The baby's back is the heaviest side of its body. This means that the back will naturally gravitate towards the lowest side of the mother's abdomen. So if your tummy is lower than your back, eg you are sitting on a chair leaning forward, then the baby's back will tend to swing towards your tummy. If your back is lower than your tummy, eg you are lying on your back or leaning back in an armchair, then the baby's back may swing towards your back.
Avoid positions which encourage your baby to face your tummy. The main culprits are said to be lolling back in armchairs, sitting in car seats where you are leaning back, or anything where your knees are higher than your pelvis.
The best way to do this is to spend lots of time kneeling upright, or sitting upright, or on hands and knees. When you sit on a chair, make sure your knees are lower than your pelvis, and your trunk should be tilted slightly forwards.
Watch TV while kneeling on the floor, over a beanbag or cushions, or sit on a dining chair. Try sitting on a dining chair facing (leaning on) the back as well.
Use yoga positions while resting, reading or watching TV - for example, tailor pose (sitting with your back upright and soles of the feet together, knees out to the sides)
Sit on a wedge cushion in the car, so that your pelvis is tilted forwards. Keep the seat back upright.
Don't cross your legs! This reduces the space at the front of the pelvis, and opens it up at the back. For good positioning, the baby needs to have lots of space at the front
Don't put your feet up! Lying back with your feet up encourages posterior presentation.
Sleep on your side, not on your back.
Avoid deep squatting, which opens up the pelvis and encourages the baby to move down, until you know he/she is the right way round. Jean Sutton recommends squatting on a low stool instead, and keeping your spine upright, not leaning forwards.
Swimming with your belly downwards is said to be very good for positioning babies - not backstroke, but lots of breaststroke and front crawl. Breaststroke in particular is thought to help with good positioning, because all those leg movements help open your pelvis and settle the baby downwards.
(Nothing to do with baby positioning, but... if you're swimming, make sure you have goggles so you can swim in a good position, with your face partially or wholly in the water as you dip down. Doing breaststroke with your neck craned, holding your face out of the water, is bad for your neck and back at any time, let alone in pregnancy when ligaments are loose.)
A Birth Ball can encourage good positioning, both before and during labour. See Birth Balls article on the MomCare website for more details.
Various exercises done on all fours can help, eg wiggling your hips from side to side, or arching your back like a cat, followed by dropping the spine down. This is described in more detail in an article on www.wellmother.org - 'Exercise for relieving backache' by Suzanne Yates.
If your baby is already posterior...
First of all, don't panic! Most posterior babies will turn in labour, but read on to find ways of helping him or her turn before.
When your baby is in a posterior position, you can try to stop him/her from descending lower. You want to avoid the baby engaging in the pelvis in this position, while you work on encouraging him to turn around. Jean Sutton says that most babies take a couple of days to turn around when the mother is working hard on positioning.
Avoid deep squatting
Use the 'knee to chest' position. When on hands and knees, stick your bottom (butt) in the air, to tip the baby back up out of your pelvis so that there is more room for him to turn around.
Sway your hips while on hands and knees
Crawl around on hands and knees. A token 5 minutes on hands and knees is unlikely to do the trick - you need to keep working at this until your baby turns. Try crawling around the carpet for half an hour - while watching TV or listening to music. It is good exercise as well as good for the baby's position!
Don't put your feet up! Lying back with your feet up encourages posterior presentation.
Swim belly-down, but avoid kicking with breaststroke legs as this movement is said to encourage the baby to descend in the pelvis. You can still swim breaststroke, but simply kick with straight legs instead of "frogs' legs".
Try sleeping on your tummy, using lots of pillows and cushions for support.
If your baby is posterior when you are in labour:
Remember, most posterior babies will turn during labour (87% according to Gardberg study - see refs), but even if yours doesn't, a baby can still be born vaginally in the posterior position - "face to pubes" - and this can happen at a homebirth. Sometimes a posterior labour can make things just too tough, but it can work out.
You may try your hardest to get your baby into a good position, but he may be determined to stay the way he is - if so, there are things you can do in labour to help a posterior baby to be born.
