Getting my baby into position for birth

Approved by the BabyCenter Malaysia Medical Advisory Board
Last reviewed: January 2013 Show referencesHide references

Highlights

• What's the best position for my baby to be in?
• What's a posterior position?
• Why are some babies posterior?
• How can I help my baby into an anterior position?
• Can I really make my baby get into the right position for birth?
• How can I improve my baby's position during labour?

What's the best position for my baby to be in?

Labour is nearly always shorter and easier if your baby is in a head-down position, with the back of his head slightly towards the front of your tummy. This is called an anterior position. Most babies get into this position by the end of a pregnancy.

In an anterior position, your baby fits snugly into the curve of your pelvis. During labour, your baby will curl his back over and tuck his chin into his chest. Your labour and birth should progress easily if your baby is in this position because:

• The top of your baby's head puts rounded, even pressure on the neck of your uterus (cervix) during contractions. This helps your cervix to widen and helps to produce the hormones you need for labour.
• At the pushing stage, your baby moves through your pelvis at an angle so that the smallest area of his head comes first. Try putting on a tight polo-neck top without tucking in your chin and you'll understand how this works!
• When your baby gets to the bottom of your pelvis, he turns his head slightly so that the widest part of his head is in the widest part of your pelvis. The back of his head can then slip underneath your pubic bone. As he is born, his face sweeps across the area between your vagina and back passage (the perineum).

What's a posterior position?

A posterior position is where your baby has his head down, but the back of his head is against your spine. By the time labour starts, about one baby in 10 is in this back-to-back or posterior position.

Most back-to-back babies are born vaginally, but this position can make labour more difficult for you, particularly if your baby's chin is pushed up rather than tucked in. As a result:

• You may have backache as your baby's skull is pushing against your spine.
• Your waters may break in early labour.
• Your labour may be long and slow.
• You may feel like pushing before your cervix is fully dilated. (Coates 2009)

When your baby gets to the bottom of your pelvis, he'll need to turn through almost 180 degrees to get into the best position to be born.

This can take quite a while, or your baby may decide he's not going to turn at all! In this case, he will be born with his face looking up at you as he emerges. He might need forceps or ventouse to help him out.

Why are some babies posterior?

Your baby may be posterior because of the type and shape of pelvis that you have. Some women have a pelvis which is narrow and oval (called an anthropoid pelvis) or wide and heart-shaped (called an android pelvis), rather than round-shaped.

If your pelvis is oval or heart-shaped rather than round, your baby is more likely to settle in a back-to-back position at the widest part of your pelvis. This is because he can rest his head more easily in this position (Vance 2009).

Lifestyle may be another factor. It seems that urban women are much more likely to have posterior babies (Sutton 1996) than women who work manually in fields, or who squat to cook or eat. It's easy to understand why.

When you relax on a comfortable armchair watching TV, or work at a computer for hours, your pelvis is tipped backwards. This encourages the heaviest part of your baby (the back of his head and his spine) to swing round to the back (Andrews 2004). In this position, he'll end up lying against your spine.

If you do a lot of upright activities, your baby is more likely to go down into your pelvis in an anterior position, because your pelvis is always tipped forwards.

How can I help my baby into an anterior position?

You may have heard about a technique called optimal fetal positioning (OFP). This is a way of encouraging your baby into an anterior position by changing your posture, particularly when you're sitting down. Keep in mind that you're trying to tilt your pelvis forward rather than back, so, if you're sitting, check that your knees are always lower than your hips.

Try the following:

• Check that your favourite armchair doesn't make your bottom go down and your knees come up. If it does, try turning the chair round, kneel on the seat pad and lean forwards over the back of the chair.
• Scrub the floor! Our old neneks used to say that washing the kitchen floor was a good way of preparing for labour. They were right. When you're on all fours, the back of your baby's head swings to the front of your belly.
• Take regular breaks and move around if your job involves a lot of sitting.
• Sit on a cushion in your car to lift up your bottom.
• Watch TV leaning forward over a birth ball.

Don't worry about getting your baby into the right position when you lie down to sleep. When you're lying down, your baby is not being pushed down into your pelvis. However, lying on your side rather than your back is the best position for sleep in late pregnancy.

Can I really make my baby get into the right position for birth?

There's nothing new about trying to get your baby into a good position. Reports of "maternal posturing" go back to at least the 19th century (Andrews 2004). It's known today as optimal fetal positioning (OFP) because of a midwife called Jean Sutton who publicised the technique in the 1990s. She advised pregnant women to get into upright and forward-leaning postures as often as possible in later pregnancy (Sutton 1994, 1996).

