What Will Encourage a Posterior Baby to Turn?

ANSWER

Hi Stacey,
Babies can be so frustrating when they don't cooperate with our plans!

From the article, Optimal Fetal Positioning, Jean Sutton says:

"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 [3]. 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."

Full article here: www.homebirth.org.uk/ofp.htmAnother very helpful article about Posterior presentation, by Valerie El Halta: www.gentlebirth.org/archives/postrppr.html

Midwives have a techniques to turn posterior babies called, "diaphragmatic release" which involves simply placing their hands at certain areas on the mom's abdomen and back. Not all midwives know how to do it, but it can be easily learned. It is described here: www.naturalchildbirth.org/natural/resources/labor/labor29.htm.Now if baby is stubborn and is still posterior when you begin labor, there are many things you can do to help the process, since presenting in a posterior position often causes, "back labor" which can be very uncomfortable. Doing the turning exercises from Optimal Fetal Positioning helps tremendously and you'll want to start doing them early on in labor when baby still has room to turn. Using a Birth Ball to help this process is a very comfortable option: "To assist rotation of the baby from posterior to anterior, kneel or lean over the ball. Place the ball on the birthing bed or floor, and lean over it, hugging it with your arms. Then rock your hips from side to side with your legs spread comfortably open. This alleviates the cramping and discomfort you would feel in your hands and wrists without the birthing ball to lean on.

While sitting on the ball as described above, your birth partner can apply counter pressure to the most uncomfortable area in your back. To do this, he/she will take one hand and, using the heel of the hand, press in where you instruct since you are the one who knows exactly where it is uncomfortable. Press in hard! Remember, the baby's hard bony back of the head is there applying pressure against Mom's tailbone and sacrum. Don't be afraid to apply quite a bit of pressure. She'll love you forever when you do this for her. As your birth partner presses in with one hand, he/she will slowly move his/her hand around in a small, circular motion. This is, undoubtedly, one of the most helpful comfort measures for pressure in the back.

"More information on Birth Balls here: www.birthsource.com/scripts/article.asp?articleid=139 Another excellent technique is to learn about the "Belly Lift" from the book, Back Labor No More. It has been known to be very effective in turning a posterior baby and instantly relieves back discomfort. Some women will do this technique before birthing begins and their babies turn, so it will benefit you to find out about it: www.backlabornomore.com If you are birthing in a hospital, they may have Sterile Water Papules available as well, to help with back pain: http://pregnancy.about.com/library/class/blclass5subq.htm Your baby can be turned and may do so at any time. Turn, Baby, Turn!

-- Kerry, HCHI, CHt