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How does midwife gauge relation to brim?

Updated: 8/18/2019
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Q: How does midwife gauge relation to brim?
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What does a midwife mean if she says 'it's at the brim'?

By 'lying in the brim' we mean that the baby's head is just at the top of the bony pelvis (pelvic brim) so the head is not engaged but almost certainly will be soon. As you have only 4 weeks until your due date it sounds as though everything is going in the right direction - that is downwards! sounds to me like she is referring to the head of the baby is crowning, meaning that it is approaching the vaginal opening.


What does relation to brim mean?

The female pelvis is shaped like a bowl with the bottom cut off. The top of the pelvis is called the brim and the bottom is called the outlet. Towards the end of pregnancy the part of the baby which is born first (hopefully the head) settles into the pelvis. This is called engagement Relation to brim describes how much of the head can be felt above the pelvis. It is usually measured in fifths. 5/5 means that no part of the head is in the pelvis. 4/5 means that the top part of the head is in the pelvis and so on. By the time the head is 0/5 the baby is almost born at the end of labor. If at the end of a first pregnancy the midwife or ob/gyn can still feel 5/5 of the baby's head it may mean that the baby is too large to be born naturally. With second or later babies the head may not go into the pelvis until the mother goes into labor.


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