Some midwives and doctors have questioned whether it really works or just gives pregnant women something else to worry about (Walmesley 2000). So far, studies into OFP show that adopting a hands-and-knees position for 10 minutes, twice a day, towards the end of pregnancy can help move your baby into an anterior position in late pregnancy.

Unfortunately, it doesn't seem to have an effect on how your baby lies at birth. Sutton recommends trying to stay in upright or forward postures regularly in everyday life, rather than for short bursts.

If you try OFP during pregnancy but your baby stays in a posterior position when labour starts, it may be because of the shape of your pelvis rather than your posture.

How can I improve my baby's position during labour?

If your baby is in a posterior position when labour starts you can still use upright or forward postures to try to help your baby to turn and to relieve your pain. It's common for babies to change position during labour and most babies get themselves into an anterior position by the pushing stage, no matter what position they were in at the start of labour (Lieberman et al 2005).

Sometimes women have niggly pains for several days before labour really starts. This can be wearing, but the pain might be a sign that your baby is trying to turn into an anterior position. The best way to cope is to:

• try to get plenty of rest at night;
• during the day, remain upright and active;
• lean forwards during contractions;
• eat and drink regularly to keep up your strength;
• try to stay relaxed and positive.

You may find that the best posture to labour in is on all fours. In this position, your baby drops away from your spine, helping to relieve backache (Hunter et al 2007) and hopefully helping him to turn, too.

When you're in actual labour, try to:

• Stay upright for as long as possible.
• Lean forwards during your contractions. Use a birth ball, bean bag, your husband or the bed to lean on.
• Ask your birth partner to massage your back.
• Rock your pelvis during contractions to help your baby turn as he passes through the pelvis.
• Don't stay sitting in a chair or on a bed in a leaning-back position for too long.
• Try not to have an epidural if you can, as epidurals may increase the chance of your baby being in a posterior position at birth (Lieberman et al 2005). Epidurals also make having an assisted birth more likely (NCCWCH 2007, Anim-Somuah et al 2005).
• If you get exhausted during labour, lie on your left side, as your pelvis can still expand to give your baby space to turn while you are resting.

 

QUESTION

Is it worth trying to stimulate my baby's development before he's born?

Last reviewed: September 2012

 

ANSWER

Dorothy Einon

Dorothy Einon is an early years play and child development expert.

It depends who you talk to. Some experts say it might be possible because your baby can hear sounds from about 23 weeks of pregnancy. If your baby hears the same sounds after birth that he heard in your uterus, he will recognise them.

For example, if you regularly read The Cat in the Hat to your bump, your baby will recognise the rhythm of the story after birth.

Your baby does more than passively listen in your uterus. He also forms associations with the sounds he hears. After birth, your baby may relax when he hears something that signalled your relaxation, the theme tune to your favourite TV show, for example.

So does this mean your baby would gain if you drew up a timetable of learning experiences for him?

Some experts feel that your baby already has his work cut out, growing and developing inside you. He doesn't need to be exposed to classical music, poetry or intelligent conversation, in the hope of setting taste and advancing language.

The fact is, your baby only knows his environment in your uterus. Naturally, this is entirely different from your world outside. As your baby has no understanding of your world yet, there is very little you can meaningfully do to stimulate him.

Like everyone else, your life follows certain patterns. You can't help but provide your baby with regular stimulation, whether you read The Cat in the Hat every day or not.

You can provide different associations, for example, Mozart with relaxation or a certain poem before you sleep. But these associations don't stretch your baby’s ability to learn. It just alters the associations your baby makes. Neither can you prime your baby for language when there is nothing meaningfully to communicate.

There is little evidence that you can increase your baby's intelligence by stimulating him in your uterus through songs and stories. But there is no harm in it, either.

So your best approach is probably to follow your own feelings. If you feel like talking to your baby as you move around the house or singing to him as you lie in the bath, go ahead. It can only deepen the way you feel about your baby. And that goes for dads-to-be as well.

If it doesn't feel right to talk or read or sing out loud to your bump, that's fine, too. Your baby will hear you, your husband and your friends talking as you go about your day anyway. After your baby is born the two of you can really communicate and will have many years to perfect his conversational skills.


