Optimal Fetal Positioning | How To Make Birth Easier

Have you heard about optimal fetal positioning but not sure what it is?

Are you worried about your baby’s position and how it could impact on your birth?

Optimal fetal positioning is an important topic for pregnant women to learn more about.

Optimal Fetal Positioning – How To Make Birth Easier

Fetal position can impact how labour progresses. On one hand, that wouldn’t be a problem. Given time and support, you will birth your baby.

However, since most births take place in hospital settings, time and support may not always be available. Even during pregnancy, women are made to feel they’re doing something ‘wrong’ if their baby doesn’t get in a good position and stay there.

Consequently, it’s ideal for babies to achieve a good position for birth for many reasons. Not the least making birth an easier journey for both mothers and babies.

What Is Optimal Fetal Positioning?

It’s important to understand the origins of optimal fetal positioning. The term, created by birth educator Pauline Scott and midwife Jean Sutton, describes how women can help their babies to assume the best position for a safe and straightforward birth.

Jean noted most births go easier when babies begin from the left occiput position. Over time, this has turned into a belief this is the only optimal fetal position, despite Jean never making this claim.

Optimal Fetal Positioning For Birth

To be born, a baby rotates and descends through the pelvis. Baby’s position influences how easy the rotation and descent will be. Ideally, your baby lines up to fit through your pelvis as easily as possible.

This is using the Left Occiput Anterior position (LOA).

To be in this position, the baby needs to be head down, with his back on the left side of the front of your tummy. Their face is pointing midway between your right hip and spine.

In this position, the baby’s head is easily ‘flexed’, i.e. the chin tucked into their chest. The smallest part of their head presses down onto the cervix first.

Most babies assume this position in preparation for birth. But there are many factors which influence your baby’s ability to settle into this optimal position.

What Affects Baby Position In Utero?

Bear in mind your baby not being in the LOA position doesn’t mean there is something ‘wrong’. However, our lifestyles do have an enormous impact on our bodies and this can affect how women carry their babies and give birth.

For the past 70 years, we’ve become increasingly more sedentary. We sit down for long periods and aren’t moving as much. Today, our sedentary lifestyles mean babies aren’t being encouraged to find the optimal position for birth. Sitting back or slouching on comfortable sofas nightly is one of the bigger culprits of creating less space for babies to find their ideal space.

Many pregnant women who work are sitting for long periods of time. We might be more aware of the importance of health and exercise but few of us have the time to actually engage in it.

During labour, women are encouraged onto a bed where they naturally lay on their back, despite great discomfort. This position is better for care providers to see what’s happening and women accept it as normal.

With so many labours being induced, it’s little wonder babies aren’t able to find their way into a good position easily. Induction requires constant fetal monitoring, usually while a mother is lying on her back on a bed.

Inductions also increase the likelihood a woman has an epidural, as the pain of contractions is intense and relentless. Having an epidural affects how she can work with her body, as she is lying down and unable to move.

How Does Baby Position Affect Labour?

A baby in an optimal position is able to tuck their chin, which helps them to fit into the pelvis. The head ‘leads’ into the cervix with the smallest diameter to fit through.

This isn’t to say it’s impossible to birth babies in other starting positions. Except transverse (cross lying) and some breech positions, most babies will still rotate for birth but it can mean labour is longer.

For more information about fetal position and the impact on labour, read 8 Signs Your Baby’s Position Is Affecting Labour. 

How Do I Know What Position My Baby Is In?

When the baby is anterior, the back feels hard and smooth and rounded on one side of your tummy, and you will normally feel kicks under your ribs.

When the baby is posterior (back against your back), your tummy may look flatter and feel more squishy. You may feel arms and legs towards the front, and kicks on the front towards the middle of your tummy.

The area around your belly button may dip into a concave, saucer-like shape.

How Do I Encourage Optimal Fetal Positioning?

The baby’s back is on the heaviest side of its body. This means the back will naturally gravitate towards the lowest side of the mother’s abdomen.

So if your tummy is lower than your back, e.g. if you are sitting on a chair leaning forward, then the baby’s back will tend to swing towards your tummy.

If your back is lower than your tummy, e.g. if you are lying on your back or slouching on a sofa, then the baby’s back may swing towards your back.

Avoid positions which encourage your baby to face your tummy.

The main culprits are slouching in armchairs, reclining on a car seat, or anything where your knees are higher than your pelvis.

The best way to do this is to spend lots of time kneeling upright, sitting upright, or on hands and knees.

When you sit on a chair, make sure your knees are lower than your pelvis, and your torso tilts slightly forwards.

For more information on optimal fetal positioning, be sure to visit the Spinning Babies website.

Recommended Reading:

• 5 Reasons Babies Get Stuck During Labour
•  Macrosomia – 5 Myths About Big Babies and Birth