The position the baby assumes can affect labor and
birth. Right up to week 36 it doesn't matter which
position the baby lies in because there is still time
for it to make the change. Basically most babies assume
the vertex or head down position by that time.
• The ideal position is head down or cephalic
with the head engaged
• Once the head engages or fits snugly, labor
will progress
• Average size babies don't have enough room
to move around and change the position
• Through vaginal examination the doctor is
able to determine if baby is in the posterior or anterior,
head down or bottom down
• About 96% babies are head down at term
• About 3% are breech position
• About 1% account for the transverse lie position
Positions in late Pregnancy
Occiput Anterior
Occiput is the back of baby's head. Known as occiput
anterior or OA for short, this is the ideal position
for baby to pass through the pelvis. In other words
there is a good chance of labor being straightforward.
Baby will be facing the mother's back with his back
to one side of the mother's abdomen. Babies mostly
assume this position. If baby's back is more on the
right side his position is said to be right occipital
anterior or ROA. It is said to be LOA if baby's back
is more on the left.
Occiput Posterior
If baby is lying with his back against the mother's
back and facing the maternal abdomen, the position
is termed occiput posterior or OP position. This is
relatively uncommon with only about 5% of babies sticking
to this position and not reversing to the OA position.
If baby remains in the OP position it does not mean
vaginal birth is not possible. However labor tends
to be longer with the mother suffering from backache
because baby's spine presses against hers. Most of
the posterior babies change positions at the end of
the first stage of labor. If it doesn't happen the
likelihood of an assisted delivery or C-section.
Breech
This position is one when baby's buttocks faces down
and his head is just under the mother's ribs. Baby's
legs may be tucked up as in frank breech or one or
both of baby's legs may be pointing down (footling
breech). EVC or external cephalic version may be offered
to the mother at week 37 if she is carrying a breech
baby. EVC will involve the obstetrician manipulating
the mother's womb to turn the baby around. About 60%
of breech babies are delivered by cesarean.
Transverse Lie
It is also known as the oblique lie. In transverse
lie or TR the baby has his head towards the mother's
left or right side and lies diagonally across the
uterus. This position is probable if the baby is small
and has more room to move about at the end of pregnancy,
in twin deliveries and if the mother has had several
children. Cesarean becomes necessary unless baby turns.
Unstable Lie
Some babies keep changing positions even after week
37. In unstable lie situations, labor may be induced
when baby has his head down.
Things you can try to help baby get into the best
position for labor:
• Sit with your knees lower than your hips
• Lean over slightly as much as you can when
standing
• Regular swimming on your front - breaststroke
is the best
• Kneel and lean over a beanbag when watching
TV
