9. Optimal Positioning

Mapping Your Belly

If you're curious about your baby's position, consider mapping your belly. Spinning babies offers a guidebook for a small cost along with many tips to encourage a breech or poorly positioned baby to shift into an optimal position. Also posted on their website are suggested balancing activities, which can help alleviate discomfort and correct a posterior position to avoid "back labor." Optimal baby positioning at the time of birth eliminates the potential for dystocia and therefore results in easier and safer deliveries for both the mother and baby.

Pay attention to your posture when you stand or sit. Sitting on a birth/exercise ball will help you maintain proper alignment after a chiropractic adjustment as well as keep you comfortable in the final weeks of pregnancy.

 

Baby’s 7 Cardinal Movements in Labor

There are many positional changes that assist the baby in the passage through the birth canal. Because of the resistance met by the baby, positional changes are specific, deliberate and precise as they allow the smallest diameter of the baby to pass through a corresponding diameter of the pelvic structure. Neither care providers nor the laboring patient is directly responsible for these position changes. The baby is the one responsible for these position changes ~ the cardinal movements.

Perhaps the baby, with an asynclitic (tipped) or extended (chin up) head, doesn’t have enough room to come down. A person with a tight or somewhat smaller pelvic outlet may benefit, as well as a larger-sized baby, to make a little more room with a technique called Cook Counter Pressure. Here’s info on when and how to do it easily during labor.

Active Birth Positions to Use in Labor

The laboring person is encouraged to get off their back to labor and birth. Please note that not all lying down positions cause a restricted pelvis - a side lying position allows pelvic mobility and simply lacks gravity, which may be exactly what is needed depending on what’s happening during labor.

Active Birth Positions include:

• Standing in a forward leaning position

• Sitting on surfaces which still encourage pelvic mobility such as sitting on a gym ball, birth stool, toilet, etc.

• Kneeling or ‘all fours’ with knees hip-width apart, torso-pelvis-knees in a right angle

• Side-lying with knees hip-width apart, hip-knees-ankles in a right angle

• Squatting or any position where her knees are higher than her hips ONLY when baby is in the outlet pelvis and the laboring person is feeling ready to bear down or push

Turn Baby, Turn!

If your baby is breech, we highly recommend that you consider these tips before trying anything else. For more do-it-yourself tips and tricks that may encourage baby to turn, visit this page.
 

Combined Acupuncture and Moxibustion

Moxibustion is simply burning moxa sticks. When performed correctly, the heat may encourage baby to move and turn head-down. It is recommended that acupuncture and moxibustion be combined for maximum effect. Afraid of needles? Here is a simple moxibustion do-it-yourself guide.

If you want to try a great acupuncturist in the Atlanta area, I highly recommend Jim Gordon at Intown Acupuncture. (He also helps induce labor when the baby is overdue.)

The Webster Technique

Dr. Larry Webster developed a chiropractic technique that balances the pelvis properly, while reducing stress to the round ligaments that support the uterus. The round ligaments hold the uterus in suspension within the abdomen and can become thin and tight like a rubber band. This tension can cause sharp, spastic pains and restricts the baby's movement, which often causes a baby to stay in a breech position beyond 37 weeks. Learn more on the Webster Technique and watch the video below.
 

External Cephalic Version

If your baby is not head down by 36 weeks, your care provider will recommend an external cephalic version to be performed at 37 weeks gestation. The "version" is a technique that manually turns a baby into the head down position. This is done in order to avoid a c-section since there are very few OBs and midwives that support breech deliveries. 

In 2008, Grootscholten et al. pooled the results of 84 studies that included 12,955 women. The average success rate for turning a baby out of the breech position was 58%. The overall complication rate was 6%, and the rate of serious complications (placenta abruption or stillbirth) was 0.24%. For more evidence-based birth information, please visit here.

The video below shows a successful version and I recommend that you watch it and be sure to ask the risks involved before you consent.