Posterior Baby

Have you been told that you have a posterior baby?

Optimal fetal positioning is about encouraging your unborn baby to take up the best position in the womb to help him initiate labor and to help him with the process of being born. If your baby is in the optimum position for you, labor can start more easily, start earlier, be quicker and have less chance of unwanted complications.

Women with posterior babies can benefit from optimal fetal positioning which is an ideal thing to be working on if you are planning for natural childbirth i.e. a vaginal birth at home or anywhere else.

I’m sure you have heard lots of birth stories about 3 or 4-day long labors. They may have gone a bit like this: A typical scenario for a mom who's baby is lying in the back-to-back position can be: going over-due by 2 weeks or more, needing to be induced, needing her waters breaking in hospital, needing IV drips and Pitocin, needing an epidural, maybe needing forceps or ventouse delivery, maybe needing an emergency cesarean section. Also baby coming out with a temporary bump on his head from trying so hard to engage and come out. This is a common 'posterior baby' story.

This all sounds rather negative, but it can be avoided. Why do we have this problem nowadays? It was rare when our Grandmothers were giving birth. They even had vaginal breech births at home. The theory around this is that our ancestors didn’t have all the helpful machines that we have now.

No washing machines, dishwashers, vacuum cleaners, bread-makers etc. They were often on all fours scrubbing the floor or leaning over lower tables cleaning, kneading bread-dough or doing other chores. This was most days a week. Their babies never got a chance to lounge-back on their mom’s spines!

These babies were often born at home after more active, shorter labors than many women see today. Housework and physical activity is your best friend when it comes to preparing for a natural birth. It’s also very good exercise and can help you keep your weight down. OK I know you don’t want to have to do too much housework!

There are many factors that influence the start of labor. Scientists are still discovering new information even now. It is well known that a combination of factors needs to be in place before labor can start naturally. One of the most important issues is how relaxed you are and what position your baby is lying in.

If your baby is lying in a posterior position, also known as back-to-back or occipito-posterior, then it can be much harder for him to instigate labor. That’s right, babies will try to trigger labor in late pregnancy when they are ready. They do this by putting pressure with their head on your cervix or neck of the womb. If a baby is in the posterior position all the pressure will go onto your lower back or bowel.

To encourage your baby into the forward-lying position (occipito-anterior), with him looking towards your back, spend ten to twenty minutes a few times a day on all-fours. With your knees hip-width apart and your hands shoulder width apart sway or rock from side to side gently. Make sure your back is level and as flat as possible.

As far as I know there is no research to back-up the ‘Optimal Fetal Positioning theory’ at the moment. However hundreds of midwives worldwide believe that optimal fetal positioning works having seen it in practice and having heard it from anecdotal evidence from moms and other midwives.

An amazing midwife from New Zealand wrote a book called "Understanding and Teaching Optimal Foetal Positioning" (by Jean Sutton and Pauline Scott). Jean first thought up the idea, you can try to find a copy of her book at Amazon.com.


How To Tell If You Have A Posterior Baby

Ask your midwife or Ob/Gyne which position your baby is laying in. if you are having a nice natural pregnancy with no complications you should not need any routine scans after 20 - 21 weeks gestation. Your health practitioner will hopefully be palpating your abdomen each time they see you for a check-up.

Palpation is when your practitioner feels your abdomen with both their hands and discovers which way up your baby is lying, how well he's grown since your last check-up, whether he's engaged in the pelvis or not and what position he's in i.e. is he a posterior baby or not. After 34 weeks they may even discuss optimal fetal positioning with you.

Being palpated by the same person at each prenatal appointment is a good way of seeing how well your baby is growing, and whether he has changed position since the previous appointment. On palpation, if your baby is a posterior baby, your midwife can easily feel your baby’s knees, feet or a lot of empty space where his back would be if he were laying facing towards your back. Midwives call this an O.P. baby.

Before you get dressed in the morning or at night when you undress – stand side on to a full-length mirror. What shape is your abdomen or pregnancy bump? Do this every few days after about 34 weeks. Take a look standing facing towards the mirror too.

