When you are preparing for delivery, a baby is typically in the face down position. However, sometimes the baby is in the posterior position, or face up. Some people call this “sunny side up,” while the medical profession calls it the occiput posterior position. This means that the hardest part of the baby’s head rests near your lower back. The result? A longer labor, since the head has to rotate further during labor. It can also mean intense back pain for mom!
Most babies turn around on their own during labor and come out face down. But for those that don’t, the doctor may need to rotate the baby manually or decide to do a cesarean section.
What Does Posterior Position Mean?
When your baby is in a posterior position, it means that he is facing the wrong way for labor and delivery. About one in ten babies start labor this way, with the back of his head against your spine. This can lead to a much more difficult labor, as you will probably have intense back pain and labor will take longer. In addition, your water may break early in labor, and you may feel like you have to push before you cervix is fully dilated. All of these things can combine to make a miserable birth experience for you.
The good news is that your baby can often turn himself when he gets down to the birth canal. He will have to turn 180 degrees to get into the best position, so that can take a while. If he doesn’t turn, he will be born face up, and he might need the help of a vacuum or forceps to get out of your body.
Why Are Some Babies in Posterior Position?
There could be numerous reasons the baby is in a posterior position. If the pelvis is oval or heart-shaped, your baby might settle into the wrong position. The same is true if you have a narrow or wide pelvis. Lifestyle could be another factor; if you are very sedentary, the baby is more likely to be posterior. Doctors note that those who live in developing countries rarely deliver children who are in the posterior position, thanks to all the movement they often do, such as manual fieldwork or squatting to cook and eat.
Another issue with lifestyle might be your job. If you sit at a computer for hours or otherwise sit in a desk chair, your pelvis is naturally tipped backward. This means that the baby will rest the heaviest part of his head on your spine in order to feel comfortable. It works for baby, but it can make carrying and delivering him more difficult!
How Does Posterior Position Affect Labour?
When you go into labor with a baby in the posterior position, it often means that you will have to deal with consequences that other mothers might avoid. For instance, you might need Pitocin to stimulate contractions, and you might push longer to get the baby out. You also have a higher risk of an assisted vaginal delivery, a c-section or a postpartum hemorrhage.
If you do give birth vaginally, you are probably to have severe perineal tears or an episiotomy. Your baby might also have some short term complications, such as lower five-minute, apgar scores, more time in the hospital and a possible stay in the neonatal intensive care unit.
How Can You Tell If the Baby Is in a Posterior Position?
Though it might be tough to tell, there are some ways that a baby makes it clear he is in the posterior position. Where are you feeling the baby kick? If the kicks are in front and your tummy is shaped like a saucer around your naval, then he is likely posterior. You could be having a great deal of back pain, and you can clearly feel your baby’s limbs through your belly. But if those kicks are coming at your back and sides and your tummy is smooth, the baby is likely in the right position for delivery.
How Can You Help Your Baby Turn in an Anterior Position?
If your doctor agrees that your baby is in the posterior position, there are a few things you can do to help move him to the proper position.
Before the Delivery
Long before you deliver, you can change your own posture in order to help your baby turn around. This is called optimal fetal positioning. To do this, always try to tilt your pelvis forward, keeping your knees lower than your hips if you are sitting down.
One trick includes turning around your favorite armchair and sitting on it backwards, by kneeling on the seat pad and leaning forward over the chair. This can tilt your pelvis to the right position. Another trick is to get on all fours as though you are going to scrub the floor. Put a cushion in your car to lift up your bottom while you drive. Lean over a birthing ball while you watch television. Finally, remember to move around a great deal when you are working, so your baby doesn’t get too comfortable in your tilted pelvis.
If you want to learn how to turn your baby through exercise, this video can help:
During the Delivery
There is still time to change your baby’s position after labor begins. Use upright and forward postures to help the baby move, this will also relieve your back pain. Lean forward during contractions. Try to stay relaxed as possible during early labor, and eat and drink regularly to keep up your strength, assuming your doctor allows it.
When you are in labor, there are still things you can do. Stay upright for as long as possible. Lean forward, whether on a birthing ball, on your partner or the back of a chair. Ask for a back massage. Rock your pelvis through contractions to encourage the baby to turn. If you can avoid an epidural, that might help, too. If you become exhausted and you must lie down, lie on your left side as your pelvis expands more this way.