osteopathy Bath, Bradford on Avon, Bristol, Wiltshire and Somerset

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Osteopathy & Fetal Positioning

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Delivering a baby is a natural process that has been going on forever. So why are almost 25% of babies delivered by caesarean section and a further 12% delivered by forceps or ventouse? (Figures from ONS maternity statistics 2008/9 for England). Part of the reason is fear of litigation by hospitals, part of it is due to women having babies later in life and part of it is due to modern lifestyles – working up to the last minute, too much time spent sitting, stress etc. However, there is a lot you can do to help yourself to have a normal childbirth.

The baby tends to lie facing the placenta, which is normally on the back wall of the womb. This naturally places the baby so that s/he is back to front. They will normally lie head down, which is more comfortable. You can encourage this optimal position by lying on your left side in the later stages of pregnancy, so that both you and the baby are supported by the bed. You can put a thin pillow under your tummy to make it more comfortable.

If the baby is not in the best position, there are several possible explanations. Perhaps the womb itself is an unusual shape or is flopped over or twisted. Your pelvis might not be the ideal shape. Or maybe the pelvis is out of position due to leg length difference or a fall onto the bottom. Your osteopath can check your pelvis for you. The placenta may be attached to the front, or low down in the womb. The baby may have the cord wrapped round his/her neck and can't move for fear of strangling himself. If there are twins, they will squeeze themselves in as best they can. If you can feel kicks pushing outwards your baby is probably back to back. If you can feel it nodding just under your ribcage, it is probably breech.

Your baby will move into a better position with a bit of help from you – unless it is impossible, such as when the cord is around the neck or the womb is an unusual shape. Pick a moment when the baby is active (sorry if that's 3am!):

Give your baby room to move by standing leaning forward, with your feet wide apart – perhaps at the sink, or holding onto the banisters of the stairs. Let your lower back drop into a ‘swayback' position, relax your tummy muscles and rock backwards and forwards or side to side, keeping the knees slightly bent.
Get down onto all fours, again with a swayback posture and relaxed tummy, and experiment with crawling, rocking back and forth and placing one knee onto a cushion, then the other and see which is more comfortable. Sometimes the baby will turn there and then, sometimes s/he does it while you sleep.
During the day, avoid sitting with your knees higher than your hips. Lie rather than slouch on the sofa.
Go for a swim – it'll give your back a rest and is perfect for helping the baby to change position.
Find a local Active Birth Teacher to help you prepare for the birth.
Ideally, give up work 6 weeks before your due date to allow yourself more time to exercise, relax and sit comfortably.
Once you are in labour try to keep active and on your feet or knees, leaning forward with support from the furniture or your partner, so that gravity can help the baby to descend. Experiment with the positions described above to help your baby ease his/her position.
If you have an epidural, try lying on your side (swapping over when the epidural is topped up) so that your sacrum (tailbone) can move out of the baby's way. Unfortunately this isn't always practical as the midwife may want to hook you up to various monitors, requiring you to lie on your back.

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If you require any further information or wish to discuss any problems you may have, please contact the Church Street Practice on 01225 868282, or book in for a free 15 minute consultation.