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
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