Reviewed by Dr Patrick Chia, a Kuala Lumpur-based consultant obstetrician and gynaecologist specialising in the screening and management of fetal abnormalities and high risk pregnancy care

 

28 Weeks Pregnant

Fetal development - 28 weeks pregnant

 

 

You're in the home stretch. The third trimester typically starts at week 29 and lasts until week 40 and sometimes even beyond. (Don't worry - 42 weeks is the maximum! After that, a woman usually is induced to give birth.) Most women gain an average of 11 pounds / 5 kilograms during this trimester.

By this week, your baby weighs nearly 2.3 pounds / a little over 1 kilogram and may measure 14.8 inches / 38 centimetres from top to toe. At about this time, your baby can open his eyes and turn his head in utero if he notices a continuous, bright light shining from the outside. His fat layers are forming and his fingernails appear.

You're probably vacillating between feeling as if you've been pregnant forever and being nervous about labour and birth. Checking off things on your to-do list can help. Start selecting possible baby names and begin thinking about life after the birth as well.

You'll probably be seeing your doctor more often in these last few weeks.

Planning to breastfeed? Then look at our complete guide to the first six weeks.

• Note: Experts say every baby develops differently - even in utero. These fetal development pages are designed to give a general idea of how a fetus grows in the womb.

27 Weeks Pregnant

Fetal development - 27 weeks pregnant

Your baby now weighs nearly 2 pounds / 875 grams and measures 14.5 inches / 36.6 centimetres from head to toe. Her eyes open and close, she sleeps and wakes at regular intervals and she may suck a finger or thumb.

Sweet dreams, little baby! Some experts believe that babies begin to dream by the 28th week. What do they dream about? No-one knows for certain but the brain is active this week as well. The characteristic grooves on the brain's surface start to appear and more brain tissue develops.

Chalk up any rhythmic movement you may be feeling to a case of the hiccups, which are common this week and throughout the pregnancy. Your baby has them but is breathing in amniotic fluid rather than air. A paper bag can't cure her hiccups, obviously, but an episode usually lasts only momentarily. The sensation for you may be strange but not unpleasant.

Since your uterus is now up near your rib cage, you may now find yourself short of breath if you haven't already. Starting now and continuing through the last three months of pregnancy, you may be plagued by leg cramps, hemorrhoids, varicose veins and an itchy abdomen. Are pregnancy discomforts getting you down? Try some natural remedies to perk you up.

If you were found to be Rh-negative earlier in pregnancy, you'll probably be tested for Rh antibodies this week or next and have an anti-D injection to combat the incompatibility. You may be offered a repeat injection at 36 weeks.

• Note: Experts say every baby develops differently - even in utero. These fetal development pages are designed to give a general idea of how a fetus grows in the womb.

26 Weeks Pregnant

Fetal development - 26 weeks pregnant

 

Measuring your baby from top to toe with his legs extended, he is about 14 inches / 35.6 centimetres. He weighs a little more than 1.6 pounds / 760 grams. Your baby's eyes begin to open around now. Response to sound grows more consistent toward the end of the seventh month, when the network of nerves to the ear is complete. He also continues to take small breaths and although he's only breathing in water and not air, it's still good practice for when he's born.

Since your baby is now growing so fast, and brain development is so intense at this stage, your nutrition is very important. Continue to eat a well-balanced diet that includes plenty of grains and vegetables. Fibre-rich foods, including whole-grain breads and cereals, lentils and brown rice are high in vitamin B and help fend off constipation.

Your antenatal classes should start sometime in the next few weeks, if it hasn't already. Classes should provide you with good, clear information about the birth and the early days of parenthood. Keeping informed goes a long way toward calming any concerns you may have about giving birth.

• Note: Experts say every baby develops differently - even in utero. These fetal development pages are designed to give a general idea of how a fetus grows in the womb.

Eating well in pregnancy: 25-28 weeks

Approved by the BabyCenter Malaysia Medical Advisory Board

Last reviewed: January 2012

Show referencesHide references

Highlights

Easing those aches and pains

Calcium and vitamin D

Recipes rich in calcium and vitamin D

Easing those aches and pains

As your second trimester ends, your bump is getting bigger all the time and you may find that back pain, headaches and leg cramps are bothering you. Headaches can sometimes happen when you are dehydrated so make sure that you drink lots of water every day. And don't forget to eat something. Headaches are sometimes sparked by low blood sugar, so a carbohydrate-rich snack can help.

 

Calcium and vitamin D

Calcium is a key nutrient in pregnancy. Calcium helps your baby to grow strong bones and teeth, healthy nerves, heart and muscles. It also helps develop heart rhythm and blood clotting. Calcium is found in dairy products, fish (especially if you eat the soft bones too), spinach and green beans, pulses, sesame seeds and almonds.

