There is so much to say on the issue of baby's position and how it plays a crucial role in your birth experience and outcome.
Most moms and health professionals are satisfied once they have established that baby is head down. But, truthfully, that is only one small part of the big picture. While most babies will lie head down, their position can vary. Here are the most common positions for a "head down" presentation:
Anterior: baby's back is facing out towards your belly. This position is called Optimal Fetal Positioning as it is, in Author of “Sit Up and Take Notice: Positioning Yourself for a Better Birth” Pauline Scott's words "the most common position and the most effective one for his journey through your pelvis. This angle follows the line of least resistance". Anterior babies usually prefer lying to the left of your pelvis, although they can also lie to the right.
Posterior: baby's back is facing towards your back. Pauline tells us "In this position, your baby may meet with some resistance because of the angle he has begun in. His journey through your pelvis may be slower than the "anterior" baby. This is because he has to turn his head 180 degrees to find the same angle that the anterior baby has taken (the "anterior" baby only has to rotate 90 degrees or less)." I would add that this position can slow down labour, increase your sensation of pain, and add an unwanted obstacle when trying to achieving a VBAC. It is not an impossible position to birth a baby in, however, it is a more challenging one. Posterior babies usually lie towards the right.
Lateral: baby's back is facing your side. This position can easily turn into an anterior position, the most optimal position for birth, especially when he is facing your left side.
Perhaps you are thinking "Huh?". If you can find a doll or stuffed animal, try this: Place the doll with its head down and back against you, slightly turned to the right. That's a typical posterior position. Now, turn the doll around with its back facing away from you, slightly turned to the left. That's a typical anterior (optimal) position. Now, turn the doll's back to face out towards your side and you're looking at a lateral position.
How can you tell if your baby is posterior or not? Well, there are some clues that moms can have. An anterior baby has its back out towards your belly. So, more than likely you will feel "rolling" sensations when baby moves. Also, if you lie down and use your palms and fingers to palpate or feel around, you will feel a big mass which would be your baby's back. An anterior baby's heartbeat is easy to find.
If your baby is posterior, you will feel a lot of little pokes and kicks towards your front and you might have more of an ache in your lower back as you head into your last weeks of pregnancy. When you lie down to feel for baby, there will be a lot of empty spaces and you might even feel small knobby protrusions (knees, hands, feet). A posterior baby's heartbeat is harder to find, not because it is weaker in any way, but because the back is not as close to the front of mom's belly.
Now, when do you start thinking more about your baby's position? Usually in the last 8 weeks of pregnancy, it is important to find out your baby's position. Surprisingly, not all health care professionals know how to palpate for baby's position. In this case, try seeing for yourself what position you feel baby in based on these clues:
Rolling sensations and kicking near the ribs (anterior) or pokes and kicks towards your middle front (posterior)?
Hard solid mass when you feel around (anterior) or small knobby protrustions and empty spaces (posterior)? (Be sure to be lying on your back and feel mostly with your palms, skin on skin, applying gentle pressure).
Belly button sticking out (anterior) or belly button sunk in or saucer shaped (posterior)?
Heartbeat easy to find (anterior) or difficult to find (posterior)?
There is something you can do in the last weeks of pregnancy to ENCOURAGE your baby to assume an optimal (anterior) position. It has to do with body mechanics and pelvis mechanics. We live in a sedentary society and far too many pregnant women spend their last weeks of pregnancy with legs up and pelvis rocked back (knees up higher than your pelvis). This lifestyle seems to encourage baby to settle into a posterior position. The key is to try and adopt positions in your everyday life that tilt your pelvis towards the front, with your knees always lower than your pelvis.
If you're thinking "Huh?" again, do not worry. Birth language can be a difficult language to navigate. Let's try looking at it this way.
Sitting: Avoid recliners and cars with bucket seats. Now, this doesn't mean you have to get a different car, it just means that you want to make sure you are always sitting up straight. For example, when riding in a car, you can bring a pillow or towel to tuck under your bottom so that you are sitting up straight. This is true of all sitting you do, make sure you are sitting up straight and that your knees are LOWER than your hips.
At home: Think, leaning forward. Try reading or watching T.V. on your knees (perhaps kneeling on a pillow) and leaning over a bean bag, cushions or an exercise ball.
Lying down: Think leaning forward again. Lie on your left side, with your right leg leaning forwards over your left leg so your tummy is touching the mattress.
Stay active! Staying active ensures that your pelvis is mobile and allows your baby more wiggle room to find that optimal position!
For more great info and resources on optimal fetal positioning, go to www.spinningbabies.com where Gail Tully has greatly expanded upon Pauline Scott’s original work on optimal fetal positioning.
“Sit Up and Take Notice: Positioning Yourself for a Better Birth” by Pauline Scott The Belly Mapping Workbook” by Gail Tully (www.spinningbabies.com )
*This article was first published at www.fruitfulvines.blogspot.com and will be featured in the April 2012 issue of HomeGrown: Parenting in the North (http://www.facebook.com/Homegrown.magazine).