Your baby’s position in the womb makes a big impact on how your labor and delivery will go. This
is especially true with your first full term pregnancy. A smooth labor and birth is everyone’s desire,
and spending some time working to help your baby be in the best position for birth can really pay
off during your labor.
Ideally, your baby will be we
ll down in your pelvis (this is called engaged), with his head facing your back (this is called anterior) his chin tucked on his chest (this is called well-flexed) and his back on your left side. We would refer to this position as LOA or Left Occiput (the very back of the baby’s head) Anterior. There are babies who really prefer to hang out on the right side, and that is generally okay, but it is a little easier for babies to rotate in a clockwise direction than a counter-clockwise direction simply because of the way your pelvis is shaped, and so if a baby starts on the right, they are a little more likely to rotate the long way around and cause back labor.
As labor progresses, your baby will gradually rotate down through the pelvis, getting lower and lower as your cervix dilates with contractions. Babies rotate from the Left or Right to straight Anterior, so that their heads come out facing your bottom, and then once the head is delivered, they rotate again so that their shoulders can come one after the other.
As you can see, the baby is an active participant in the birth process, and has a vital role to play in
labor. The organization, Spinning Babies, has built their philosophy on the principle that helping
your baby have the optimal environment to do what they need to do in labor makes for a more
efficient labor, and it is a philosophy that your midwives heartily concur with. Working with your
baby prenatally to help them be in a good position for birth once labor starts can be the difference
between a long, drawn out exhausting labor and a smooth labor. It can also make the difference
between having a home birth as planned, or requiring transport to the hospital due to baby’s
position and your exhaustion.
Fortunately, we don’t have to leave baby’s position to chance. There are distinct things you can do in
order to make space for your baby to naturally settle into a good position. Here are a list of activities
broken down by weeks of pregnancy that can help. You’ll find detailed instructions on each by
following the links, the vast majority of which are from the Spinning Babies website.
28 weeks on
- Walk Every Day. A brisk, full-motion 30 minute daily walk helps to stretch the psoas muscles and keep the pelvis in alignment.
- Sit properly in upright positions that allow your belly to come up and forward, encouraging your baby’s back to settle into the front of your belly like a hammock. Be especially mindful of keeping your knees at or below your hips. Avoid crossing your legs. Instead, tailor-sit on the floor as much as you comfortably can, inflate your birth ball until your knees are lower than your hips, and sit on a pillow when on couches to keep your knees lower. Avoid reclining as much as possible. A little time at the end of the day to put your feet up is great, but the rest of the day should be spent in upright positions. Your baby’s back is the heaviest part of their body, and a lot of reclining encourages them to settle into posterior positions.
- Stretch and relax: Start with your jaw: yawn and breathe deeply, move to your neck, doing neck rolls. Stretch your arms, shoulders, and back with windmills, and arm stretches behind your back. Legs and pelvis get worked with forward lunges, calf stretches and squats. There are detailed instructions under Activity 4 on the Daily Activities Page of Spinning Babies.
- Cat/Cow or Pelvic tilts: rest on your hands and knees, and keep your back flat (cow), then arch your back and tuck your pelvis under (cat). Repeat 20+ times.
32 weeks on
- Open Knee Chest is particularly helpful if baby is having a hard time getting to, or staying, anterior. This gives baby more freedom to rotate without all the downward pressure of gravity on your pelvis.
- Forward Leaning Inversions are an even more dramatic way to let baby move, plus they stretch all the uterine ligaments which helps create room inside the uterus.
- Sleep optimally: you are probably already sleeping with a small pillow fort all around you. Now it’s time to arrange those pillows to get as close to sleeping “on your stomach” as possible.
36 weeks on
- Release and lengthen your psoas muscle even further with various exercises/stretches. This will help your baby engage into your pelvis making your labor more efficient.
- Side-lying release: this one you need a partner to help with. It’s fairly complicated, but worth learning as it is beneficial in the last weeks and in labor!
- The Jiggle: a gentle release, again, with a partner.
- Miles Circuit: the miles circuit combines several of these daily activities into one “circuit”. It can be very helpful in calming irritating prodromal labor, helping baby achieve optimal positioning, and helping to stay calm, loose, and limber in early labor. The original circuit calls for 30 minutes of each position, which makes it a 2+ hour activity. However, it can be completed more quickly by doing each position for 10-15 minutes instead.