The majority of babies who experience a posterior labour, actually start labour in an ideal position, and then turn posterior while you are in labour. Gardberg et al found that 68% of posterior babies took this route. This seems very unfair - but if it happens, these tips should still help.
These movements can help the baby wriggle through your pelvis, past the ischial spines inside it, by altering the level of your hips. They are also helpful if the baby is anterior but has a presentation problem, eg his head is tipped to one side (asynclitic).
In early labour, walk up stairs - sideways if you need to.
Rock from side to side
March or 'tread' on the spot
Step on and off a small stool
Climb in and out of a birth pool
The positions listed below may also help.
For the second stage:
Use kneeling or all-fours positions. Kneeling on one knee can help.
Supported squatting in second stage, but the mother must be lifted quite high up; her bottom should be at least 45cm (18 inches) off the floor.
Birth stool seats should be at least 45cm (18 inches) from the floor.
Avoid lying on your back, semi-reclining, sitting or semi-sitting. These positions all reduce the available space for the baby to turn. Lying on the side is OK.
My first baby, Lee, kept trying to settle in a posterior position because his placenta was attached to the front wall of the uterus (anterior placenta). Babies generally tend to face the placenta, and most placentae implant on the back wall of the uterus (posterior placenta). So if your baby's placenta is on the front wall then you will need to be extra-careful about positioning as the baby's natural tendency may be to settle in a posterior position. This has long been noted amongst midwives, and has now been confirmed by research
Source =
http://www.homebirth.org.uk/ofp.htm
Tuesday, July 20, 2010
Optimum Foetal Positioning
The 'occiput anterior' position is ideal for birth - it means that the baby is lined up so as to fit through your pelvis as easily as possible. The baby is head down, facing your back, with his back on one side of the front of your tummy. In this position, the baby's head is easily 'flexed', ie his chin tucked onto his chest, so that the smallest part of his head will be applied to the cervix first. The diameter of his head which has to fit through the pelvis is approximately 9.5 cm, and the circumference approximately 27.5cm. The position is usually 'Left Occiput Anterior' or LOA - occasionally the baby may be Right Occiput Anterior or ROA.
The 'occiput posterior' (OP) position is not so good. This means the baby is still head down, but facing your tummy. Mothers of babies in the 'posterior' position are more likely to have long and painful labours as the baby usually has to turn all the way round to facing the back in order to be born. He cannot fully flex his head in this position, and diameter of his head which has to enter the pelvis is approximately 11.5cm, circumference 35.5cm.
If your baby is in the occiput posterior position in late pregnancy, he may not engage (descend into the pelvis) before labour starts. The fact that he doesn't engage means that it's harder for labour to start naturally, so your baby are more likely to be 'late'. Braxton-Hicks contractions before labour starts may be especially painful, with lots of pressure on the bladder, as the baby tries to rotate while it is entering the pelvis. Be aware that if you accept induction on the basis of being postdates, and your baby is in a suboptimal position, you may have a tough haul ahead of you.
The 'occiput posterior' (OP) position is not so good. This means the baby is still head down, but facing your tummy. Mothers of babies in the 'posterior' position are more likely to have long and painful labours as the baby usually has to turn all the way round to facing the back in order to be born. He cannot fully flex his head in this position, and diameter of his head which has to enter the pelvis is approximately 11.5cm, circumference 35.5cm.
If your baby is in the occiput posterior position in late pregnancy, he may not engage (descend into the pelvis) before labour starts. The fact that he doesn't engage means that it's harder for labour to start naturally, so your baby are more likely to be 'late'. Braxton-Hicks contractions before labour starts may be especially painful, with lots of pressure on the bladder, as the baby tries to rotate while it is entering the pelvis. Be aware that if you accept induction on the basis of being postdates, and your baby is in a suboptimal position, you may have a tough haul ahead of you.
Apgar Score
The Apgar score was devised in 1952 by Dr. Virginia Apgar as a simple and repeatable method to quickly and summarily assess the health of newborn children immediately after birth.[1][2] Apgar was an anesthesiologist who developed the score in order to ascertain the effects of obstetric anesthesia on babies.
