Maternal Positioning

Fetal Positioning

Fetal Positioning is the phrase used to talk about the baby’s position in the womb and how to help baby into one of the easier positions to fit through the pelvis during birth.

Babies change position in pregnancy and during the birth process. True! That’s nature’s design!

But,  fetal position changes are not random. There are multiple factors that come together to affect the fetal position changes.

• Tensions and torsions in the soft tissue structures supporting the uterus and in the pelvis
• Looseness in these same structures or the abdomen
• The location of the placenta
• The shape of the uterus (some have a cylinder or a heart shaped uterus and this may restrict baby’s attempts to reposition)

If a woman’s womb is relatively balanced, then getting into gravity-friendly positions during pregnancy may help a breech baby to flip head down or a posterior baby to scoot over to the mother’s left side and face her right hip. If your own position selections don’t work, see our ebook, Helping Your Breech Baby Turn; page called flip-a-breech; or online course for pregnancy techniques and insights called Breech for Pregnant Parents. We also have a course for providers helping pregnant parents called Breech for Practitioners Package. All of these resources include body balancing techniques expectant parents themselves can do.

The time necessary for rotation may be shortened when a woman uses body balancing techniques and gravity-friendly maternal positions. Gravity-friendly positions are more likely to reposition baby if the womb is already in balance. Do you see how they are connected?

Pregnancy Maternal Positions

Some helpful maternal positions in pregnancy are:

• Sitting with your hips higher than your knees
• Sitting with your back straight and your rib cage lifted off your middle
• Sitting on a firm exercise ball that allows your hips to be level with your knees or higher than your knees
• Laying with your navel aiming towards the bed, floor or couch/ sofa, if not directly on your belly, then so that eventually an imagined light-beam coming from your navel would eventually find the floor
• Brief Forward-Leaning Inversions, once a day
• Anterior pelvic tilts with knees bent (work gradually up to where you can squat with your feet flat on the floor for 2-5 minutes)
• Holding your shoulders back, and pulling your chin back so your head is over your hips while you walk briskly

Le Boursier du Coudray, Abre’ge’ (1773) “counseled … that women sleep on one side so that the opening of her womb, a bit off kilter, would be pulled by gravity into alignment with the vagina.” -The King’s Midwife; A history and Mystery of Madame du Coudray by Nina Rattner Gelbart

Labor Maternal Positions

Some helpful maternal positions in labor are:

• All the same that are listed above, plus
• Standing and leaning forward with your knees “soft” (slightly bent)
• Standing and leaning back (straightening, even arching your back slightly)
• Standing and flattening your lower back against the wall while lifting your lower abdomen during the entire contraction (See Belly Lift)
• Kneeling
• Kneeling and leaning forward on a bed or chair or exercise ball (hands and knees)
• Kneeling and lifting your arms to grip a shawl or rope or bar above you
• Kneeling and resting your elbows on the mattress or floor in front of you
• Kneeling and resting your shoulders on the floor or mattress in front of you
• In the deep birth tub, kneeling in a way that stretches your knees far away from your hips, so that your thighs are at a diagonal and your knees are further from your belly than your hips. This opens your pubic bone away from your spine and lets a posterior baby drop into the pelvis (engage). Do this only in active labor after you’ve tried to help baby rotate to the Left occiput transverse and that hasn’t been able to happen for whatever reason.
• Sitting on a birth stool
• Lifting your arms to grip a shawl (Rebozo) and standing with your knees “soft” (slightly bent)
  

  Melissa stands and leans forward during contractions (Photo by Melissa Booth)

Adding your instinctive movements is an excellent way to “tune in” to what your body needs to do to respond to your labor.

From Christine Kent, RN “..How our spine is is primary, but how the abdominal wall is is equally primary. We’re a whole tension-compression system. The whole thing works in harmony. There are really no parts in this system; it is a whole.

Katy Bowman Says on her Facebook called Aligned and Well: “I’ve said this before, but it can’t be said too many times: Posture does not equal alignment. Posture is how something looks. Alignment is how something works. Katy has got a lot to say, and you may learn a lot from visiting her website.

Find more details on our Rest Smart^SM page!

Conclusion

• Maternal position alone is not usually enough to ensure a good fetal position by the time labor begins.
• Balance in the uterus and pelvis precedes the success of using maternal positioning for changing fetal position.
• Maternal positioning is Spinning Babies^® Principle 2: Gravity.

Gravity-friendly positions are rarely enough! Add movement to increase flexibility and reduce pain. Before either, add Balance to help both Gravity and Movement ease birth.