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Optimal Fetal Positioning

Sometimes labor is faster than what "the books" say, sometimes it's slower than our expectations have prepared us for. We've all read: Your labor should be 12 hours, on average. Anything over that mark is a "long labor" while anything under three hours is precipitous. Hmmm. What does that say about labors with variations from these benchmarks? Are we still doing it "right" if we labor for longer? What if we labor for MUCH longer? And is one length better than the other? When does the clock even start, now that we're talking about length of labor? Some labors start, then stop, starting up again days or even weeks later. What if there were some simple things mom could do to encourage a shorter labor?

I've seen labors progress evenly and steadily. And then I've seen labors get "stuck" and take longer. I've seen labor "stall" and require medical support. Is there anything mothers can do to guarantee steady and even labor progress?

There are no guarantees in birth; that's the beauty and magic of birth, one of the lessons we learn as we enter into our rite of passage as parents. Sometimes we have to trust in something larger, to be open to the moment and accept the unknown with grace.

But sometimes, we can educate ourselves and take some steps to maximize the chances that baby is in the best possible position for birth. In birth, we call this Optimal Fetal Positioning. In practice, this means using gravity to help your baby position himself optimally in your uterus.

Look down at your pelvis. You want your baby to be born with his face looking down. (You've heard of back labor, right? Otherwise known as posterior positioning? That's when babe is born facing UP, some call it sunny-side up, so the back of his head presses into your spine and coccyx. You don't want that. You want babe facing DOWN, leaving plenty of room for your coccyx to move freely). How to encourage this position? In a word, gravity. You basically want your babe's heaviest body part (his own back and spine) to follow the curve of your belly. This puts his head facing DOWN, towards your back, which is optimal! But how can you encourage his back and spine to follow the curve of your belly? Use gravity to pull his heaviest body part towards your belly. This means mom, you'll need to position your own body in ways that are forward-facing.

Think about what happens if you are kneeling on all fours. With enough practice, baby's spine swings DOWN to follow the curve of your belly. (Conversely, picture what happens if you recline back on the couch: baby's heaviest part, his spine, swings back to press against your own spine. Ouch. Not to mention he's now facing UP in your uterus, which is not an optimal position for birth).

Anything you can do to tilt your pelvis forward will encourage Optimal Fetal Positioning. Sit on a birth ball and rock your pelvis forward; browse the internet with your laptop on the floor while you are on all-fours; sit backwards on a kitchen chair and lean forward on the chair back; use a wedge-pillow while you're driving your car.

I read a story on the internet of one midwife's account of OFP. She said that once she began instructing her pregnant moms to practice OFP for 15 minutes a day, she virtually stopped seeing "stalled" labors. One reason being that baby is in a position that encourages cervical dilation. Labors are quicker in addition to being less painful, on balance.

Can babies be born "sunny side up?" Of course. It happens every day. Some of these labors are easier than others. Can there be other factors which determine length and ease of labor? Yes! Many! But many of the other factors are decided by fate; this one is easily directed by our own actions. Aside from prenatal nutrition, Optimal Fetal Positioning may be the single most important thing you can do during pregnancy to foster an easier birth.

Check out these resources below for some additonal information on OFP.

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