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How to get Baby in the right Position for Labor – How to turn a posterior Baby to occiput anterior

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Did you know that your baby can be head down but still not in a good position for labor? It’s true! And because of that it’s important to check baby’s position first before trying any exercises to engage your baby in your pelvis.

So, in this article, pregnancy & birth consultant and tcm therapist, and researcher and science geek, tell you what the best position of a baby is for labor.

To be precise, they explain the difference between an occiput posterior and an occiput anterior position.

Moreover, they tell you which signs to look out for in order to find out if baby is in a good position for labor.

In other words, they explain how those signs would be different, depending on if your baby is in an occiput posterior position or occiput anterior position.

Next, they explain why traditional methods of turning a posterior baby, including hand-knees positions and pelvic rocking, do not work according to scientific studies.

And they also explain what you can try instead to get baby in the best position for labor.

Finally, they also explain what it means if baby is not in the best position for labor when labor starts.


How to get Baby in the right Position for Labor – How to turn a posterior Baby to occiput anterior



How to get Baby in the right Position for Labor – How to turn a posterior Baby to occiput anterior



At some point, after your baby has turned head down, your baby is going to engage in your pelvis in preparation for labor.

However, not every head down position is ideal for labor.

And so, ideally, your baby moves into a good position for labor first before you try anything to help the baby engage in your pelvis.

So in this article, we are first gonna explain what the optimal position for labor looks like, and what the signs are, that the baby is not in a good position for labor.

And then we are gonna tell you what you can try to bring your baby into a better position.

And then at the end of this article, we are also gonna tell you what it means if baby is not in the best position when labor starts.

A pregnancy and birth consultant and tcm therapist, and a researchers and science geek and we are here to help mommies and their babies naturally and science based.

So, let’s talk about your baby’s best position for labor.

Okay, so first of all, what is the best position for labor? Well, when your baby moves through your pelvis during labor, your baby cannot just move from top to bottom in one and the same position.

Baby has to constantly change the position of the head to adjust to the shape of your pelvis.

By the way, we explain exactly how a baby moves through the pelvis in our free mini birthing course.

Anyways, because of the shape of the pelvis, the best position for baby to move through it is obviously a head-down position.

But it is equally important that your baby also faces your back.

This is called occiput anterior.

The opposite position is called occiput posterior.

It is the most common malposition in labor and it often leads to complications and medical interventions, including c-sections.

That said, luckily, some 85% of posterior babies will rotate into a better position during labor.

The only problem is that this often means a longer and more painful labor.

And so, ideally, it does not even come to that which is why we want to help the baby rotate into a better position before the baby engages in the pelvis.

Because once baby has engaged, it is going to be more difficult.

And because of that, before you try any exercises to engage your baby in your pelvis, ideally, you look for signs first that your baby is in the right position.

Now, we are not gonna lie to you: finding out if your baby is in the right position is not a simple task, even for experienced professionals.

In fact, the only really reliable method is an ultrasound.

However, in general, when baby is head down and anterior, you would feel the back of your baby on your tummy.

This can either be more on the left side or the right side, depending on baby’s position.

And that side would feel hard, smooth and rounded.

And in most cases, if baby is occiput anterior, the area around the belly button will feel rather firm and the belly button itself will most likely poke out.

Plus, you would feel baby’s kicks mostly under your ribs, right? Yes.

However, when your baby is posterior, your tummy will most likely look flatter and the whole area may feel more like squashy.

Moreover, you would feel your baby’s arms and legs towards your front.

And as a result, you would also feel your baby’s kicks in the front.

In addition, women can often feel little twitching sensations right above the pubic bone because this is where you would find the little fingers of your baby.

So those are signs that your baby is posterior.

But again, don’t be disappointed if you cannot figure out the position of your baby.

This is not a simple task.

Now, the question is: how can you increase the likelihood of baby ending up in the right position before baby engages in your pelvis? Well, to our surprise, almost every pregnancy guide out there will tell you that the most effective exercise to do so are hands and knees positions including pelvic rocking.

This basically means that you elevate and lower your back while kneeling on all fours.

But the problem is that scientists have not found any evidence that this can really help rotate a baby into the right position.

So, if this does not work, what can you do instead? Let’s find out: among others, scientists have found that the rate of posterior presentations has drastically increased over the last few decades.

And many of them assume that that’s due to changes in lifestyle which often cause a woman to adopt not so optimal positions.

Most importantly, we are talking about positions which involve reclining the back.

And this has to do with gravity.

The baby’s back is the heaviest side of baby’s body.

So, when you lean backwards, your back is lower than your tummy.

As a result, baby’s back will naturally gravitate towards your own back.

