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Optimal Fetal Positioning

ENCOURAGING YOUR BABY TO ENTER YOUR PELVIS IN AN ANTERIOR POSITION​

One of the things you can do to help your labour go well is to line the baby up so that it can take the easiest pathway through your pelvis.

Ideally the baby should have its back on Mums left and towards the front with feet kicking on your right (anterior position).

Think of your baby lying in the hammock made by your abdomen.

In our daily life we sit a lot (not something our ancestors did), and often we recline and slouch back when we are sitting – our chairs and couches all encourage us to sit this way. Slouch sitting tilts your pelvis backwards towards your spine and narrows the angle through which the baby must move to get its head into the pelvis (engage) and out again during birth.

To negotiate these angles, baby moves into a posterior position (back on your right and around near your back) to get into the pelvis. It is not easy to move down and through the pelvis when beginning in that position – the labour tends to be longer and with a lot of backache. The contractions are also described as more agitating, exhausting and difficult to handle.
 

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POSITIONS TO HELP

It is advised that you adopt the following positions from 32 weeks to assist the baby to line up in an anterior position. Be aware that they can change right up until the birth.
 

  • Incorporate into your daily life leaning forward positions e.g. hands and knees, leaning over a bean bag / cushions, pelvic rocking, gardening, scrubbing floors
     

  • Keep your knees lower than your hips as much as is possible
     

  • Do not cross your legs
     

  • When sitting, sit up straight on your sit bones with your back straight
     

  • In the car, place a cushion under your bottom and lower back especially if it has bucket seats
     

  • Lie predominantly on your left (the recovery position is good with your tummy almost touching the bed, bottom leg out straight with top leg bent up and resting on a pillow)
     

  • Exercises such as walking, swimming (with tummy lower most), yoga are all good and encourage good posture (which means no slouching)
     

  • Gym ball to sit and rock on.



Avoid:

  • lazi-boy chairs, reclining on lounge chairs / couch
     

  • Sitting with bottom lower than knees as you do when sitting on most lounge furniture
     

  • Long car trips in bucket type seats

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These are some positions which are good in pregnancy and labour
If your baby is lying with its back on your right and especially if this is your first baby you need to practice the following to try to get baby to move onto your left side. This is especially important for your first pregnancy as your uterus is pear shaped this means it narrows at the bottom as opposed to a woman who has had a baby before – her uterus is more apple shaped and so it is easier for her baby to move into a more anterior position.

It is advisable to try the first two exercises when baby is awake as they are more likely to turn when already moving.

  • Pelvic Rocking for 20 minutes three times a day. Gravity helps to bring the heaviest part of baby (the back) to the front. Mother rotates or rocks her pelvis while on all fours.

 

  • Knee / chest position for 20 minutes three times a day.

  • Talk to your baby, ask him to shift and visualise him in the position you want.

  • You may wish to try acupuncture, accupressure and/or homeopathic to try to help baby move.

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If you are in labour and it is not progressing as well as it could you could try the following

  • Rocking and rotating your hips in a hands / knees position – pelvic rocking.

  • Sitting astride a chair.

  • Getting up and down for contractions.

  • Marching on the spot or stepping up onto a pile of books e.g. Phone books

  • Walk up the stairs sideways two at a time

  • Side lying

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