36 weeks pregnant: baby is the size of a head of romaine lettuce

Your baby this week

Your baby's lanugo, the fine downy hair, is mostly gone, and much of the vernix is going. The gums are firm, and the grasp is strong. The lungs are close to full maturity, and the digestive system is ready for milk. Your baby has stored fat that will help keep warm after birth.

The head is proportionate to the body, and the skull is still soft. Your baby has little space, but you should still feel movement each day.

How it happens. In most pregnancies, the head is the heaviest part, so a baby tends to settle head-down under gravity. Some babies stay bottom-down, sideways or at an angle, especially with a lot of amniotic fluid, twins, a low-lying placenta or a differently shaped uterus. Often there is no clear reason.

Your body this week

Your uterus is at its highest, and it may sit lower if your baby has dropped. You may feel more pressure in the pelvis and a need to urinate often. Your baby's head may be described as engaged when it has moved into the pelvis, and that is common in a first pregnancy from about now. In later pregnancies, it may not happen until labour.

At your visit, the midwife or doctor will feel your belly to work out how your baby is lying, measure the top of the uterus, and check your blood pressure and urine.

How your baby's position is checked

• Feeling the belly. A midwife or doctor can usually tell by feel where the head and bottom are. This is called palpation.
• Ultrasound. If they are not sure, or the baby seems to be breech, a quick scan confirms it.
• Vaginal examination. Sometimes done later, in labour.

The medical term for head-down is cephalic. For bottom-first, it is breech. There are three kinds: the baby has legs up by the head (frank breech), the legs bent (complete breech) or one or both feet are lowest (footling breech).

If your baby is breech at 36 weeks, there is still time. Some babies turn on their own, even after 36 weeks, though it becomes less likely as space runs out.

Options if your baby is breech

Wait and see. Some babies turn without help. Your provider will check again at your next visit.

External cephalic version (ECV). This is a procedure in which a doctor or midwife, using their hands on the outside of your abdomen, gently turns the baby. It is usually offered from about 36 weeks in a first pregnancy and 37 weeks in later ones. It takes place in a hospital, with a scan and monitoring of your baby's heartbeat, and sometimes a medicine to relax the uterus. About half of ECV attempts work. It can be uncomfortable, and it may be stopped if you ask.

ECV carries small risks, including a temporary change in the baby's heartbeat, and, rarely, a need for an emergency cesarean. Your team will monitor you and your baby closely. It is not suitable in some situations, for example if you have a low-lying placenta, vaginal bleeding, ruptured membranes or a twin pregnancy. Some babies turn back afterward.

Home techniques. Positions, such as being on your hands and knees, and treatments such as moxibustion or acupuncture, are popular. Evidence that they turn babies is limited, but many are low risk. Ask your provider before you try them.

Planned cesarean. If the baby stays breech, a planned cesarean around 39 weeks is common in many places.

Planned vaginal breech birth. Some centres with experienced staff offer this for carefully selected people. It is not available everywhere, and it may involve more risk than a cesarean for the baby in some situations. Ask what your hospital offers and what its own results are.

Cesarean or vaginal birth: things to know

Whether you have a cesarean because of a breech baby or another reason, or you plan a vaginal birth, it helps to know what each involves.

Vaginal birth. Recovery is usually faster, and you are often home within a day or two. Risks include tearing and pelvic floor problems.

Cesarean birth. A surgical birth, usually under a spinal or epidural block so you are awake. It takes about 30 to 60 minutes, and your baby is usually born in the first few minutes. You typically stay in hospital for two to four days. Recovery takes about six weeks, and you should avoid heavy lifting. A cesarean is major surgery, and it has risks, such as infection, bleeding and clots, and it affects future pregnancies.

Ask your provider how each choice applies to you. You can ask about skin-to-skin contact in the operating room, delayed cord clamping and how quickly you can feed your baby.