So what can you do? Well, from about week 34 onwards, ideally, whenever you sit, you don’t cross your legs, you don’t put your feet up and you try to avoid reclining positions! Also, try to make sure that you sit straight and that the level of your knees is lower than the level of your hips.

Even better, try to slightly lean forward if that’s comfortable for you because this will provide your baby with more pelvic space.

Plus, in that case, your baby’s back will gravitate towards the lower side of your abdomen.

So, for example, when you read a book, rest your elbows on the table while leaning slightly forward.

Or, if you like, sit backwards on a chair with your arms resting on the back of the chair.

But an even better way to sit, is sitting on a birth ball as often as you can throughout your pregnancy because when you do, you keep your feet apart, your knees are below your hips and you don’t recline your back.

On a birth ball, you always either keep your back straight or slightly lean forward to keep the balance.

So, it’s an ideal position to help your baby rotate into the right position.

Next try to avoid car seats – if you can - or use a wedge cushion below your buttocks.

Because such cushions can help you keep your upper body upright and they also keep your knees below your hips.

Just make sure that the use of such cushions does not jeopardize your safety in the car, right? And finally, try to avoid back-lying positions and try to sleep on your side instead.

We have already mentioned that there is no scientific evidence that pelvic rocking on all fours can help rotate a baby.

However, scientific studies to date have not focused on pelvic rocking on a birth ball for optimal fetal positioning.

Scientists did find though, that birth ball exercises can have all kinds of positive effects on a pregnant woman, for example, in terms of how ready her cervix is for labor or in terms of turning a breech baby.

And at nathalie’s practice we do believe to observe that there is a tendency for babies of women who do birth ball exercises to be in a better position for labor.

We just don’t have any proof because it is obviously very difficult to say what exactly has caused a baby to change the position.

But that would not be a surprise because unlike pelvic rocking on all fours, pelvic rocking on a birth ball makes you constantly change the angle of the pelvis for your baby.

That together with the movements that you make when rocking your pelvis on a birth ball, offers your baby many different kinds of positions to help the baby get into a better position for labor.

Keeping active is always a good idea during pregnancy because it comes with lots of benefits for both, mother and baby, as many scientific studies have found.

However, when it comes to helping a baby move into a better position for labor, swimming is thought to be particularly helpful.

When you do, please make sure that you don’t do backstrokes.

You want to keep your belly downwards when you swim.

In fact, breaststrokes are thought to help particularly well here because the movements of your legs help to open your pelvis and encourage good positioning.

As long as you are not sure if baby is in the right position, it is recommended to avoid deep squats.

That’s because deep squats encourage your baby to move downwards and to engage in the pelvis.

You can still do squats when you exercise, just don’t do deep squats and keep your back straight.

Okay, this is a tip that we have heard so many times from midwives.

In fact, we even know women who claim that this has worked for them.

But this is absolutely not science-based.

So, the idea here is that babies like to keep their backs warm.

As a result, they are often going to turn their backs away from the cold.

So, how can pregnant women use this for optimal fetal positioning? Well, if you are pregnant in winter, make sure that you keep your belly warm too.

Pregnant women often like to walk around with an open coat because to them, their belly feels warm.

But if your baby is in an occiput anterior position, they are going to feel the cold in their backs.

As a result, they might decide to rotate into the wrong position.

So, keep your belly warm in the winter.

On the other hand, if your baby is in the wrong position, you could try putting an ice pack on your back while keeping your belly warm.

Again, some have said that this has helped them rotate their baby into a better position for labor.

Maybe it works for you too! Right.

Now, in general, we have to admit that rotating a baby into an occiput anterior position with the help of natural treatments is not a simple task.

And there are several reasons for that.

First of all, there can be good reasons why a baby just cannot rotate into an occiput anterior position, for example, because of the position of the placenta.

But an even bigger problem is that even when you do manage to rotate your baby into a better position for labor some babies like to rotate back before labor starts.

So, there is never a guarantee that the baby stays in that position.

Yes, but here is the good news: first of all, it would be wrong to assume that an occiput posterior position always results in a much longer and more painful labor.

We really know many cases of women who had quite a short and easy labor despite their baby’s malposition.

But that tends to be more the case if this is not the first pregnancy, right? Still, even if your baby remains in a posterior position for labor, please don’t automatically assume that it’s gonna be a problem.

And second, as mentioned already, some 85% of babies who are occiput posterior before labor do rotate into a more favorable position during labor.

And there are lots of positions and techniques that your midwife can show you to support that process.

Once you are in labor, your baby is “more willing” to rotate into a better position because then the forces of labor require them to adopt a more favorable position.

But these requirements are not present before labor.

And if you want to know why a baby is more willing to rotate during labor, watch our mini birthing course in which we teach you exactly how a baby moves through the pelvis.

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