Practical Ways to Avoid Back Labor

I have been discussing optimal fetal positioning with a client and thought it was something that I should write about!  

One of the positions that you hear about a lot among mamas is the occiput posterior position (OP).  OP is the position that is responsible for the often painful "back labor" that is the subject of so many labor horror stories.  You probably know someone who has had back labor.  Here are some practical ways to avoid it yourself!

Your baby's back is the heaviest side of its body. This means his back will naturally gravitate towards the lowest side of your belly. So, if your belly is hanging lower than your back (you are sitting on a chair leaning forward) then the baby's back will tend to swing towards your belly. If your back is lower than your belly (you are lying on your back or leaning back in a recliner) then the baby's back may swing towards your back.

Avoid positions which encourage your baby to face your belly. The main culprits are said to be reclining chairs, sitting in car seats where you are leaning back, or any position where your knees are higher than your pelvis.

The best way to avoid the wrong positions 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 or lotus 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! (not that you can anymore anyway) Crossing your legs 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.  Switch sides whenever you wake up (and I know you wake up a lot!!)
  
  
• 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.  Sitting on a birth ball or a low stool with your legs in a deep spread is a good way to open your pelvis. 
  
  
• 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. A mask and snorkel may be helpful.
  
  
• A Birth Ball can encourage good positioning, both before and during labour. Doing "hula" movements is particularly helpful.
  
  
• Various exercises done on all fours can help. Wiggling your hips from side to side, or cat/ cow (arching your back like a cat, followed by dropping the spine down). 

Helping your baby into the proper position before labor begins is the best way, but if you find yourself in a tremendous amount of back pain during labor, try these techniques again!  They may keep you from having one of those horror stories!