If your shape is completely round from top to bottom then you most likely have a baby who is lying anteriorly. That is with his back towards your front. This is an ideal position, which will make it easier for your baby to start labor when the time is right.

If you have an abdomen that seems high at the top but dips down and away towards your pelvic area it could be that you have a posterior baby. If you suffer with frequent low backache or lumbar region aches that can be another sign of a posterior baby.

Feeling constant pressure on your rectum or bowel can be another posterior baby sign. Alternatively if you need to pee all the time your baby’s head is pressing on your bladder and this is a normal sign that he is in a good position – sorry!


Encourage your Baby With Optimal Fetal Positioning.

As a pregnant mom there are many ways you can help influence the way your baby lies inside you. Having a posterior baby isn't an impossible situation, there are many things you can do to encourage him off your back and into an anterior position.

Firstly try very hard not to lie on your back after about 24 weeks gestation. I know this might seem a hard habit to break, but if you can make a new habit of lying in a forward-leaning position on your side, it will encourage your baby to stay off your back. Optimal Fetal Positioning is like a pregnancy-long habit you need to adopt if you have a posterior baby. it really is worth the effort.

If you have a posterior baby (lying on your back) – using your back like a hammock in other words – he can become very comfy there and not want to shift! If he stays there until you are full-term (37 – 42 weeks) then he may find it much harder to engage his head into your pelvis. Use Optimal Fetal Positioning tips to help get your baby off your back.

• Don’t lie on your back.

• Use positions like lying on your left or right side and leaning forward slightly. Think of Cleopatra eating grapes! Use the length of the sofa. Lying on your left is best.

• Sit on straight-backed, upright chairs or stools. Choose the highest seat in the house.

• Try using a fitness ball to sit on; make sure it is well pumped up with air and not too soft.

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• Ensure that your knees are lower than your hips when sitting down anywhere. Just think "knees below hips".

• Avoid squatting and also avoid crossing your legs. Crossing your legs (more specifically your knees) will tilt your pelvis backwards, encouraging baby towards your back.

• When driving or traveling in a car have a small cushion or folded towel/rug under your butt to raise you up at the back helping to bring your hips higher than your knees.

• When sitting at the table try placing the chair the wrong way around. Now sit facing the back of the chair, leaning over the back-rest. This is comfy if the chair is the right shape. Try different chairs.

• When you need to do any chores like cleaning the floor spend some time kneeling forward on the floor doing this job.

• Ensure that your knees are lower than your hips when sitting down anywhere. Birthing or fitness balls help with this.

• Avoid reclining backwards in easy chairs or on anything.

• Avoid beanbags unless using them to kneel forward.

• Spend a little time on all-fours, rocking gently from side–to-side; ("pelvic rocking") 10 - 20 minutes at a time, 3 or so times a day.

• Try kneeling and leaning over a piece of furniture or a fitness ball. It's very comfortable and will encourage baby into a forward-lying position.

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At the end of the day all you can do is follow this advice and also check out the incredibly comprehensive advise on Gail's website Spinning Babies.com. Also talk to your baby encouraging him to move off your back if that's where he's decided to settle! Sometimes babies have their own reason for lying in what we consider to be an awkward position. Remember that your baby often knows best.

For example, the majority of babies like to lie facing their placenta. So if your placenta is located completely on the front wall of your uterus your baby may possibly end up being more happy lying on your back. In this case very little you do will change where he settles. It makes a lot of sense that babies don't want to squash their placenta; it's their life-line after-all.

So while following the 'posterior baby' advice of Natural Pregnancy Midwife.com remember as always, follow your instincts and respect your baby's wishes. He is very sensible and knows what's best for him. A percentage of posterior babies do have quick labors with no backache.


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This woman has a nice round abdomen, she is 9 months pregnant and her baby is laying in the optimal position for labor to beguin.

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This woman's baby is probably laying with his back on her back - O.P. Her bump is high up with a big dip below.

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