The position the baby assumes can affect labor and birth. Right up to week 36 it doesn't matter which position the baby lies in because there is still time for it to make the change. Basically most babies assume the vertex or head down position by that time.
- The ideal position is head down or cephalic with the head engaged
- Once the head engages or fits snugly, labor will progress
- Average size babies don't have enough room to move around and change the position
- Through vaginal examination the doctor is able to determine if baby is in the posterior or anterior, head down or bottom down
- About 96% babies are head down at term
- About 3% are breech position
- About 1% account for the transverse lie position
Positions in late Pregnancy
Occiput is the back of baby's head. Known as occiput anterior or OA for short, this is the ideal position for baby to pass through the pelvis. In other words there is a good chance of labor being straightforward. Baby will be facing the mother's back with his back to one side of the mother's abdomen. Babies mostly assume this position. If baby's back is more on the right side his position is said to be right occipital anterior or ROA. It is said to be LOA if baby's back is more on the left.
If baby is lying with his back against the mother's back and facing the maternal abdomen, the position is termed occiput posterior or OP position. This is relatively uncommon with only about 5% of babies sticking to this position and not reversing to the OA position. If baby remains in the OP position it does not mean vaginal birth is not possible. However labor tends to be longer with the mother suffering from backache because baby's spine presses against hers. Most of the posterior babies change positions at the end of the first stage of labor. If it doesn't happen the likelihood of an assisted delivery or C-section.
This position is one when baby's buttocks faces down and his head is just under the mother's ribs. Baby's legs may be tucked up as in frank breech or one or both of baby's legs may be pointing down (footling breech). EVC or external cephalic version may be offered to the mother at week 37 if she is carrying a breech baby. EVC will involve the obstetrician manipulating the mother's womb to turn the baby around. About 60% of breech babies are delivered by cesarean.
It is also known as the oblique lie. In transverse lie or TR the baby has his head towards the mother's left or right side and lies diagonally across the uterus. This position is probable if the baby is small and has more room to move about at the end of pregnancy, in twin deliveries and if the mother has had several children. Cesarean becomes necessary unless baby turns.
Some babies keep changing positions even after week 37. In unstable lie situations, labor may be induced when baby has his head down.
Things you can try to help baby get into the best position for labor:
- Sit with your knees lower than your hips
- Lean over slightly as much as you can when standing
- Regular swimming on your front - breaststroke is the best
- Kneel and lean over a beanbag when watching TV