They Told You the Baby is Posterior
They told you the baby is posterior, what exactly does that mean? Posterior fetal position (OP), otherwise known as “sunny-side-up,” is a term used to determine how the baby’s head is presenting when inside mom’s belly. In the OP position, the back (occiput) of the fetal head is towards the woman’s back (posterior), and the baby is looking “sunny-side-up.” Babies have many challenging tasks to accomplish when going from in-utero to mother’s arms. The majority of these efforts are done without mom having to do anything special to be successful in finding the optimal fetal position for birth. In a nutshell, babies are driven to find the correct way out of the water world. Most munchkins settle into the optimal fetal position between the 32nd and 36th week of pregnancy. Eager to find their comfy spot while waiting for labor to begin, the little guy sometimes forgets the rules and gets into an awkward position; breech, transverse, posterior, etc. Ideally, when labor begins, the baby is positioned head-down, facing your back, with the chin tucked to his chest and the back of the head ready to enter the pelvis. This is the cephalic presentation. The goal is to have the smallest part of the head enter the largest opening into the pelvis for an easier labor. Medical Jargon Each time you have an appointment during pregnancy, the caregiver will undoubtedly “palpate” your tummy to learn the position of your baby. Since they don’t have a crystal ball, her longevity of experience can prove helpful. A seasoned midwife or obstetrician should be able to get a good idea if your little one is cooperating. Be sure to ask your attendant what the prediction is. You may not have heard some of the terminology, so take a look at these: Occiput – This refers to the back of the baby’s head or the nape of the baby’s neck Transverse – Sideways, or laying horizontally across Left – The baby’s occiput (back of their head) is facing left Right – The baby’s occiput (back of their head) is facing right Anterior – The front of the mother Posterior – The back of the mother Breech– The baby’s head is up and his bottom is down Even under the best of circumstances, head-down facing your hip or back, baby can change his mind and flip at the last minute. Getting your caregivers’ observation will help you to practice certain behaviors if the babe is in an awkward position ahead of time. If he flips during labor, you can still practice specific exercises with excellent support by your side. Many impossible situations can be remedied with a few small tricks. 20 Tips to Help Baby Rotate You can practice any of these positions during pregnancy & labor unless told otherwise. Always check with the doctor or midwife if you are a “high risk” patient. If anything hurts- back off and adjust to your body signals! Don’t be obsessive, just check them out before your next appointment. Sometimes doing nothing helps too, so I don’t want you to be concerned if you forget to do them here and there. Pelvic rock in a hands and knees position several times a day. Take a deep breath, tuck the chin in and arch your back up like an angry cat. Hold for 5 seconds. Then slowly breathe out while bringing your back to a flat position, bring your head up to face out over 5 seconds. Repeat ten times. Childs Pose will also help encourage a baby to roll more anterior. Taylor sitting helps to keep the woman’s pelvis rotated forward and encourages the baby to do the same. As another variation, try using a rebozo (or any large piece of fabric) in the above positions. When you sit on a chair, make sure your knees are lower than your pelvis, and your trunk should be tilted slightly forward. Sit on an exercise ball whenever possible, especially in labor. Watch TV while kneeling on the floor, over a beanbag or cushions, or sit on a straight back chair. Try sitting on a chair or toilet rear-facing. Sit on a wedge cushion in the car, so that your pelvis is tilted forwards. Keep the seatback upright. Don’t cross your legs! For proper positioning, the baby needs to have lots of space at the front of the pelvis. Don’t put your feet up! Lying back with your feet up encourages posterior presentation. Sleep on your side, not on your back. Preferably your left side. Avoid deep squatting. Squat on a low stool instead, and keep your spine upright, not leaning forward. Crawl on the floor. Walk upstairs two at a time. Lie on your back with a thick towel rolled in the small of your back for 5-10 minutes. When the baby is posterior, he will hyperextend his neck in the posture, which is uncomfortable and forces him to rotate. Swimming with your belly downwards (breast and crawl strokes-not back) is good practice for best positioning. Breaststroke, in particular, is thought to help with proper positioning, because the leg movements help open your pelvis and settle the baby downwards. Various exercises done on all fours can help, such as wiggling your hips from side to side. Lunge side to side and make hip circles while sitting on the birth ball. Use a peanut ball in labor. Research suggests this one device can make a big difference. Hire a doula. Have extra support for you and your partner to benefit from her knowledge. Babies can come out in precarious positions despite all the plans, medical help, preparations, exercises, etc. These tips are to try to avoid prolonged labor or pushing, back pain, instrument delivery, and or cesarean birth. So if they tell you the baby is posterior, remember it doesn’t have to define your birth; your baby may change direction at any time and surprise you. Hang in there!
How to Keep Breastfeeding Comfortable
To master how to keep breastfeeding comfortable can take time and patience but feeling pain shouldn’t be part of the equation. It’s hard to know what breastfeeding should feel like if it’s your first time. You’ve probably heard women tell stories of nipple and or breast pain at one time or another. Maybe you’ve witnessed someone wincing or crying out while feeding. Or perhaps you have experienced this yourself. Some women think suffering is part of the natural process of being a successful breastfeeding mother. What no one tells you is that breastfeeding should not be painful. Sure, you’ve never done this, and you may feel “tender” for the first week or two, but that’s it. Typically, in the first minute of the feeding. A strong tugging and pulling sensation is appropriate. A pinching, biting, or burning feeling is not. Statistically, most women with pain throughout feedings are incorrectly latching the baby. Yes, everyone does have a different pain perception, so deciding what is reasonable can be a struggle for some mothers who seem to be doing everything right. Questions to Keep Breastfeeding Comfortable Are you in the early weeks postpartum? Are you supporting the breast and baby’s head with your hands? Has baby turned tummy to tummy? Are his ear, nose, and hip in alignment? Are you bringing the baby to your breast, not leaning into the baby? Is baby opening wide, like a yawn, when bringing him to latch? Do you feel tugging/pulling? Are your nipples intact? Long, but rounded when baby pulls off. Not flat like a pancake. Have you tried different positions? If you answered yes to most of the above questions, then tenderness should be getting better by 2-3 weeks. Otherwise, keep reading: When More Help is Needed Are you fair-skinned with light or red hair? Are your nipples usually sensitive? Some women don’t even like to be touched. Do you have Raynaud’s Syndrome, vascular disorders or fibromyalgia? Have you recently (past few months) had a yeast infection, used antibiotics or corticosteroids (asthma), or have a baby with thrush or diaper rash? Could the baby be tongue or lip tied? Have you ever had surgery to your breast or chest? Do you feel pinching or biting throughout the feed? Are your nipples cracked? Do you take any medicine or herbal supplements? Are you using something on your nipples for comfort? Do you use a breast pump? What type of bra and or breast pads are you using? If you’ve answered yes to any of #1-12, please reach out to your lactation consultant or la leche league leader. A phone consult can be helpful in certain instances, or for a visual assessment, you should go on FaceTime or Skype. Understand that a better perception of the whole picture may take working one on one with an expert in the field to keep breastfeeding comfortable. Make an appointment for a home or office visit with an IBCLC as soon as possible. Most important, know that this is temporary. With help, time, and patience, you could be on the road to a more comfortable breastfeeding journey. Happy Parenting!
