It’s birth day, and you find yourself experiencing back pain with your contractions, or perhaps a puzzling delay in active labor. It’s a possibility that your baby may be in the occiput posterior (OP) position. Say what? This simply means that the baby’s occiput (back of the head) is on on your posterior (fancy word for bum).
While it’s entirely possible to progress normally with this kind of positioning(usually with the baby turning for the actual birth), you will find that it is more comfortable for you and profitable for your labor to try to convince your baby to move to the occiput anterior(OA) position (back of the head toward your front). Posterior babies are notorious for causing back labor, and often earn you the diagnosis “failure to progress” because of the difficult time they have moving downward through the pelvis. Since this can lead to various interventions to try to move the baby along (pitocin to intensify contractions, vacuum or forceps to help the baby out, or c-section if nothing else works), it’s definitely worth a shot to get that baby to turn!
Here are some ideas for turning your OP baby:
1) Move those hips!
Try pelvic rocking, slow dancing, walking, or the “labor hula” to give baby room to wiggle around. Any upright position gives you the additional benefit of gravity to help move the baby down.
2) Abdominal Lifting
Birth partners: wrap a rebozo sling, blanket, or towel around the lower part of the mother’s abdomen. Stand behind her and gently lift and pull back during a contraction. This can be an enormous relief of pressure for mom. Moms: You can put your hands under your belly to lift and support the weight of your baby through contractions.
This one may be tricky to accomplish while in labor, but it’s a good move to try for an OP baby. Mom should stand with one foot on a chair (preferably with someone helping keep her steady!) and lunge a few times during each contraction.
Being on hands and knees or leaning forward over a chair or birth ball drops the baby’s head off of your tailbone, and can help to relieve some of that tremendous back pain. It might also encourage the baby to turn. I spent the majority of my labor with my son in these positions. In fact, I found it unbearable to do anything that involved leaning back!
5) Restful positions
If you are particularly in need of rest or if you have had an epidural, you should try side lying on the same side as the baby’s back (baby’s back is on the left side, you lie on your left side):
Or, you can try lying semiprone on the opposite side of the baby’s back (baby’s back is on the left, you lie on the right side):
If you’re not sure which side baby is on, just switch sides every 20-30 minutes. The changing of position itself may be enough to encourage baby’s movement.
(Adapted from The Birth Partner: 3rd Edition by Penny Simkin, p. 186-187.)
No matter what, pay attention to what you are feeling. If you are having extreme pain, move to where it’s more comfortable! It will make it easier on you, and probably easier on your baby too. If you’ve found a more comfortable position, it probably means that baby is finding his way out more comfortably too. Don’t feel silly about talking to your baby and encouraging him to turn the right way- you never know how baby might respond to your voice! Finally, stay patient, calm, and optimistic. That might be the best help of all. 🙂