Please help! Question on baby's position prior to birth.

[NYCVeg]

I have a question about my baby's position. Until last week, she was head down, back on the left (optimal position, in other words). By the time of my appointment last week, however, she had turned--so now her back is on my right side. It's very unclear to me how she did this, as I lie almost exclusively on my left side, but...

I'm wondering if I should be doing anything to get her to turn back, and, if so, if anyone has suggestions. I do pelvic tilts and squats, and I generally sit leaning forward, rather than reclining, to create a "baby hammock." I've been trying to stay on my left side as much as possible, to get her to drop the other way, but so far no dice. I'm not sure if I should be doing any inversion (the kind on hands and knees, with butt in the air and head down); when I had my "check if the baby is head down" exam a week and a half ago, the mw marked her at -1, so I'm a little wary of doing anything that might lift her out of my pelvis if she's not engaged yet (do head-down babies ever turn breech at the last minute? Eek).

If anyone has advice/thoughts, I'd love to hear them. I feel like the clock is ticking!

Thanks!

BTW, I've been to the spinningbabies website, but I couldn't find anything that really gave me answers. On the pregnancy page, they have a link to "Inversion", but I can't get it to work.

[starlein26]

About your breech concern...I don't think she would/could turn breech at this point...and as far as where her back is facing...I never thought that this mattered, unless the baby's back is facing your back (baby is posterior). Ds was that way and although that made labor excrutiating (terrible back labor), he managed to turn around at some point and was born anterior...

[NYCVeg]

Hmm...spinningbabies includes both "back to the right side" and true posteriority as things that could lead to a longer, harder labor and/or c/s. Are they just being alarmist, then?

[starlein26]

Well ds being posterior didn't hinder the speed of my labor at all (which was 5 h 45 mn total, with 2 h of pushing) but it was definitely painful...all in my lower back. But then again...I'm sure laboring with an anterior baby isn't a piece of cake either...

[nurturedbirth]

Originally Posted by NYCVeg

Hmm...spinningbabies includes both "back to the right side" and true posteriority as things that could lead to a longer, harder labor and/or c/s. Are they just being alarmist, then?

The reason a ROA (right occiput anterior) position is categorized with the posterior position is because it is very rare for a baby to enter the pelvis and be born from that right position. Almost every baby will rotate to a left position before descending through the pelvis and they will do it by turning clockwise (when viewed from above), meaning that a right-positioned baby (baby's back on the right) will rotate through a complete posterior position and then continue on to a left position before descending through the pelvis.

I recently attended a presentation by a doula who specializes in teaching optimal fetal positioning to parents-to-be and other doulas and she confirmed that she approaches ROA positioning just as she would a posterior position.

And to address the OP, it sounds like you're doing the right things to encourage optimal positioning. Except the squatting, squatting will encourage babe to further engage into the pelvis in his/her current position, which in your case is not an optimum one. It is especially ideal to do your OFP exercises when you are having pre-birth waves ("Braxton-Hicks") because it is the effort of these "practice contractions" to help move baby into the correct position. As an extreme measure, the doula I mentioned above recommends crawling on hands and knees to get from place to place while you're at home, full time.

[starlein26]

Dana-
Interesting info! I didn't think ROA would even be an issue. One question, when your body is actually ready to birth the baby...would the baby get into that ideal position on it's on if it isn't completely posterior?

[NYCVeg]

Unfortunately, I haven't had any BH contractions, so I can't time the exercises that way.

I'm kind of torn on the squatting--on the one hand, I want her to engage when I know she's head down (I'm carrying pretty small, so I'm not totally convinced that there isn't still room in there for her to flip), because ROA seems preferable to breech...but I also want her to get back over to the left! I'll add some more pelvic tilts, though.

Urg...darn turny baby.

I have a prenatal on Thurs. night, so mw will confirm her position then...I'm pretty sure her back is still on the right, though.

BTW...I have all hardwood floors, so crawling isn't really an option, unfortunately.

[flapjack]

It doesn't matter. There is absolutely no benefit whatsoever to having a baby whose head is engaged LOA if that head is flexed and a brow presentation, because labour will still be slow in starting and progressing (happened with my first- he was transverse until 37 weeks then was born with a Klingon ridge across his forehead, 3 weeks late, because of the way his head engaged. An induction before he moved would probably have led to a c-section). My two youngest both spent a lot of time lying laterally with their backs to the right and their feet poking out of the left just before labour started, then ctx moved them round and labour really started progressing.
Keep your pelvis open and keep visualising. Your baby knows what s/he is doing, and when the time is right will be born safely and calmly into your waiting arms.

[nurturedbirth]

Originally Posted by starlein26

Dana-
Interesting info! I didn't think ROA would even be an issue. One question, when your body is actually ready to birth the baby...would the baby get into that ideal position on it's on if it isn't completely posterior?

Most babies that are not initially in optimum position, including complete posterior, will eventually move to LOA, sometimes before active labor begins, sometimes during labor and birth. Some babies remain in a persistent posterior position and are born "sunny side up" meaning facing the mother's belly rather than her back. I'm not sure if I'm answering your question exactly. Is that what you wanted to know?

