Thursday, August 22, 2013

Postion of the baby for labour

Baby's position during labour

During labour, the baby's position is very crucial in deciding if we can deliver our baby normally or by C-sect. We might have heard about the baby is either engaged or breach. Before being pregnant, I just knew the term and a very minimal information about the position. But, ever since I have been attending Amani Birth class and reading books on giving birth, this sort of information is important to know.

According to Mayo Clinic, there are five positions that the baby might be at during labour.
  • Facing downward (Occiput anterior position) : The most preferable and common fetal position.
Illustration of baby in the facedown position
  • Facing upward (Occiput posterior position) : If there is enough room, the baby will turn on their own to face downward. Sometimes forcep is used to turn the baby or an incision to extend the opening of your vagina (episiotomy).
Illustration of baby in the faceup position
  • Buttocks first : The baby is in frank breach position. 
Illustration of baby in the buttocks-first position
  • Feet first : The baby is in complete breach position.
    Illustration of baby in the feet-first position
  • Lying sideways : The baby is in traverse lie - position horizontally across the uterus.
Illustration of baby lying sideways

The last three positions, the health care provider will try to turn the baby manually by placing their hand on your abdomen, then pushing or lifting. If the baby remains in this position, C-sect is recommended.

The ideal baby position to be delivered is the Facing downward (Occiput Anterior Position)
When the baby is position like so, the baby is lined up as the baby can fit through our pelvis as easily as possible and the baby's head is easily 'flexed'. The diameter of his head is approximately 9.5cm and the circumference is approximately 27.5cm. With this position, the smallest part of his head will be applied to the cervix first. 

The Facing upward (Occiput Posterior position) is not to good although the baby's head is down but facing our tummy. Mothers who have their babies in this position tend to have a long and painful labour. Baby with this position cannot fully flexed his head and the diameter of his head is approximately 11.5 cm with the circumference 35.5 cm. Why it is painful? Before the labour starts, the baby will try to rotate while he is entering the pelvis.

However, the rate of having the baby in facing upward  is getting higher and higher due to our everyday life routine - sitting in the car, leaning back on comfortable sofas and not having enough physical work. I myself fall into this category. 

What can we do about it?
We can avoid this from happening if we pay attention to our postures through out the day in our last 6 weeks of pregnancies for first timers (like me!) and the last two or three weeks for the subsequent pregnancies.

Logically, the baby's back is the heaviest and the back will naturally gravitate towards the lowest side of the mother's abdomen. So, if your tummy is lower than your back, for example leaning forward when you are sitting on a chair, then the baby's back will tend to swing towards your tummy. But if your back is lower than your tummy, for example lying on your back or leaning back on a chair, the the baby's back will swing towards your back.

Positions that are recommended are :
  • sitting upright
  • on hands and knees
  • on a chair, make sure your knees are lower than your pelvis and you are slightly tilted forward
  • kneeling on the floor over a beanbag, cushion, gymball 
  • sitting on a dining chair facing and leaning on the back of the chair
  • yoga style, crossed legged (duduk bersila) while leaning forward
  • sleep on your side, preferably on your left side
  • swimming with your belly downwards
  • practice a few exercises
    • moving/wiggling your hips from side to side on gym ball
    • pelvic tilt

I hope this will make us a step closer in having natural gentle birth In Sya Allah, Amin Amin. 

*Credits to Mayo Clinic, Kak Bidan and  Vivante Midwifery