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Getting baby into the best position for birth

Otherwise known as 'Optimal Fetal Positioning'.

Why is it important that your baby is in the best position for birth?

Simply - it is much easier and more comfortable to birth a baby that is in the optimum position. There are several different fetal positions that your baby can be in, and some are better for birth than others. If your baby is in a less-than-ideal position, it can cause painful and prolonged labor, fetal distress, and possibly even interventions like a C-section.

How to tell what position your baby is in?

You will be able to tell in scans what position baby is in. As you progress in your pregnancy, your midwife will check your baby's position at your appointments. They will record this in the Badger Notes App - you might see 'cephalic' written which means 'head down' or 'breech' which means head up or 'transverse' which means your baby is lying longways. You may see abbreviations such as 'OA', or 'OP' sometimes with a 'L' or 'R' before them - more on these below.

You can also tell by feeling your bump. If you feel your stomach and identify a wide, hard shape, this indicates that the baby’s back is facing forward. If however you feel a lot of small lumps and protrusions, this indicates that you’re feeling the baby’s limbs, and that baby is facing forward. Sometimes the position of the placenta, tone of the abdomen, abundance of amniotic fluid, or excess weight can make it difficult for you to figure out baby’s fetal position on her own so don't worry if you can't work it out.

What positions are there?

To keep things as simple as possible, lets take these 5 terms.

  • Occiput – This refers to the back of baby’s head, and means head down. Your baby may be lying left or right so you may see 'LO' in your notes for Left Occiput example.

  • Transverse – Sideways, or laying horizontally across

  • Anterior – The front of the mother

  • Posterior – The back of the mother

  • Breech - Baby is bottom down, head up.

Which position is best?

The best position is known as 'OA' which stands for 'Occipito Anterior'. The 'Occipito' refers to the baby's head and means that it is head down. The 'anterior' part means the baby is facing your back, with their spine coming up the front of your tummy, bottom under your ribs.

Which position is worst? *

A transverse baby must be born via c-section. In most cases, hospitals will advise a breech baby also be born via c-section. Although it is possible to birth a breech baby vaginally, it does come with increased risk and many care providers are uncomfortable with supporting a breech vaginal birth.

'OP' is when baby is head down but instead, their back is coming up your back with their limbs in the front of your tummy. This is known as 'back to back'. A baby lying 'OP' or 'back-to-back' can lead to a lot of back discomfort in labour. Unlike contractions coming in waves, the discomfort can be constant and prolonged in your back, and labour can last significantly longer as baby can't tuck their chin down to move through the birth canal. 95% of OP babies will turn in labour eventually, although 5% will be born in this position. There is also an increase risk of having an assisted birth or a tear with an OP baby.

*It is important to mention here - don't stress about your baby's position until about 36-37 weeks pregnant. Baby will move around a lot during pregnancy, and it is common for a baby to be sitting breech at a 32 week scan but to have moved head down by 36 weeks.

So how can you get baby into the best 'OA' position for birth?

Baby's head is really heavy, and it will move with gravity. If you are reclining a lot, baby will move round into that position back-to-back. So the key is to try to lean forward as much as possible. (Watch the video above for a quick demo).

Way's to lean forward:

  • Swimming - this is my best tip! Get