Every mother-to-be wants the delivery to be as easy, fast, and pain-free as possible. The speed and ease of delivery depend to a large extent on the baby’s position in the uterus at the time of birth. If the baby is in the ideal birth position and has descended in the birth canal, delivery is likely to proceed smoothly. But, what is the ideal birth position and what are the other positions a baby can be in in the womb? If your baby is not in the ideal birth position, is there anything you can do to help him get in the ideal position? Read on to find out more:

Ideal Birth Position - Occiput anterior Position or longitudinal lie

This position is the most ideal way a baby can be positioned in the womb for birth. In this position the baby lies with his head down facing the mother’s back, chin tucked into his chest and the back of the head ready to enter the pelvis. Most babies settle into this position between the 32nd and 36th weeks of pregnancy. A baby in this position has the highest chances of a normal delivery. There are some other birth positions which are not so ideal, which can cause the mother and baby some trouble during birth. If the baby is in these positions, additional assistance and monitoring are required at the time of delivery. Also Read: Stage wise development of fetus (0-9 months)

Other Birth Positions:

Posterior position

In this position, the baby is lying head down but is facing the mother’s stomach instead of the back. About 10% to 30% of babies are in this position in the first stage of labour but manage to rotate themselves towards the end of labour, just before birth. However, in cases where the baby fails to rotate himself, the chances of a prolonged delivery are increased. The mother can experience severe back pain during delivery because of the baby’s head being towards her back.

Breech Position:

A breech baby is positioned with his feet or buttocks pointed towards the birth canal. In this position, the head is the last part of the body to emerge from the birth canal, which makes giving birth difficult. The different types of breech positions are:

1. Complete breech. The buttocks are pointing toward the birth canal (downward), with the legs folded at the knees. The feet are near the buttocks.
2. Frank breech. The buttocks are toward the birth canal, but the baby’s legs are straight up in front of their body, and the feet are near the head.
3. Footling breech. One or both of the baby’s feet are pointing downward toward the birth canal.

The breech position can cause problems because it increases the risk of forming a loop in the umbilical cord that could injure the baby if the baby is delivered vaginally. Though a breech position is not ideal for birth, a large number of breech positioned babies are delivered successfully.

Transverse Lie

This is an extremely rare position where the baby lies horizontally in the uterus which makes vaginal birth almost impossible. Most babies naturally turn themselves to the head-down position prior to their due date, but in this position, they may fail to do so. Babies in this position require a cesarean delivery as there is a small risk of “umbilical cord prolapse” (Umbilical cord coming out of the womb before the baby) when the water breaks. An umbilical cord prolapse is a medical emergency, and the baby must be delivered very quickly via cesarean section if it happens. Also Read: In-Vitro Fertilization (IVF): Procedure, Preparation & Risks

Umbilical cord presentation

An umbilical cord presentation (also called funic presentation) is the position of the baby in the uterus where the umbilical cord points towards the birth canal. This birth position is different from the cord prolapse. It may be a temporary position the baby adopts and the baby should be able to turn himself in the ideal birth position by about 32 weeks. The difference between cord presentation and cord prolapse has to do with when the waters break (when foetal membrane ruptures). Cord presentation is when the cord enters the birth canal before the waters break. This gives the doctor time to plan for delivery. In the cord prolapse, the cord enters the birth canal after the waters break, but before the baby enters the birth canal. A cord prolapse is considered to be an emergency due to the risk of it becoming trapped against the baby’s body during delivery. Due to this most cord prolapses require an urgent C-section.

How to correct the baby’s birth position?

1. External Cephalic Version (ECV)

To correct a breech position, your doctor might suggest a technique called an External Cephalic Version (ECV). This procedure involves applying pressure to your abdomen while closely monitoring the baby’s heartbeat. While this may be uncomfortable for you, it isn’t dangerous for the baby. The ECV technique is known to be successful in about 50% of cases. In case the ECV doesn’t work, a cesarean delivery is required to safely give birth to the baby.

2. Walking and light exercises:

Taking walks and stretching your calves can help loosen the ligaments and connective tissue that support the uterus and pelvis. This can create more space so that a baby in a posterior position may rotate their body. You could even do squats (with the doctor’s approval only) to help the baby descend properly. Also Read: Birth Defects – Causes, Solutions, and Cure

3. Sit right

If your baby is in an incorrect position you can tweak the way you lounge or sit. While sitting, make sure your hips are higher than your knees. Avoid leaning back while sitting or relaxing, sit forward with your back straight instead. Make sure your favourite seat or car seat doesn't make your bottom go down and your knees come up. If it does, sit on a cushion to lift up your bottom. This encourages your baby to turn in the ideal birth position because of gravity. Factors which might contribute to the incorrect position of the baby at birth:

• Multiple births - twins, triplets, etc..
• Preterm labour
• Previous abnormal birth positions
• Abnormalities in placenta or uterus
• If there is too much or too little amniotic fluid wherein the baby moves about too much or too little in the uterus.
• If the mother has an abnormally shaped uterus or has other complications, such as fibroids in the uterus.
• Certain foetal medical conditions like megacephaly (baby has an unusually large head).

During the final weeks of your pregnancy, your doctor should be able to tell you your baby’s current position by feeling your belly or more accurately with the help of scans. While you, with the assistance of your doctor, can try to turn your baby in the ideal birth position, do not panic if your baby does not cooperate. A timely c-section will successfully deliver your baby no matter what position he is in. Also Read: 7 ways to do garbh sanskar at home

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