shape carefully. Do the ends of the babe seem to be in the mother'due south sides? If so, the baby is probably lying sideways. Many babies prevarication sideways in the first months but most turn caput down past 8 months or so. Babies cannot be born through the vagina from the sideways position. A infant that is sideways and cannot be turned when labor starts must exist born past cesarean surgery in a infirmary. If the infant is sideways after 8 months, go medical help.

It tin can exist difficult to feel the position of the baby if the female parent has very strong muscles on her belly, or if she has a lot of fat on her belly. If yous have a difficult time feeling the position, inquire the mother to take a deep jiff and let it out slowly, and to relax her torso as you experience.

Is the baby facing the mother's front or her back?

Next, feel the mother's belly for a large, hard shape (the infant's back). If you cannot feel the babe's back, feel for a lot of small lumps.

A big, hard shape probably means the infant is facing the mother's back.	If you feel a lot of small lumps instead of a big hard shape, you are probably feeling the arms and legs. The babe is probably facing the mother's front.
		See nigh when the baby is facing the mother'southward front.


head down	lesser downwardly (breech)

Is the babe head down or lesser down?

By the last month earlier nascence, most babies are lying with their head toward the cervix. This is called a head-downwardly position. The head-down position is easiest for childbirth.

If a baby is head up, with her bottom toward the birth opening, this is called a breech position.

By the 7th or 8th month, the baby'southward head has usually moved downwardly in the mother'due south pelvis. Here is how to experience for the infant's caput:

I can feel the top of your pubic bone right here.

pubic
os

Find the mother'south pubic bone with your fingers. You can feel it just under the skin nether the mother's pubic hair. Ask the mother to have a deep breath in and and then let it out slowly.

As she breathes out, press deeply only above her pubic bone. Be gentle and finish if you hurt her.

If you experience a circular, hard object that you can move a little from side to side, information technology is probably the back or side of the baby'south head.

If you do non experience anything in the mother's lower belly, the babe may exist lying sideways.

If the shape is non clearly round, information technology may exist the babe'south confront or the baby's bottom.
Or sometimes the baby's lesser is upward, just the head is non straight down.

The head may exist bent to the side, or the chin may exist up. (These could be signs that the baby will not fit through the female parent'due south pelvis at nascence.)

If the lower role of the baby is not as well deep in the female parent's pelvis, effort moving that part of the infant from side to side.

If moving the lower part of the babe makes its whole back motion, then the babe may be breech. If the dorsum does not move, then the baby may be head downwardly.

Now feel the top of the female parent's womb. Does it feel round and hard, like a head? Or is it a different shape — like a bottom, a back, or legs? If the top of the womb feels more like a caput than what you felt in the mother's lower abdomen, the baby may be breech.
Put one hand on the baby's back. At the same time, with your other hand, push the top end of the baby gently sideways.

If the whole back moves when you move the pinnacle end, the baby is probably in a head-down position.

If the dorsum stays where it is while you move the upper role of the babe, you may be moving the caput (because the neck can bend, the back stays in place). If you are moving the head, the baby is breech.

Meet more information on breech babies during pregnancy. Come across data on when the baby is breech at the fourth dimension of birth.

When you bank check the infant's position, you might think you experience two heads or ii bottoms. The mother may accept twins.

Listening to the baby's heartbeat

The infant'due south heartbeat gives information about the infant's position within the mother and about the health of the baby. Listen to the heartbeat at each visit starting at 5 months.

Past the last 2 months, you can often hear the baby's heartbeat in a serenity room by putting your ear on the mother's abdomen. The heartbeat will exist easier to hear if you accept a fetoscope or a stethoscope. You tin make a simple fetoscope from wood, clay, or a hollow tube of bamboo. Or yous tin can purchase a fetoscope.


2-ear fetoscope	stethoscope	1-ear fetoscope

The baby'southward heartbeat is quiet and quick. Information technology may sound similar a sentinel ticking nether a pillow, only faster. The baby's heartbeat is nearly twice as fast equally a healthy adult heartbeat — usually 120 to 160 beats a infinitesimal.

