Position Matters in Pregnancy

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For any guys reading this: it’s all about pregnancy, labour and delivery… Just a heads-up (ummm, or down!) 🙂

I know I haven’t talked about pregnancy much on here, but since our third little one is due in less than 3 weeks, it’s kinda big in my life right now… along with the rest of me!

Most pregnant women know that the ideal position for a baby to be in before birth is, of course, head-down, but also anterior (with baby’s spine towards your front).

But what if your baby prefers a different position? This can mean a LONG, painful labour ending in assisted delivery or emergency Caesarean in some cases.

Fortunately, there is something we can do about it. We just have to educate ourselves a little before we get to the delivery room.

My first two babies were not in ideal positions for birth – both were direct posterior at the start of labour. And neither is this little one so far (although that will most likely change a few times before the big day – lots of flipping around going on), so I’ve been doing a lot, I mean, A LOT, of research on babies’ positions during pregnancy and labour and how the way my baby is positioned, as well as my own posture and movements, can have big effects on the length and intensity of my labour, as well as the possible need for a Caesarean or assisted delivery.

With our first, I had painful back labour for about 10 hours with no progress at all, before I accidentally helped him turn around by going on my hands and knees for a while to relieve the pain. After that, with the help of some Pitocin that the nurses were pretty eager to give me after that many hours of no change, he was born fairly quickly with only a few minutes of pushing. Of course, I didn’t know much about babies’ pre-birth positions at that point, only that he was head-down and that was good.

Yeah, right.

After that experience, I started to read up on posterior babies before our daughter was born, to prepare myself in case she was posterior as well. I figured anything I could learn might help with the pain if I had back labour again. My water broke, and contractions didn’t start right away, so labour was induced the next day. From the very first contraction, I could tell she was posterior… the back labour was very painful, magnified by the induction. But, knowing a few techniques that might help, I tried the Abdominal Lift & Tuck, otherwise called the Belly Lift, through 10-15 contractions. She turned around quickly and was born less than 3 hours after I was induced, with very little back pain for the rest of the labour and also very little pushing. Definitely keeping that one in mind this time!

This third time around, I’m determined to be more aware of the baby’s position before going into labour, so I can hopefully do something to help this little one have an easier birth, not to mention eliminate hours of pain for me.

I stumbled across the Spinning Babies website before our second child was born. That’s where I learned about the Abdominal Lift & Tuck technique that really helped get her into a better position. They also have great explanations for the different fetal positions and why some are better than others (for example, Left Occiput Anterior (LOA) is better than Right Occiput Anterior (ROA), even though both are equally facing the ‘right’ direction).

With this pregnancy, I’ve been paying really close attention to how the baby moves, and what position he/she is in, since about 32 weeks. This little one also seems to favour posterior positions, specifically left occiput posterior. But after reading and learning more about how my posture affects the baby’s position, I have noticed that the baby tends to be more posterior after I’ve spent a day or two sitting down and reclining more than usual. If I pay close attention to my posture, lean forward more often than back and try to stay upright, the baby swings around to a more anterior, better, position.

It’s pretty simple, really. Just like all things in nature, gravity pulls the heaviest part of an object down first. The heaviest part of the baby’s body (the spine, bottom and back of the head) will settle in the most open, lowest place it can.

This is one of the main reasons why epidurals result in a higher risk of assisted delivery or C-section. If you are stuck in bed, mostly on your back, with very little opportunity to go on all fours or to walk around in an upright position, the baby, with the force of your contractions, will be more likely to settle in a posterior (back down) position, requiring greater dilation and effort to be born. This will sometimes, especially if you have a bigger baby, result in a “stalled labour”, where the baby is stuck in the pelvis and can’t manoeuvre his/her way through the birth canal – leading to either the use of forceps or an emergency Caesarean.

Now, of course, there are sometimes good reasons for a baby’s position. An odd-shaped pelvis, or the location of the placenta, can sometimes mean that baby is better off in a posterior position. But this is generally not the case, and even if there is a good reason, practicing good posture never hurts. Even if baby doesn’t turn, he/she can still be born face-up, and proper posture can help your abdominal muscles stay, or get, evenly toned and your pelvis properly aligned, making contractions that much more effective.

I know from both of my previous experiences, and stories from others, that most Labour & Delivery nurses, and even doctors and OB/GYNs, know very little about turning a baby before birth to help labour progress. They tend to be more reactive than proactive, using medical and surgical assistance in more cases than is really necessary, although there are definitely exceptions (‘THANK YOU!’ to those wonderful nurses and midwives who care enough to get educated on fetal positioning in order to help their patients).

So we can’t really count on the nurse or doctor knowing what to do to turn our babies during labour. This is why it is really beneficial to know beforehand what WE, as mothers, can do to help our little ones into the world in a safer, less traumatic way.

(And, I know most hospitals automatically deliver breech babies by Caesarean, but I was surprised to find out that turning a breech baby is very possible, with much less risk than a Caesarean, even during labour.)

Sorry for the long-winded post, but I hope it will help any moms-to-be and their babies to have a safer, less painful birth.

Knowledge is power, right?

Here are some more links on Optimal Fetal Positioning and different techniques to use during pregnancy and labour:

Best Labour and Birth Positions – Giving Birth Naturally (a wonderful site with TONS of information on natural birth)

How to Prevent a Posterior Labour

Optimal Fetal Positioning

Spinning Babies Techniques

 

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