This information is for expectant mothers and their partners to help encourage your baby to move into the ideal position for birth before labour begins. If your baby is coming head first and is a single baby (not a multiple pregnancy), from about 34 weeks onwards this advice is given to encourage your baby to lie with its back to your left side/front. This can help your baby engage for a more straightforward birth.
This advice is meant to complement your antenatal care and may not be suitable for all women or pregnancies. Always consult your midwife, GP, or physiotherapist.
Understanding Fetal Positioning
During antenatal check-ups, especially in the last twelve weeks, your doctor or midwife will palpate your abdomen to detect the baby’s position. While most mothers know that head down is good, few understand the significance of a baby facing the mother’s navel or spine.
- Occipito-anterior (OA): Baby is head down, facing the mother’s spine. This is the optimal position for birth.
- Occipito-posterior (OP): Baby is head down, facing the mother’s navel. Labour is often longer and more painful, and may involve more back pain.
Advice for Optimal Fetal Positioning
Things to Do
- Use upright and forward-leaning postures to allow more space in the pelvis for your baby to turn.
- Sit with your knees lower than your hips, back straight, using pillows or cushions under your bottom and lower back.
- Sit to read on a dining/kitchen chair, elbows resting on the table, knees apart, leaning slightly forward.
- Sit facing the back of a chair, resting your arms on the back (not suitable for pelvic girdle pain).
- Kneel on the floor, leaning over a large beanbag or cushion to watch TV.
- Use a wedge cushion under your bottom when driving.
- Swim using a variety of styles.
- When resting or sleeping, lie on your side (preferably left) with a pillow between your legs and back supported.
- Do exercises on all fours, such as wiggling hips side to side or arching your back like a cat, then levelling the spine.
- Use forward-leaning postures during Braxton Hicks contractions to help the baby manoeuvre into the optimum position.
- During contractions, stay on your feet, leaning forward and rocking hips from side to side/up and down.
Things to Avoid
- Avoid positions that encourage your baby to face your tummy, such as slouching in armchairs, leaning back in car seats, or sitting with knees higher than your pelvis.
- Don’t cross your legs, as this reduces space at the front of the pelvis.
- Don’t put your feet up, as lying back with feet up encourages posterior presentation.
- Avoid deep squatting until you know your baby is facing the right way.
- Use a birth ball to encourage good positioning before and during labour.
Helpful Positioning Hints During Labour
- Birth Ball: Sit upright on a birth ball with legs at a ninety-degree angle. Use a supportive surface in front of you if needed. Sitting on a birth ball during labour allows you to move your pelvis freely, encouraging the pelvis to expand and giving baby more room to move down.
- Leaning: Place the birth ball on the bed or floor. Lean forward so the ball supports your head and chest. This takes pressure off your back and allows you to rock your pelvis. It also leaves your back open for massage.
- Cat Arching (Pelvic Rocking): From hands and knees, tuck your bottom under by contracting abdominal muscles and arching your back, then relax and level the spine. This relieves back pressure and strengthens abdominal muscles.
- Pelvic Tilts: Lay flat on your back, knees bent, tilt your pelvis backwards to flatten your back onto the bed, then release. This strengthens abdominal and back muscles during pregnancy (not optimal during labour).
- Optimal Seated Position: Sit straight up with your spine aligned, feet flat on the floor, and a pillow behind your back for comfort. Avoid slouching.