I recently had a query about a very long, slow to progress labour, this lead me on to a discussion of the position of the baby just before going into labour.
During the late stages of pregnancy the majority of babies lie with their head down and their back pointing out so they are facing their Mum’s back. This is called the occipito-anterior (OA) position and is the optimal position for the baby to be in when labour starts.
The baby should be lined up to fit through the pelvis as easily as possible. In this position, the baby’s head is easily ‘flexed’, i.e. his chin tucked onto his chest, so that the smallest part of his head will pass through the birth canal first.
Sometimes babies start labour with their backs against their Mum’s back, looking forwards, this is called occipito-posterior (OP) position. If a baby is in this position at the start of labour women may complain of backache and/or feeling their contractions ‘in their backs’. Labour can be longer when the baby is in this position as the baby tries to turn to the anterior position. They can also be longer because the baby’s head doesn’t fit snugly on the cervix in this position and the baby’s head on the cervix is what stimulates the release of oxytocin, the hormone that drives contractions and labour.
The good news is that there are ways to encourage your baby to get into the best positon before labour. It is called Optimal Fetal Positioning.
Optimal Fetal Positioning (OFP) is a theory developed by midwife Jean Sutton and Childbirth educator,Pauline Scott. They realised that the mother’s position and movement could influence the way her baby positioned itself in the final weeks of pregnancy.
Posterior babies are more common in first pregnancies as we tend to be more sedentary. Gravity encourages the baby into the best postion if we move about, because the back is the heaviest side of its body. Today most women continue to work during their first pregnancy and therefore they spend a lot of time sitting at a desk, in a car, or reclining on a sofa at the end of a tiring day. This means the baby’s back will gravitate to the mum’s back, the posterior position.
With subsequent pregnancies, women are much more active and bend forward much more, usually to pick up a toddler or their toys. So the baby’s back is much more likely to gravitate to the front of the Mum’s tummy and therefore be in the optimal postion.
Ways to encourage your baby to face your tummy in your first pregnancy are:
- spend lots of time on your hands and knees (Scrubbing the floor in late pregnancy works brilliantly)
- when you sit on a chair, make sure your knees are lower than your pelvis, and your body is tilted slightly forwards
- take regular breaks and move around if your job involves a lot of sitting
- sit on a cushion in your car to lift up your bottom, or adjust the sit to tilt you forwards
- check that your favourite chair at home doesn’t put you in a reclined position with your bottom down and your knees up
- watch TV leaning forward over a birth ball