 

Your body needs vitamin D to help absorb calcium. It is made naturally in our bodies in response to sunlight. Good sources of vitamin D in your diet are oily fish, eggs and milk.

 

Have a look at our daily meal planners, specially drawn up by BabyCenter nutritionist Ng Yee Voon to help you get the right nutrition at the right time.

 

Recipes rich in calcium and vitamin D

Lunch: ciabatta with halloumi, basil and sundried tomatoes

Serves one

 

Ingredients

1. 1 ciabatta roll
2. 1 clove garlic
3. 2 slices halloumi cheese
4. Few leaves of fresh basil
5. 2 sundried tomatoes, drained of oil
6. Rocket leaves, washed, to serve

Slice the ciabatta in half. Take the garlic clove, cut in half and rub the cut edge over the ciabatta. Roughly chop the sundried tomatoes, and arrange on the roll. Grill the cheese on the roll for a couple of minutes and add some fresh basil leaves. Grind over some black pepper and drizzle some olive oil on top.

 

Serve hot, with a side salad of rocket leaves.

 

Snack: hummous with pitta bread

Try this simple hummous with pitta bread for a high-carbohydrate snack which will keep your hunger at bay.

 

Ingredients

1. 400g can chickpeas
2. 1 tbsp tahini (sesame seed paste)
3. juice of half a lemon
4. 1 clove garlic
5. 1 tbsp olive oil
6. wholemeal pitta bread, to serve

Drain the chickpeas and place in a food processor with the tahini, the lemon juice and the garlic clove, peeled. Whizz briefly to break up the chickpeas and drizzle in the olive oil and a little water to make it a creamy mixture.

 

Chill in the fridge and serve with fingers of pitta bread. Vary the mixture by adding a tablespoon of finely chopped coriander, or a tablespoon of chopped pitted black olives.

 

Dinner: mushroom and celery pasta bake

Serves three to four people

1. Preparation time: 20 minutes
2. Cooking time: 15-20 minutes
3. This simple dish is full of calcium.

Ingredients

1. 25g olive or sunflower spread (minimum 59 per cent fat)
2. 2 sticks celery, chopped
3. 150g baby button mushrooms
4. Pinch dried thyme (or 1 sprig fresh thyme, leaves only)
5. 1 heaped tbsp flour (40g)
6. 300ml semi-skimmed milk
7. 100g mature cheddar, grated
8. 150g penne or other pasta shapes

Preheat the oven to 190 degrees C, gas mark 6. Melt the spread in a saucepan and add the chopped celery and mushrooms. Cook, gently, stirring occasionally for five to 10 minutes or until the celery is softening. Add the thyme.

 

Meanwhile cook the pasta according to the packet instructions, and drain. Stir in the flour to the mushroom and celery mixture and gradually stir in the milk. Bring to the boil, stirring all the time.

 

When the sauce has thickened, stir in three quarters of the cheese and the drained pasta. Tip into an ovenproof dish and sprinkle over the remaining cheese.

 

Bake for 15-20 minutes or until the cheese is golden brown. Serve at once with a colourful salad.

 

 

 

You can also read more about eating well in weeks 29 to 32 of your pregnancy.

 

 

 

  

25 Weeks of Pregnancy : Baby Semakin Aktif Bergerak :)

Fetal development - 25 weeks pregnant

 

The baby now weighs nearly 1.5 pounds / 660 grams and is approximately 13.5 inches / 35 centimetres long from crown to heel. He makes breathing movements but has no air in his lungs yet. At 26 weeks, fetal brain scans show response to touch. If you shine a light on your abdomen, your baby will turn his head, which according to researchers, means his optic nerve is working.

At every antenatal visit, your doctor will take your blood pressure and do tests on a sample of your urine. In this way, pregnancy-related conditions such as pre-eclampsia and diabetes can be detected and treated.

Your fingers, wrists and hands may be feeling achy and numb. The carpal tunnel in the wrist is swollen, as are many other tissues in your body. Nerves that run through the tunnel end up pinched, creating pressure that manifests itself as shooting or burning pain. Wearing a brace may help; so will taking vitamin B6. Talk to your doctor about other ways to cope. Find out about natural remedies for numb or achy fingers.

Planning to go back to work? Get organised now. Our work and childcare section will tell you all you need to know.

• Note: Experts say every baby develops differently - even in utero. These fetal development pages are designed to give a general idea of how a fetus grows in the womb.