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Your Baby's Position

The position that your baby is lying in at the time of labour and delivery can have a huge effect on the experience you will have. We have outlined what the different foetal positions are, and how they might affect your labour and delivery.

Anterior Position

This is the optimal position for your baby to begin the process of labour and to be delivered in. Around 93%-96% of all babies move into this position without any assistance. The anterior position refers to a baby that is head down with their face towards the mother’s spine. Being positioned this way enables your baby the most simple way of exiting your uterus through the cervix, down the birth canal and out from the vagina.

If this is your first baby it is likely they that they will move into the engaged position around the 35th-37th weeks of your pregnancy. For second time mums it is more likely that your baby will not settle in your pelvis or engage until just before, or once labour begins.

Posterior Position

The posterior position refers to when your baby is head down, with the spine and back of their head against your spine. Many babies will start labour this way and turn themselves before they start the descent down the birth canal.

Here are some tips to help your baby move into the anterior position, or optimal foetal position, ready for birth. You can start doing these from 30 weeks onwards.

Take time out during your day to get down on your hands and knees and gently rock your pelvis forward and back. 4-5 times per day for about 10mins would be ideal.
Try not to hunch over while sitting at your desk.
If your job involves a lot of sitting, try to walk around as often as possible.

If your baby has not turned to the anterior position prior to your labour starting, it can make it a more painful experience for you.

You will probably suffer from backache during and in between contractions.
Usually your labour will be longer, as your baby is not well positioned for descent.
It is more likely that your baby will need to be assisted by forceps or vacuum extraction in the final stage of delivery.
Your baby will be born facing upwards.

To relieve the pain of backache during labour you should try to remain active and move around.

Avoid lying down or leaning back for any length of time.
The ideal position for you to use is on your hands and knees. This way your baby will fall away from your spine and this will ease your discomfort.
Your partner can massage your lower back and also can direct warm water from a shower nozzle onto your back.

A Breech Baby*

As a baby reaches full maturity at about 37 weeks, he becomes heavier and tips head-down. Some babies, however, remain breech until term.

If a baby is in the breech position at term he may be delivered by Caesarean section. If your baby is breech in the last weeks of pregnancy, though, you can be reassured that he will probably turn himself before labour actually begins:

30% of babies are breech at 30 weeks. Over half of these will turn spontaneously during the next two weeks.
14% of babies are still breech at 32 weeks. There is a 60 percent chance that a baby that is bottom-down will turn of his own accord before labour starts.
Less than 5% of babies are still breech at 37 weeks. A quarter of these will turn on their own, although this is less likely if the legs are extended or there isn’t enough room in the uterus, for instance because it is a multiple pregnancy or the baby is too large.
A few babies will kick themselves round once labour starts, as long as there is room.

Ideas for Turning a Breech Baby

There are a few alternatives when considering turning your breech baby into the normal position for birth. We suggest you talk to your doctor or midwives before trying any of these options.

It is recommended that you try the following positions 2-3 times per day, for 10-20 minutes at a time. Ideally this should be attempted before your 37th week and performed on an empty stomach. The aim is raise your hips above your head so that gravity will use its force and encourage baby to move out of the pelvis and allow your baby more room to turn into a head down position. Place a board (an ironing board is ideal) at about a 45 degree angle from the floor to a stable piece of furniture. You should then lay on this with your head towards the floor and feet up in the air. If this is not possible an alternative is to position yourself on your hands and knees, dropping your head towards the floor and keeping your bottom high in the air.
Increasing the amount of fluid you drink can also increase the amount of amniotic fluid around your baby. This may provide a greater chance of your baby turning by herself.
Pelvic rocking on all fours.
Music therapy may assist to move your baby’s position. There are two ways of doing this.

Position head phones near your baby’s head and play loud, heavy rock. This is supposed to make the baby want to turn away from the music. Or,
Position the headphones down near your pelvic bone and play some Mozart or other soft and gentle music. This is supposed to encourage your baby to turn towards the pleasant sounds.

Applying cold packs to where your baby’s head is positioned is thought to encourage your baby to move away from the cold sensation. A pack of frozen peas or corn is ideal for this.
Gentle exercise in a swimming pool is also thought to assist with turning a breech baby.
External Cephalic Version – this procedure can be performed, once you have reached the 37th week of your pregnancy, by an experienced practitioner. Put simply your doctor, if they are trained in this procedure, can use their hands and push through your womb and encourage your baby to perform a somersault to leave them in a head down position.

Your baby would be monitored throughout this procedure to ensure they do not show signs of distress. You will experience quite a bit of discomfort, but it should not be painful. You will probably be given a drug to assist your muscles of your womb to relax.

Success rates for this procedure vary from 40-70%. It is more likely to be successful if;

this is not your first baby
there is plenty of amniotic fluid for your baby to move in
your baby has not already descended into your pelvis.

If you wish to consider this option you will need to talk to your doctor or midwife.

Acupuncture or acupressure – One of the more successful and safer treatments for turning a breech baby is “moxibustion” of an acupuncture point found on your little toes. This treatment is performed by applying compressed Mugwort herb as a heat source to the area, and then applying pressure to the area just next to your little toes. On your right foot this is at about 5 o’clock and on your left toe it is about 7 o’clock. You should speak to your doctor before attempting this.