I talk a lot about the importance of optimal foetal positioning with my pregnant patients, how the pelvis influences this during pregnancy, and what we can do to achieve it.
It is well known that a baby in a breech or transverse position are not ideal for vaginal delivery. However, did you know that there are even better positions for your baby to be in than simply head down?
What is Optimal Foetal Positioning?
The posture of a mother to be and the way she moves during pregnancy can influence the way a baby is positioned in the pelvis at term thus having a major effect on labour and birth. There is a large school of thought that many difficult births may be the result of a mal-positioned baby. This can result in long and painful labours, and the use of medical interventions.
In the optimal position the baby is head down, facing the mothers back, with its own back on the front left side of the mothers tummy. The baby in this position allows for a smooth passage through the birth canal as the chin is tucked to the baby’s chest allowing the smallest part of the head to be presented first. This ideal position is called an occiput anterior (the baby’s occiput or back of head is facing the mothers front) and has been shown to be more likely to result in an easier labour. Occiput posterior presentations – where the back of the baby’s head is facing the mothers back are more likely to produce longer and more painful labours as the baby will need to turn during labour to enter the birth canal.
What can be done to achieve the best position for my baby?
There are lots of things you, as an expectant mother, can do to help with this – starting in the first trimester. To achieve this optimum position the baby needs to have plenty of room in the womb to move around. Balance, gravity and movement are three core principles that are relevant during pregnancy.
Ensure that your pelvis, spine and associated soft tissues are functioning well, and are balanced and symmetrical. Low back pain, pubic pain (SPD)or pelvic discomfort (PGP) are all indicators of pelvic dysfunction and therefore imbalance. Chiropractic treatment delivered by a practitioner experienced in the care of pregnant women is an effective, gentle and non-invasive way of resolving such issues in addition to balancing your pelvis.
As pregnancy progresses your abdomen increases in size. Use gravity and movement to encourage your baby into the ‘hammock’ this creates. Rest smart, and be mindful of the position you are relaxing in. Regularly sitting in a slouched position, causes the pelvis to tilt backwards encouraging the baby to enter the pelvis in a posterior position as their back, heaviest part of them is more likely to to be positioned against your back.
Try and sit forward rather than slouching backwards when in a chair or on a sofa. Sitting on a gym ball (or birthing ball) will also encourage this position; ideally, your knees should be slightly lower than your hips when sitting on a chair or ball. Kneeing forwards, on hands and knees, or sitting leaning onto a ball is a great way to relax in the evenings.
If you prefer to sit on the floor then sitting cross legged sitting can be comfortable by following these tips. Place cushions under your bottom to raise your hips slightly higher than your knees can help increase comfort and placing firm cushions under your knees can help to increase stability and enable you to relax. The same principle applies when sitting in a car. When in a car have the seat upright and tilt the pelvis forwards using a wedge cushion.
Sleep on your left side, not your back (lying on your back puts pressure on your major blood artery). As you lie on your side, place a pillow underneath your bump. This helps prevent the weight of your baby pulling your pelvis forwards; another pillow should be placed between your knees and ankles to assist alignment and reduce strain on your hips, spine and pelvis.
Using these positions regularly during your pregnancy will help to give you the best chance of optimally positioning your baby prior to labour.
If you have any questions about any of the points raised in this article or require a y further information, please don’t hesitate to contact us at the clinic.