Tuesday, November 27, 2007

What we know about fetal positioning

Spinning Babies is only one piece of evidence for the growing interest in fetal positioning. Parents, midwives, nurses and doulas are increasingly interested in how a baby's position may influence a birth. Physicians have been studying this connection for decades.

Understanding fetal positioning is not as simple as noting the differences between 1 position, anterior, with another position, posterior. There are many nuances, such as
  • how much the chin is tucked towards the chest,
  • the shape of the inlet and
  • the size of the outlet,
  • the synclitism of the baby's head,
  • the activity of the mother and
  • the strength of her labor.
  • Even whether her amniotic sac is intact or ruptured can make a difference.

As we learn something new about fetal positions and how babies rotate we can forget older concepts that still hold their own value when looking a large group of posterior births.

We know that posterior births involve more complications and interventions that anterior births, when comparing groups of births. (Not necessarily a single posterior or anterior birth.)

We know that in labors where the baby begins labor in a posterior position, about 30% of the babies will still be posterior at the end of birth
and
that of first time moms whose babies have been posterior in labor, 29% will have a cesarean operation to finish their births.

We don't know an easy activity for all mothers to do to prevent a posterior labor.
We don't know an easy activity for all mothers to correct a posterior fetal position.
We don't really know which babies will rotate out of the posterior position into an anterior (and easier) position and finish the birth vaginally.

But, I do know, that in the mothers I help through pregnancy and in labor, that there are some important activities that mothers can do to either help their babies rotate themselves into a better position, or to descend through the pelvis to be born either posterior or occiput transverse.

Please see the Short List of What to Do in Pregnancy. Its on the SpinningBabies.com website.

1 comment:

chefmcdonald said...

Hi, I have a question regarding turning a breech babys positions. I am 31.2 weeks pregnant with twins. They are breech according to my last ultrasound. My doctor says we might as well schedule the c-section because they wont turn at this point. Their weights are 3lbs 1oz and 3lbs 7oz's. What do you think? are there things I can do that might get them to turn. I really wanted a vaginal birth.

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