#12 Achieving “optimal fetal position” before birth

As pregnancy progresses and your baby grows, it helps to be mindful of positioning. This includes both your position throughout the day and the baby’s position in the uterus.

Baby’s Positioning

Optimal fetal position later in pregnancy is head down with baby’s face looking to mom’s right hip. This puts the baby in position to rotate to face your tailbone and slip down the birth canal during delivery. If your baby is facing your pubic bone, the pressure of their head against your tailbone may give you uncomfortable back labor. If your baby is breech or sideways after 32 weeks, consider your options: vaginal breech delivery, cesarean birth, or try to turn the baby to be head down. It’s a good idea to have your provider check for the baby's position at 32 weeks so you have time to get treatment or adjust your birth plan if needed. If your baby has settled into a position other than what’s considered “optimal,” don’t worry, babies may turn or rotate right up until the time of delivery.

Your Positioning

Here’s what you can do to encourage an optimal fetal position:

1. Sit tall. Avoid slumping or sitting in soft couches that promote a rounded spine. Slumping reduces the space in your abdominal cavity. Try not to cross one leg. Sitting properly is the most basic thing you can do to help your baby get into optimal position.

2. Check your car’s seat. Sit with your hips slightly higher than your knees. Use the lumbar support if you have one. If not, roll a small towel and use it to fill in the space between the backrest and the seat pan. This will tilt your pelvis a bit forward and put some arch in your lower back. Play around with the controls on your car seat to find what works for your body as it grows.

3. Exercise! Take daily walks for about 5-20 minutes. Get down on hands and knees and do pelvic tilts, crawling, or rocking. Sit criss-cross on the floor whenever possible. Switch out your office chair for a yoga ball, if practical.

4. When you have Braxton-Hicks contractions, lean forward or get on hands and knees to create as much space as you can, as described above, for these practice contractions to be effective at positioning your baby.

5. Look for asymmetries in your daily habits that might adversely affect your posture. For example, if you have a toddler, alternate which hip you carry them on. If you are standing, ensure you do not always lean to one hip. If you sit at work all day, get up and change position every 20-30 minutes. If you have asymmetries in your pelvis or hips, you likely have pain there. This may lead your tissues to pull abnormally on the uterus and its ligaments and make it more difficult for your baby to find its optimal position for birth. For individualized postural corrections and other recommendations to achieve optimal fetal positioning, consider a consultation with a physical therapist or other body worker.

References: www.spinningbabies.com, www.mybreechbaby.org, www.breechbirthblog.org