Spinning Babies

That's an odd title. As Jill said when I first told her, it sounds like something from the Exorcist movie, but it's not. It's actually a title of another blog and one thing it discusses is the optimal position for a baby to be in to be born. At first it was really confusing to me, and I know it was to Kelly too. The more I read about it, and there is quite a bit out there, the more it all made sense to me.

I thought about my own pregnancies and births. I had lots of Braxton Hicks during both Josh and Kelly's pregnancies and I know for sure Josh was posterior. With Josh I ended with a cesarean which could have been avoided if they'd just gotten me up and given me some time. My labor with Kelly was REALLY long, though not terribly difficult, and I bet it was because she wasn't in the best position and her head wasn't applied directly to my cervix to move things along. Matt, on the other hand, came after a 4 hour labor and flew out. (Was it the chiropractic care I had only during that pregnancy?) It's all very interesting!

I thought it might be easier if I compiled a primer for Kelly (29 weeks!!). (And if this is still too much to take in, basically spend a lot of time on your hands and knees, especially when your baby is moving, and keep your back straight.)

GETTING BABY IN THE BEST POSITION FOR BIRTH

Prevention of posterior babies is possible. The left occiput anterior position (for the baby) is usually considered the easiest position for the start of labor. When the baby's back is on the mother's left, or to her front (anterior), labor will usually be short and productive. When the baby and head are in the optimal position, contractions are generally regular, with time in between, and the cervix dilates well. This is because the smallest part of the baby's head is presenting;the part of the head that molds most easily. This part of the baby's head gives direct pressure to the cervix and helps with smooth, easy (easier) dilation.

If baby is not well positioned, Braxton-Hicks contractions before labor may be especially painful. A mother may also feel lots of bladder pressure, as her baby tries to rotate while entering the pelvis.

What to do during pregnancy:

• Avoid reclining in chairs (or anywhere), sitting leaned back in a bucket seat, or assuming any position where your knees are higher than your pelvis.
  
• When you sit, be sure that your back is absolutely straight. Put a wedge or lots of pillows behind you. make sure your knees are lower than your pelvis, and your trunk should be tilted slightly forwards.Reclining can weaken your back muscles and encourage your baby to get comfy in a less than optimal position.
• Don't cross your legs or put your feet up.
  
• Sit on a wedge cushion in the car, so that your pelvis is tilted forwards. Keep the seat back upright.
• Watch TV while kneeling on the floor, over a beanbag or cushions, or sit on a dining chair. You can also sit backwards on a dining chair.
  
• Spend lots of time on hands and knees, kneeling upright or sitting upright.
  
• Do the pelvic tilt -- On your hands and knees, lift lower back up toward ceiling. Don't arch your shoulders. Then straighten your back but don't dip it. Switch from curling your lower back to straightening it rhythmically. Do 40 or so. Get up slowly to avoid dizziness.
• Starting any time after 32 weeks, get in an optimal position, such as hands and knees or do some pelvic tilts if your baby is actively kicking. This could be a time your little one is trying to assume a better position.
• Crawl forward and backward for at least 10 to 30 minutes a day. (Clean floors on hands and knees!)
  
• Sway your hips while on all fours.
• While on your hands and knees, stick your butt in the air while your chest is on the ground. This gives your baby more room to turn around.
• Assume yoga positions while relaxing. (For example you can sit upright with the soles of your feet together, knees out to the sides while reading or watching TV.)
• If comfortable, rest or sleep on your stomach with lots of pillows or a partially inflated donut-shaped swim ring.
  
• Get a massage
• Have fun belly dancing
  
• Use a birth ball
  
• Use a scarf or "sift" your belly to loosen ligaments (in hands and knees position?)
  
• Until your baby is optimally positioned, avoid deep squatting, which opens up the pelvis and encourages your baby to move down.
  
• Swim with your belly down, using breaststroke and the front crawl.
  
• Journal, pray and practice forgiveness for emotional resolution.
  
• It may be necessary to accept that your baby is going to stay 'sunnyside up.' That may just be the position she needs to be in.

When your baby turns to an anterior position:
Encourage her to descend further into the pelvis - by walking around upright, massaging your bump downwards, deep squatting, and swimming (including 'frog's legs kicking').
Overdue? If your baby is not in a good position she may not be exerting enough pressure on your cervix to trigger labor. Your baby needs a little more time to rotate.

What to do during labor if baby isn't in optimal position:

• Remember that MOST posterior babies turn in labor.
• In early labor, walk up stairs - sideways if you need to.
• Rock from side to side.
• March in one spot
• Step on and off a small stool
• Climb in and out of a birth pool
• Get in a position where hands and shoulders are as low as they can go, with your knees apart. Arch your back and have your butt up in the air.
  

For pushing:

• Kneel (on both knees or one knee) or assume an all-fours positions.
  
• Avoid lying on your back, semi-reclining or sitting.
• Use supported squatting or a birth stool. The mom should be at least 18 inches off the floor.

Good references:
Get Your Baby Lined Up!
Optimal Foetal Positioning
Malpresentation -- When the Baby is in a Difficult Position