Note: If y'all hear a "swishy" sound (shee-oo shee-oo shee-oo), you are probably hearing the baby's pulse in the cord. Cord sounds tell y'all how fast the baby's heart is beating, but they do not help you lot find the baby's position.

If the heartbeat sounds tedious, you are probably hearing the mother'south pulse instead of the babe. Try listening to a dissimilar place on her belly.

This is where the heartbeat is loudest:

Find the infant'south heartbeat

Call up about which way the babe seems to be lying. Then start listening for the heartbeat near the spot where you think the baby's eye should exist. You may need to listen in many places earlier y'all find the spot where the heartbeat is the near loud and articulate.

Find the baby's position past listening to the heartbeat

Is the heartbeat loudest in a higher place or below the mother's bellybutton?

If you hear the heartbeat loudest below the mother's umbilicus, the baby is probably caput downwardly.	If you lot hear the heartbeat loudest above the female parent'south bellybutton, the infant may be breech.
female parent's bellybutton babe'due south heartbeat is loudest hither caput down	baby'southward heartbeat is loudest here mother's bellybutton breech

Sometimes when the baby is facing the mother's front, the heartbeat is harder to find because the babe's arms and legs go far the way. Listen virtually the mother'south sides, or directly in the middle of her abdomen to hear the heart.

If you can, keep a record of where y'all heard the baby's
heartbeat past making a simple drawing.

female parent's bellybutton

baby'southward heartbeat

In this flick, the dot in the center is the mother's belly button, and the X shows where the heartbeat was found.

a record of the baby's position

In this record, for example, the baby did non turn caput downward until 7 months. Even and so the baby moved from side to side, and then the X moves from the left side to the right side of the mother's belly and then back over again. This kind of motion is normal.

Cheque how fast the baby'due south eye beats

Salubrious SIGNSBaby's heartbeat is betwixt 120 and
160 beats a minute.

Alarm SIGNSA baby whose heartbeat is slower than 120 or faster than 160 beats a minute may be having trouble. A baby whose heartbeat is slower than 100 or faster than 180 needs medical help. Follow these steps to check how fast the babe's middle beats:

Use a clock or a watch with a second hand, a digital watch, or a telephone with a clock every bit you lot would for checking the mother's pulse. If you do not accept one, compare the baby'southward heartbeat to your ain pulse when you are resting and at-home. (Or brand a timer out of homemade materials.) The baby's heartbeat should be about ii times every bit fast every bit your pulse.
Count the number of heartbeats in one infinitesimal. If you accept trouble watching the clock and counting at the aforementioned time, accept someone tell you when to start and stop counting. If the baby's heartbeat seems very slow, feel the mother'south pulse in her wrist while you listen. If the mother'south pulse and the heartbeat you hear are the aforementioned, yous are hearing the mother's heartbeat by mistake.
Continue a tape of where y'all establish the heartbeat and how fast it beats.

If the baby's heartbeat is higher up 160, expect a few minutes and check information technology again. Sometimes the heartbeat is faster when the baby moves. If the heartbeat stays above 160 (specially if it is 180 or more) the mother may have an infection. Check if she has a fast pulse or a fever.

If the baby'south heartbeat is irksome, the baby may be in danger. If the heartbeat is between 100 and 120 beats a minute, attempt moving the babe a little from the exterior. The baby may be sleeping. Bank check if the heartbeat is faster when the baby is awake.

If the heartbeat is slower than 100 beats a minute, get medical help. The baby is in danger! At a hospital the woman may be able to get a cesarean surgery to help the baby to be born early.

Note: A quiet heartbeat does not mean that the baby is weak. It but means that the infant'southward chest or back is far from your ear, or that the mother'southward belly is difficult to hear through. For example, the wall of the belly might be thick if the mother is fat.

What to do if you discover warning signs

Baby is breech

Breech babies are often built-in without any trouble, particularly if the mother has had other children and her births were easy. Only breech babies are more likely to get stuck or take other serious problems.

