Optimum Foetal Positioning Article

Sarah W Baby Belly

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Saw this article and as it can possibly take hours off the birth and make it less painful, I thought I would pass it on! Apologies if you already know about this!

"Many difficult labours result from 'malpresentation', where the baby's position makes it hard for the head to move through the pelvis, so changing the way the baby lies could make birth easier for mother and child. The 'occiput anterior' position is ideal for birth - it means that the baby is lined up so as to fit through your pelvis as easily as possible. The baby is head down, facing your back, with his back on one side of the front of your tummy.

The 'occiput posterior' (OP) position is not so good. This means the baby is still head down, but facing your tummy. Mothers of babies in the 'posterior' position are more likely to have long and painful labours as the baby usually has to turn all the way round to facing the back in order to be born.

This means that often posterior babies do not engage (descend into the pelvis) before labour starts. The fact that they don't engage means that it's harder for labour to start naturally, so they are more likely to be 'late'. Braxton-Hicks contractions before labour starts may be especially painful, with lots of pressure on the bladder, as the baby tries to rotate while it is entering the pelvis.
the rate of posterior presentation has increased drastically in the last few decades, apparently in line with changes in the way women use their bodies. Sitting in car seats and leaning back on comfortable sofas, together with less physical work, have combined to produce an increase in posterior presentations. Paying attention to your posture in the last few weeks of pregnancy can help to reverse this trend. Since keeping reasonably active in pregnancy, and practising good posture, isn't going to do anyone any harm, this theory at least deserves to be considered.

Pay attention to your posture at the time when your baby may be starting to 'engage', which means its head will be descending into the pelvis. This means for the last six weeks of your first pregnancy, the last two-three weeks for subsequent babies. Avoid positions which encourage your baby to face your tummy. The main culprits are said to be lolling back in armchairs, sitting in car seats where you are leaning back, or anything where your knees are higher than your pelvis.
The best way to do this is to spend lots of time kneeling upright, or sitting upright, or on hands and knees. When you sit on a chair, make sure your knees are lower than your pelvis, and your trunk should be tilted slightly forwards.
· Watch TV while kneeling on the floor, over a beanbag or cushions, or sit on a dining chair. Try sitting on a dining chair facing (leaning on) the back as well.
· Use yoga positions while resting, reading or watching TV - for example, tailor pose (sitting with your back upright and soles of the feet together, knees out to the sides)[3]
· Sit on a wedge cushion in the car, so that your pelvis is tilted forwards. Keep the seat back upright.[3]
· Don't cross your legs! This reduces the space at the front of the pelvis, and opens it up at the back. For good positioning, the baby needs to have lots of space at the front
· Don't put your feet up! Lying back with your feet up encourages posterior presentation.
· Sleep on your side, not on your back.
· Avoid deep squatting, which opens up the pelvis and encourages the baby to move down, until you know he/she is the right way round. Jean Sutton recommends squatting on a low stool instead, and keeping your spine upright, not leaning forwards.
· Swimming with your belly downwards is said to be very good for positioning babies [1] - not backstroke, but lots of breaststroke and front crawl. Breaststroke in particular is thought to help with good positioning, because all those leg movements help open your pelvis and settle the baby downwards. [3]
· A Birth Ball can encourage good positioning, both before and during labour. See Birth Balls article on the MomCare website for more details.
· Various exercises done on all fours can help, eg wiggling your hips from side to side, or arching your back like a cat, followed by dropping the spine down.
 
Sarah

What an excellent article! have been using my birthball, but really need to get a cushion for my car I think!

LBxx
 

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