Yippeee!!! You are now in the homestretch and so very close to bringing your newborn home.
By now you know the drill—your physician is concerned with your blood pressure, weight and urine sample. We are concerned regarding your baby’s movements. But additionally, the 36 week visit is very important for establishing two important considerations for labor; the position of your baby’s head, (vertex or breech), and whether you are colonized with a common vaginal bacteria, group B strep or GBS.
FETAL POSITION
As you may already know, delivering a baby vaginally from breech presentation has become less frequently attempted. There is potential for serious complications and many providers are reluctant to perform breech extractions. Fortunately, most babies are head down or what obstetricians refer to as “vertex” presentation by 36 weeks. However, some babies are not and if that’s your case, your doctor will discuss options for you. (Yes, it is possible for your baby to still turn to a vertex position without any intervention, but by this time, it is not very common for that to happen.)
When breech presentation is confirmed, a cesarean section will be necessary unless your provider will perform a breech delivery or unless a version procedure is performed successfully. A version attempt is typically attempted at 37 or 38 weeks.
GBS COLONIZATION
Also at this visit, your provider will also swab your vagina and rectum for the presence of GBS, which is a bacteria that may colonize the vaginal/rectal area of nearly 25-30% of women at term. This is not a sexually transmitted disease. This bacteria generally does not affect you and most women are unaware they are colonized. However, this bacteria may be transmitted to your baby at time of labor. Transmission of GBS to your baby, if it were to occur, may cause serious infections for your baby including neonatal meningitis or pneumonia. Therefore a patient confirmed to be positive will receive IV antibiotics at that time they are in labor. Please note, administration of these antibiotics dramatically decreases transmission to your baby.
