Normal position for baby
What's the best position for birth?
The best position for your baby to be in when you go into labour is head down, with the back of his head slightly towards the front of your tummy. In this position, he fits snugly into the curve of your pelvis and it's easy for him to move gently down during labour. When he gets to the bottom of your pelvis, he turns his head slightly so that the widest part of his head is in the widest part of your pelvis. The back of his head can then slip underneath your pubic bone and, as he is born, his face sweeps across the perineum, which is the tissue between the back of the vagina and your back passage.
Your doctor describes a baby who has the back of his head towards the front of his mother's abdomen as being in an ANTERIOR position. Labour is nearly always shorter and easier if the baby is anterior.
What's a posterior position?
Some babies go down into the pelvis with the back of their heads towards their mothers' spines. This is called a POSTERIOR position and it can lead to several things happening:
• Your waters are more likely to break at the beginning of labour.
• You have a lot of backache during and in between contractions.
• Labour is slower.
• You may need forceps or ventouse (a suction device) to help you give birth to your baby.
The close proximity between the baby's bony skull and your spine can be very uncomfortable, and you might well find that the best position to labour in is on all fours. In this position, your baby drops away from your spine, helping relieve the backache. When your baby gets to the bottom of your pelvis, he'll need to turn through 180 degrees to get into the best position for him to be born. This can take quite a while, or your baby may decide he's not going to turn at all! In this case, he will be born with his face looking up at you as he emerges. He might need forceps or ventouse to help him out.
Why are some babies posterior?
It seems women leading a modern lifestyle are much more likely to have posterior babies than women who work in traditional ways in the fields, or bending over their cooking pots. So lifestyle might be one cause of posterior babies. It's not difficult to understand why. When you are sitting in your car, or curled up on a comfortable armchair watching television, or working at a computer for many hours, your pelvis is tipped backwards. This is always true if you are in a position where your knees are raised above the level of your pelvis.
When your pelvis is tipped backwards, the heaviest part of your baby, which is the back of his head and his spine, will also tend to swing round to the back. So he ends up in a posterior position, lying against your spine. If you have a lifestyle which involves very little sitting and a lot of upright activities, your baby is far more likely to go down into your pelvis in an anterior position because your pelvis is always tipped forwards.
How to help your baby into an anterior position?
There is a lot of talk nowadays about how to get the baby to enter the pelvis in an anterior rather than a posterior position. This is called "optimal foetal positioning". You can encourage your baby to take up an anterior position by making sure that your knees are always lower than your hips:
• Sit on a cushion in your car to lift your bottom up.
• Check that your favourite chair doesn't make your bottom go down and your knees come up. • Take regular breaks and move around if your job involves a lot of sitting.
• Watch television on all fours for 10 minutes every day.
• Scrub all your floors and skirting boards - our grannies used to say that washing the kitchen floor was a good way of preparing for labour. And they were right! When you are on all fours, the back of your baby's head swings to the front of your abdomen.
Incidentally, you don't have to worry about getting your baby into a good position when you're in bed. When you're lying horizontally, your baby is not being pushed down into your pelvis. It's when you're upright that he'll enter the pelvis either in an anterior or a posterior position.
One study has shown that women who did hands and knees with slow pelvic rocking exercises from 37 weeks of pregnancy to the onset of labour did not have fewer babies in the posterior position. However, in this study women only tried positions to help the baby turn for 10 minutes twice a day, and the researchers only recorded the position of the baby at birth or just before delivery, if they needed rotating manually or instrumentally, and not the position at the start of labour.
Previously, a review of hands and knees position concluded that adopting this position for 10 minutes when the baby is in the lateral or posterior position does have short-term effects on the baby's position. More research is clearly needed, however, expert midwives such as Jean Sutton, are convinced through their long experience, that the mother's posture during late pregnancy does have an effect on the position of her baby.
Getting ready for labour
If you are expecting your first baby, you could try to adopt the lifestyle described in the previous section from around 35 weeks of pregnancy. This is when your baby sinks down into your pelvis, and this is the time to get his position right. If you are expecting your second baby, even though the baby won't engage in your pelvis until later, it's still wise to try to keep his back facing the front of your tummy from about 35 weeks.
Sometimes women have a lot of niggly pains for several days before labour really starts. These can be very exhausting. However, the pains might well be due to the fact that your baby is trying to turn from a posterior position into an anterior. The best way to cope is to try and get as much rest as possible during the night, and during the day to remain upright and active, leaning forwards during the pains. Eat and drink regularly to keep up your strength. And don't despair. Nature is getting your baby into the best position for birth.
How can I improve my baby's position during labour?
Women instinctively know how to labour if they are left to their own devices. However, giving birth in hospital sometimes means that it's hard to do what your body tells you because of lack of space in the delivery room or because you have to lie down for various procedures to be carried out.
Try to:
• remain upright for as long as possible
• avoid lying on the bed for any length of time
• lean forwards during your contractions
• ask your labour companion to massage your back
• rock your pelvis during contractions to help your baby turn as he passes through the pelvis
• avoid sitting in a chair or on a bed in a leaning back position.
• If you get very tired during labour, lie on your side as this still allows the pelvis to expand a bit to give your baby more space whilst you are resting.
No comments:
Post a Comment