Dana

[starlein26]

Yeah, thanks Dana!

That's what I thought since ds did this (he was posterior prior to labor and during most of it but he came out anterior).

[phoebemommy]

Oh man, I just felt this same thing going on today -- the baby has mostly been hanging out head down on the left, but this morning he spent some time on the right. He moves around a lot, but if he's up in front like that, he has preferred the left until today. It also coincided with my chiropractic problems that were under control suddenly going downhill, so I'm going into the chiropractor today. The problems are rooted on my left side, so my gut is telling me the right side thing is a sign that things need some help in there.

[KBinSATX]

Mine seems to change positions on the weekends when I am cleaning the bathrooms (leaning over the tubs, etc.). But then he went back to ROA. Oh well. Main thing is he's head down so I can have my homebirth. I am almost finished with week 39.

[coobabysmom]

Ds was ROA most of my pregnancy and into labor. I am not sure when during labor or pushing he turned but he did... Prior to labor, I did do the webster technique to encourage better positioning and even though he didn't move, I know it made me feel better.

But, I've always wondered if ds being ROA contributed to a 24 hour (longish), disorganized (never followed any pattern) labor with an additional 2 hours of pushing...? Or my labor could have been this way as a result of everything I did to try to encourage labor in order to avoid at 42 wk scheduled hossy induction.

[KBinSATX]

To be honest at nearly 39 weeks the baby still changes position so easily that quite frankly I don't really understand why people would get worked up about it before labor?
He's head down. According to the midwives his head is waaay low in the pelvis. I don't expect him to come back out of the hole so to speak. But he was ROT on Wednesday. Today he is LOA - almost OA. Who knows how he is tomorrow?
In my birthing class people are so set on position. It almost seems like theirs stays the same all the time. Can that be?
I am 5'10" so maybe mine just has more room to turn around?

[BelgianSheepDog]

I'm also 5'10 with a long torso so you would think mine would shift more, but she has been head down with her back against my left side for a month now. I think she flipped to the right side a couple times in the night, but she always goes back. I guess it's just comfy there. Also, I think my placenta is on the right, it probably gets in her way.

[NYCVeg]

Actually, mine is back to LOA. Clever girl.

For me, the baby was LOA from the time they started being able to feel her--that is, the WHOLE pregnancy until last week. She kicked a ton, but never ever turned--so I thought there was a good possibility she might not turn back. I also think the likelihood of them turning depends so much on how you're carrying, how much amniotic fluid you have, and whether or not the head is engaged. My tummy is also pretty small, relatively speaking, and the baby really fills the space quite thoroughly.

From my reading, and asking around, there doesn't seem to be a lot of consensus on the ROA issue--some people say that you should do everything possible to get baby LOA before labor; some say it's no big deal. As a first time mama, though, willing and wanting to do everything I can to avoid a transfer, I was/am certainly on the lookout for anything that might incline the babe toward posteriority--the number one reason FTM's in my mw practice transfer is due to exhaustion, and I know a posterior baby usually makes labor much longer and harder to deal with, especially for first-timers.

[grisaleen]

Seriously, I had to check the name on this post because I thought that I might have written it a few weeks ago. My baby was on the left for I don't know how many appts, and then suddenly she flipped to the right for a week, and now she changes positions everyday. It's driving me nuts, because I'm a little obsessed about the "left side" thing, too. I know everyone is saying to just relax because they turn on their own, but what's wrong with trying to help her out with some gravity on her side, right? I've been sleeping on my left as much as possible, but that's easy because my right hip hurts when I lay on it.

Today at my mw appt, the baby was facing straight back, so her butt is dead center and she's got a foot on each side of my ribs. So I'm not just getting kicked in one rib, oh no. I get kicked on both sides at once. Fun.

[Oana]

[QUOTE=nurturedbirth]The reason a ROA (right occiput anterior) position is categorized with the posterior position is because it is very rare for a baby to enter the pelvis and be born from that right position. Almost every baby will rotate to a left position before descending through the pelvis and they will do it by turning clockwise (when viewed from above), meaning that a right-positioned baby (baby's back on the right) will rotate through a complete posterior position and then continue on to a left position before descending through the pelvis.

I recently attended a presentation by a doula who specializes in teaching optimal fetal positioning to parents-to-be and other doulas and she confirmed that she approaches ROA positioning just as she would a posterior position.[QUOTE]

Nurtured, this seems to be what I am also reading -- do you happen to know WHY? What is the reason for the LOA/ROA asymmetry? Why does the ROA babe need to turn to LOA before being born?

I am concerned because my first was probably an ROT, I supposedly have a flatter than ideal pelvis, and my current also favors the right side.

I will approach her as posterior, but I would like to understand why is this so -- do we even know, or is it just based on statistics of ROAs in birth?

Thanks for any info!
Oana

[Stephanie L.]

I had my chronic back pain issues through my pregnancies and one thing helped: the cat stretch. It also encourages the baby to get into that optimal position because of moving the baby into a hammock.

On hands and knees, back flat, stretch back up, way up. And back again.

I don't think your leaning forward is enough. Worked great for me. HTH!