The Apgar score is determined by evaluating the newborn baby on five simple criteria on a scale from zero to two, then summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10. The five criteria (Appearance, Pulse, Grimace, Activity, Respiration)
Wikipedia
http://en.wikipedia.org/wiki/Apgar_score
The Apgar score is determined by evaluating the newborn baby on five simple criteria on a scale from zero to two, then summing up the five values thus obtained. The resulting Apgar score ranges from zero to 10. The five criteria (Appearance, Pulse, Grimace, Activity, Respiration)
Wikipedia
http://en.wikipedia.org/wiki/Apgar_score
Hydrocephalus = Water on the brain.
The diagnostic signs and symptoms of hydrocephalus depend upon the age of the person:
•In infants the most obvious sign of hydrocephalus is usually an abnormally large head. (That is one reason a baby's head should be measured at every well-baby visit). Symptoms of hydrocephalus in an infant may include vomiting, sleepiness, irritability, an inability to look upwards, and seizures.
•In older children and adults there is no head enlargement from hydrocephalus, but symptoms may include headache, nausea, vomiting and, sometimes, blurred vision. There may be problems with balance, delayed development in walking or talking, and poor coordination.
Irritability, fatigue, seizures, and personality changes such as an inability to concentrate or remember things may also develop. Drowsiness and double vision are common symptoms as hydrocephalus progresses.
Treatment of hydrocephalus involves the insertion of a shunt to let the excess fluid exit and relieve the pressure on the brain. The shunt is a flexible, plastic tube with a oneway valve. The shunt is inserted into the ventricular system of the brain to divert the flow of CSF into another area of the body, where the CSF can drain and be absorbed into the bloodstream.
The prognosis (outlook) with hydrocephalus depends the cause and the timing of the diagnosis and treatment. Many children treated for hydrocephalus are able to lead normal lives with few, if any, limitations. In some cases, cognitive impairments in language and non-language functions may occur. Problems with shunts such as infection or malfunction require revision of the shunt.
Hydrocephalus is sometimes called "water on the brain." The word "hydrocephalus" in Greek literally means "watery head."
•In infants the most obvious sign of hydrocephalus is usually an abnormally large head. (That is one reason a baby's head should be measured at every well-baby visit). Symptoms of hydrocephalus in an infant may include vomiting, sleepiness, irritability, an inability to look upwards, and seizures.
•In older children and adults there is no head enlargement from hydrocephalus, but symptoms may include headache, nausea, vomiting and, sometimes, blurred vision. There may be problems with balance, delayed development in walking or talking, and poor coordination.
Irritability, fatigue, seizures, and personality changes such as an inability to concentrate or remember things may also develop. Drowsiness and double vision are common symptoms as hydrocephalus progresses.
Treatment of hydrocephalus involves the insertion of a shunt to let the excess fluid exit and relieve the pressure on the brain. The shunt is a flexible, plastic tube with a oneway valve. The shunt is inserted into the ventricular system of the brain to divert the flow of CSF into another area of the body, where the CSF can drain and be absorbed into the bloodstream.
The prognosis (outlook) with hydrocephalus depends the cause and the timing of the diagnosis and treatment. Many children treated for hydrocephalus are able to lead normal lives with few, if any, limitations. In some cases, cognitive impairments in language and non-language functions may occur. Problems with shunts such as infection or malfunction require revision of the shunt.
Hydrocephalus is sometimes called "water on the brain." The word "hydrocephalus" in Greek literally means "watery head."
Friday, July 2, 2010
Books to Read
Natural Birth The Bradley Way by Susan McCutcheon Rosegg
Husband Coached Childbirth by Dr Robert Bradley
Ina May's Guide to Childbirth by Ina May Gaskin
The Birth Book by Dr Sears
The Thinking Woman's Guide to a Better Birth by Henci Goer
Birthing From Within by Pam England
The Baby Book by Dr Sears
The Womanly Art of Breastfeeding by La Leche League International
Husband Coached Childbirth by Dr Robert Bradley
Ina May's Guide to Childbirth by Ina May Gaskin
The Birth Book by Dr Sears
The Thinking Woman's Guide to a Better Birth by Henci Goer
Birthing From Within by Pam England
The Baby Book by Dr Sears
The Womanly Art of Breastfeeding by La Leche League International
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