Friday 29 August 2014

 Optimal fetal positioning from Call The Midwives

Today's blog is all about ensuring baby is in the best position for labour or at least baby gets into the correct position for labour. When I write these blogs I link other information so that you can do your research & explore as much literature as you can in order for you to have the best outcome.

As a practicing midwife I have explored this subject in great detail and attended many courses & used the knowledge to help women either in antenatal clinic antenatal classes or during labour.  Our life styles can have an impact into how baby sits in the uterus during pregnancy & how baby's position can impact on labour.  The ideal position for baby is the Occipital Anterior (OA) position, this means baby is head down has its back facing out towards the world and tummy facing mummy.  


As you can see in this diagram there are many different positions for baby to move into during pregnancy these are all fine, so don't get overly concerned.  We just know that during labour we need baby to move into the OA position as this is the quickest & easiest position.

Some women panic if baby is in the Occipital posterior position (OP) prior to labour.  This is known as a back to back labour, labour can take longer & baby's transit can be delayed especially if the woman is lying on her back unable to move around.

So what can you do to encourage you baby into the correct position for labour? Pregnancy yoga classes are a great place to start. Yoga techniques enable you to be aware of your posture, strengthen your core muscles and also teach you great breathing techniques again check out the literature.

Keeping active is very important, so is being aware of your posture.  We live in an age whereby we have machines to do all our housework for us, and we sit on comfortable sofas when at home which encourage us to slouch.  Another step I would advise you to do is to invest in a Yoga/Birthing ball

Here are some other tips for you to try during pregnancy and in labour
  • Regularly use upright and forward leaning positions which will enlarge the size of the pelvis and encourage your baby’s back (the heaviest part of the body) to lie towards your abdomen.
  • Sit with knees level with hips with your 
  • back as straight as possible
  • Sit to read on a dining chair with elbows resting on the table, knees apart and leaning slightly forward
  • Kneel on the floor leaning over a bean bag, floor cushion or chair to watch television or other such activities
I have also listed positions to avoid during pregnancy & labour
  • Relaxing in semi reclining positions where you have your knees higher than your hips
  • Sitting with your legs crossed
  • Sitting for long trips in a car with bucket seats either as the driver or as a passenger. If necessary then use a wedge cushion under your bottom to alter the angle of the seat.

So now you have a little insight into how to get the baby into the best position for labour.  I would like to add some baby's get comfortable in certain positions, even by following these rules you may start labour with the baby in the OP positions, don't worry baby's do move during labour & the best way to help this is to keep active and explore all the resources, the NHS choices website for example has a video that may help.

By applying these simple steps you will increase your chances of a normal labour, reduce your need for pharmaceutical pain relief and enjoy a really good outcome for you and your baby. If you are a 'low risk' reasonably healthy woman then you may want to consider delivery at home or a birth centre where you will be able to move around.  In any situation the midwife will encourage you to change positions let her advise you.

For regular updates and information visit my facebook page.  I will keep you posted on many subjects ladies now enjoy your pregnancy.

Best wishes
Registered Midwife