Head engagement in pregnancy and labor

What engagement means is that most of the baby's head has descended into the mother's pelvic cavity and only a small part can be felt abdominally (or not at all). The significance varies. If there are known potential problems, such as a uterine abnormality, pelvic abnormality or a pelvic mass; lack of engagement in late pregnancy (beyond 38 weeks) or at the onset of labor may warn of potential problems. The same may be the case if the fetus has been noted to be very large.

The attending obstetrician may then re-evaluate the planned method of delivery and if there are other strong indicators of potential problems in labor, then the relevant advice should and will be given.

It is, however, very unusual to advise against labor or vaginal delivery simply on the basis of an unengaged head.

Early engagement of the head and its significance

It is a common question asked by expectant mothers in late pregnancy: “Is the head engaged?”

It may be reassuring to have the head engaging early but this does not guarantee a successful vaginal delivery.

When everything is normal, early or late head engagement does not make any significant difference. In fact, in women of black African descent, engagement before the onset of labor is unusual, except in a first pregnancy, when it is slightly more common.

Next Page: Stages of Labor