Otherwise known as back-to-front, LOA or ROA. Your baby’s head is shaped in a way that fits the opening of your pelvis only when he or she is facing your back. Have you ever heard of painful back-to-back labors? They are longer because your uterus has to work to turn the baby around to the correct position before allowing decent through the pelvis, or, because since the baby did not turn the decent is not a good fit and the baby does not slip through as quickly as they ought to. Most mothers with a back to back labor opt for an epidural to cope. Thankfully, with just some practical tips and working on your own posture during the last couple of months of pregnancy you can actively help your baby get in the proper position, by shaping your body in a way that makes it most comfortable for him/her to face your back.
First, here are the positions to avoid; the ones which encourage your baby to face your tummy. The main culprits are said to be lolling back in armchairs, sitting in the car where your seat is leaning back, or any position 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 your 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, cushions, birthing ball, or sit on a dining chair. Try sitting on a dining chair facing backwards, resting your elbows on the backrest as well.
- 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! Reclining with your feet up encourages posterior presentation.
- Sleep on your side, not leaning onto your back.
- Avoid deep squatting, which opens up the pelvis and encourages the baby to move down, until you know that he or she is the right way around. If you do want to practice deep squatting as labor preparation, try squatting supported on a low stool, which keeps 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 thorught to help with good positioning, because all those leg movements help open your pelvis.
- A birthing ball can encourage good position, both before and during labor. See Your Birthing Balls on the Active Birth and Pregnancy 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 your spine down. This is described in more detail in an article by Suzanne Yates – Exercise for relieving backache.