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Make more space
Why is it that some women pop their babies out while others have drawn out labours that end in inductions or caesars?
Article: Tina Otte from Your Pregnancy magazine

It's got a lot to do with the way your baby is lying in your pelvis. Here's how to get your baby into the best position for birth.

Babies normally engage in the pelvis at around 36 or 38 weeks, but some babies will only engage as labour starts. On entering the pelvis, the widest part of the baby's head needs to be in line with the widest part of your pelvis, which is sideways.

But the outlet at the bottom of your pelvis is widest from front to back. So when your baby is born, her head needs to rotate so that the widest part of her head now lines up with the widest part of the outlet. The ideal position for a baby in labour is to lie head down with the back of the head against the mother's left or right hip (left occipito anterior or LOA). In this position the baby only has to turn 45 degrees to line up with the wide inlet.

In about 25% of women, the baby's back lies more towards the mother's spine (occipito posterior or OP). This makes it harder for the head to enter the pelvis and it will have to rotate much further during labour. These labours are usually longer as the baby has to work her way around and they cause terrible backache. A sign that your baby's in this position is if you see a saucer-shaped dip around your navel, the head does not engage at the usual 36 to 38 weeks, you feel kicking in the front and you experience low backache, constant pressure on the pubic bone and pressure on the bladder. The good news is there is a lot you can do to give your baby space to move into the best possible position. The secret is to keep your pelvis open.

The importance of posture
Not many women spend time on all fours scrubbing the floor. Granted it is a thankless job but it's a very good way to open your pelvis and help your baby move down into a good position for birth. Slouching in a soft couch, behind your desk or in the car causes your pelvis to tip backwards and close, creating less space for your baby to nudge into a good position.

New moves to try

  • In the last six weeks of pregnancy, try to maintain upright and forward-leaning positions (especially a first time mother) to open up your pelvis, giving your baby more room to wiggle into the right position.

  • Braxton Hicks contractions can be very intense and frequent in the last four weeks. Your body and baby are gearing up for labour. When you feel these contractions, lean forward. This will help nudge the baby into the best possible position for birth.

  • Sitting and moving your pelvis on the exercise ball is very beneficial.

  • Deep couches and car seats force the pelvis to tip backwards, which prevents the baby from entering the pelvis. Sit on straight chairs, on a birth ball or backless chairs where the knees are supported in the front and the pelvis is tipped forward. This will also ease lower back strain.

  • If you are sitting in a deep couch, make sure you have a firm pillow wedged under your buttocks and in your lower back so as not to tip your pelvis up in the front and not to crowd your uterus (which closes your pelvis).

  • Rocking your pelvis back and forth several times a day is very beneficial while standing, in the all fours position or while sitting on a birth ball.

  • When sleeping or resting, lie on your side with pillows behind your back with your top leg and knee resting forward on the mattress. You may need a pillow between your thighs. (The "Preggy Roll" available at most baby stores is wonderful for this!)

  • Do swimming, yoga and prenatal exercise classes that include crawling and ball work. These heighten your awareness of posture, breath work and muscle control.

  • Although it may seem unnatural, from early on in pregnancy start spending some time during the day in the all fours position. In the latter part of pregnancy the importance of this position cannot be over emphasised, both for helping babies to settle into the optimal position and for the sake of mother's back and abdominal muscles. Doing it from early on in pregnancy means the baby is much less likely to settle into the posterior position.

    Image: Your Pregnancy magazine


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