Posterior Positioning

Before birth, the positioning of your baby is something that can cause a lot of confusion and potential anxiety. As a doula, it is my job to educate the mother on ways to promote the optimal position for their baby before labor and more importantly, educate myself on the different positions, as well as pain coping techniques that the mother can use before and during labor. The more I am learning about OP (occiput posterior fetal position) babies, the more I am discovering about what you can do to prepare for a posterior labor and what one can do during posterior labor.

The OP position is when the back of baby’s head is up against the mother’s back as opposed to the more optimal OA position, in which the baby’s head faces the mother’s back. A posterior baby doesn’t fit as well through the pelvis as the anterior baby, since the posterior baby’s head seems larger due to the angle it has when in the pelvis. However, it is good to keep in mind that most posterior babies rotate to the anterior position during labor.

Some things the mother can do to encourage the baby to rotate into the OA position include using the rebozo, abdominal release, pelvic tilts, hands and knees position, the lunge position, the inversion position and using the birth ball, to name a few. It is important to choose a few techniques that work best for you and stick to them daily up until labor and throughout early labor as well.

During labor it is important to do activities that encourage your body to be balanced. This can include using the rebozo, doing the belly lift, or trying the forward leaning inversion. Being vertical as much as possible can be very beneficial as well. When you feel the need to rest, using the birth ball to sit on or a birthing stool, encourages good maternal positioning and in turn, create space for the baby to rotate. You can also use the birth ball to create some movement during contractions, by making circles with your hips.

There are also several comfort measures that either your partner or doula can use for the laboring mother. Massage of the lower back can be very helpful in releasing tension during back labor. Counterpressure can be done by firmly gripping the front of the mother’s hip while pressing into her back. This can be done during contractions and can feel quite nice with a considerable amount of pressure. The double hip squeeze is another great method to be done with either your partner or doula (if either are accessible). From behind, someone presses on both sides of the mother’s hips with the palms of their hands. The pressure should be applied towards the center, pressing her hips together. This can also be done during contractions. Rolling pressure over the low back either using a rolling pin or tennis balls can be soothing during or in between contractions as well. Cold or hot compresses, the shower or tub, and electric massagers are all useful tools to use for back labor as well.

Overall, as daunting as posterior labor may be, there are many things that a mother, partner, or doula can do the make her experience one that is more enjoyable. As the incidence of posterior labor increases, it is great for me to remain informed as a doula and continue to educate myself on the different situations that I might be presented with before, during and after childbirth.

I hope this information is as helpful to all of you as it has been for me. If you have any questions or would like more details on the information I have presented, please don’t hesitate to contact me directly. Talk to you all soon and happy birthing!

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