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#1 of 4 Old 05-02-2005, 05:36 PM - Thread Starter
 
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NEW YORK (Reuters Health) - Receiving epidural analgesia during labor seems
to increase the risk that the baby will be delivered face up instead of the
normal face -down position, new research shows. This may explain the higher
rate of c-sections associated with epidurals.

It has been theorized that women with infants in the face-up or "occiput
posterior" position have more painful labors, which leads to their request for
epidural analgesia. However, in the current study, reported in the medical
journal Obstetrics and Gynecology, the researchers found that it was, in fact, more likely that the epidural was administered before a fetus moved into this position.

To investigate, Dr. Ellice Lieberman and colleagues at Brigham and Women's
Hospital in Boston examined 1,562 pregnant women during labor and delivery.
Ultrasound examinations were performed when women were first admitted to the labor and delivery unit, at the time of epidural administration or 4 hours
after the initial examination, and when they were close to full dilatation.
Ninety-two percent of patients received epidural analgesia. Requests for
epidurals were not associated with fetal position in early labor or with more
painful labor. Fetal position changes were common during labor, the authors report, and the initial position was not a strong predictor of position at delivery. At the initial examination, approximately 49 percent of fetuses were facing sideways, 27 percent were facing down and 24 percent were facing up. The corresponding rates at the time of delivery were 8, 80,and 12 percent.

At delivery, fetuses were in the face-up position in 12.9 percent of patients
given epidurals, but only 3.3 percent of those without epidurals. Epidural
analgesia was not associated with the sideways-facing position.
The rate of cesarean delivery was strongly dependent on fetal position -- 6.3
percent with face down, 65 percent with face up, and 74 percent with face
sideways. However, fetal position did not influence the need for obstetrical
instruments.

SOURCE: Obstetrics and Gynecology, May 2005.

Prenatal/Pediatric Chiropractor (Diplomate) , raising the next generation drug-free!
DS - CJ :, the love of my life
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#2 of 4 Old 05-02-2005, 05:52 PM
 
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Interesting. I always wonder why babies get into posterior postions. In my case, it wasn't pain peds because I didn't get any. I think with me it was from pushing before I felt the urge and forcing him to descend a little early. I was fully dilated, but he wasn't engaged. This time, I plan on not pushing until I really want to. Lesson learned from first labor. I am hoping to stay away from an epidural again this time around. Wish they didn't have the tendency to cause so many problems because from what I have heard it can be bliss after a long back labor to get the epidural. Such is life....
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#3 of 4 Old 05-02-2005, 07:13 PM
 
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Interesting indeed. (By the way, I have a copy of the original and can send anyone interested a PDF.) I just read Pauline Scott's "Sit up and take notice" on optimal fetal positioning as well, which is really interesting. bummer, though, since she strongly recommends leaning-forward positions (kneeling, etc) rather than laid-back-on-couch-with-feet-up position during the last month or so. drat drat drat! the illustrations were really helpful--I now get the physics of why OP is so much harder than AP.
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#4 of 4 Old 05-04-2005, 03:58 AM
 
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Interesting....my first was born "sunny side up"...He was an almost homebirth, but got stuck so we transferred for a "little help."

Anyway, my mw suggests trying to lie on your left side as much as possible, especially near the end of pregnancy, so as to keep the baby on the left side. Her opinion is that for some reason it is easier for a baby to turn around to face up if the baby is on the right side...more room, less organs? I don't know. Just some food for thought...no science to back this up.

Maury
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