It may exist possible to go the babe to turn. Attempt these methods:

Lift the mother'southward hips. This lifts the baby out of the pelvis and then he can plough effectually and put his head down. The mother lies on her back and puts something soft

(like a pillow) under her hips for 15 minutes, 3 times every 24-hour interval. It is best to exercise this when the baby is moving a lot.
Afterwards lying this way for xv minutes, the mother should walk around for nigh 5 minutes. If she thinks she felt the baby turn, she should not lift her hips similar this again until yous take checked to run into if the babe is withal breech.

Enquire the mother to become on her knees with her caput resting on the floor. This is another way to move the baby out of the pelvis and then that he can plow.
Try talking to the infant, shining a flashlight, or playing music low on the mother's belly, nearly her pubic os. The baby may turn to be closer to the light or sounds.
You may have found medicines in your area that can assistance.

WARNING! Just try massage to turn the baby if y'all have been taught how to do it safely and can go medical help. Trying to turn the baby by pushing on the womb is very dangerous.

Never turn a babe if the mother's waters have broken or if she has ever had vaginal haemorrhage, loftier blood pressure, surgery on her womb, or cesarean surgery.

A doctor tin pull the baby out with forceps.

If the baby is non head downwardly when labor starts, it is safer for the mother to requite nascence in a medical center or hospital. Doctors can use forceps (pulling tools) if the baby gets stuck. Or they can do a cesarean surgery.

If a breech infant is going to exist born at home, it is important for a very skilled midwife to be there (see information about how to deliver a breech baby).

Remember, there are some times when breech birth is even more than unsafe. Do not try to evangelize a breech at domicile if:

this is the mother'southward first baby.
the mother has had long or difficult births in the past.
the babe is large.
the mother is weak or has been ill, and then she cannot push well.
the midwife is not very skilled or experienced with breech births.

Babe is sideways

If the baby is sideways — non caput down or head upward — by viii months, you tin can attempt lifting the mother's hips. If the baby does not turn, you should make arrangements for a hospital birth by cesarean surgery.

This baby must be born by cesarean.

Sideways babies cannot fit through the mother'due south pelvis to be born. If you try to evangelize the baby without surgery, the female parent'southward womb will pause during labor, and she and the baby will die without medical intendance.

If the baby turns head down at any fourth dimension — even on the day the mother goes into labor — information technology is OK for the mother to requite birth at home. But retrieve that turning a sideways baby by paw is just equally dangerous as trying to turn a breech baby.

Twins

It can exist very hard to know for sure that a mother is pregnant with twins.

Their borer is different. I may accept twins.

Signs of twins:

The womb grows faster or larger than normal.
Yous tin feel 2 heads or two bottoms when you feel the female parent's belly.
You can hear 2 heartbeats. This is not easy, just it may be possible in the last few months.

Hither are two ways to try to hear the heartbeats of twins:

Observe the heartbeat of ane baby. Take a helper listen for other places where the heartbeat is piece of cake to hear. If she hears a heartbeat, accept her listen to ane place while you mind to the other. Each of you can tap the rhythm of the heartbeat with your paw. If the rhythms are the same, y'all may exist listening to the same baby. If the rhythms are not exactly the same, y'all may be hearing ii dissimilar babies.

If you do not take a helper just y'all accept a lookout man with a second manus, a digital watch, a telephone, or a homemade timer, try timing each heartbeat separately. If the heartbeats are non the same, you may be hearing 2 dissimilar babies.

If you recall there might exist twins, even if you can find only one heartbeat, get medical help. At a medical centre or hospital, someone can use a sonogram to meet if there are twins.

Because twin births are oftentimes more than difficult or unsafe than unmarried births, they are safer in a medical center. Since twins are more probable to be built-in early, the mother should try to have transportation ready at all times after the 6th month. If the medical center is far away, the mother may wish to move closer in the last months of pregnancy. Be certain to have a plan for how to get help in an emergency.

If the babies must exist built-in at home, 2 very skilled midwives should attend the nascence. Lookout for labor starting too presently. See more than near twin births.

This page was updated:22 April 2021

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Source: https://en.hesperian.org/hhg/A_Book_for_Midwives:Check_the_baby