Optimal Foetal Positioning means that labour may be more straightforward with baby in certain positions
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Why is Baby's Position Important?
Upright and forward-leaning positions during the last 6 weeks of pregnancy (last 2-3 weeks if it is a second or subsequent baby) give baby has a better chance of positioning itself in an ‘OA’ position (anterior) before labour starts.
A better chance is not a guarantee.
OA or 'occipito anterior' means the back of the baby's head (occiput) is towards mum's tummy (anterior = front).
OP or 'occipto posterior' means the back of the baby's head (occiput) is towards mum's back (posterior = back).
OA is known as the best position, because it allows the baby to make the best use of the space available. This is called Optimal Foetal Positioning – OFP.
OP or posterior babies have their backs to mum’s back. All babies twist or turn during labour. This baby generally has to turn further during labour to come through your pelvis. So it takes longer. This baby is also less likely to maintain a good angle of the head. Instead of tucking in her chin, her head becomes deflexed, or lifted, and this does not present so favourably. The head is effectively wider in this position.
Posterior babies may not press their heads so well onto the cervix, so this does not stimulate the cervix to open so well. For this reason, it is thought that labour may begin rather later, or take longer to get under way, than with anterior babies.
Plenty of posterior babies are born quite normally, but a few are more difficult, so it is worth encouraging your baby into the best position for birth.
Sitting cross legged. Instead choose a firm cushion or low stool, knees lower than hips.
Slouching back in an armchair or sofa particularly if knees higher than hips.
Squatting too deeply, it encourages the baby to engage and it may be too soon.
Driving for long. A cushion to sit on will help raise your hips.
All these positions will reduce the amount of space in the pelvis at the crucial time when the baby is trying to enter the pelvis ready for birth. Do your best not to spend long in these positions, from around 36 weeks.
Aim for your baby to lie with its spine on your left side.
This is because, statistically, babies lying on the right are slightly more likely to change into a posterior position. However, either side in an anterior position is preferable to posterior.
Ask your midwife for more advice.
Some babies are not keen to move despite our best efforts.
During labour, if your baby is posterior, you may sometimes have a lot of back pain. Try forward-leaning or kneeling positions. Babies can turn, even during labour.
It may also help to use positions where the legs are ‘uneven’, that is, only one is raised. For example, partial squat with one knee up and one down (alternate); climbing stairs sideways; raising one foot sideways onto a stool, step or chair (alternate); marching on the spot.
Firm massage or pressure, on your sacrum or hips, may relieve back pain in labour. Never firmly massage the lower back (lumbar region) above the edge of the pelvis, as it is relatively unsupported by bones, and you may do more harm than good. Ask for guidance from your midwife, antenatal teacher, yoga teacher or other qualified professional.