Explanation of Fetal Positions; What Poses Are Beneficial and What Poses Should Be Avoided During Pregnancy
April 21st, 2008
The cervix is opened by the baby’s head pushing against it with each contraction. You can visualize this action by picturing the cervix as a turtle neck sweater through which the head is slowly emerging. Ideally, to push the cervix open most effectively, the baby’s chin is flexed, and the smallest part of the baby’s head (the occiput) presents first. However, sometimes the baby’s occiput is facing backwards or is posterior, so it does not emerge first.
Posterior Position
• Occiput Posterior (OP)
• Right Occiput Posterior (ROP)
• Left Occiput Posterior (LOP)
The baby presenting in a posterior position can lead to a host of issues. For one, dilation and progression usually take longer, and some women get “stuck” at a certain point in dilation. The mother may experience intense back pain, since the baby’s skull is pressed up against her sacrum. She may also experience the urge to urinate during each contraction, because the baby’s forehead is pushed up against her bladder.
At times it is it difficult to rotate a baby out of the posterior position, especially if the baby has entangled itself in the cord. There are yoga poses that are encouraged and discouraged during the last trimester to help the baby move into the ideal birthing position.
Specific yoga poses to omit from the 3rd trimester practice are:
• Legs up the wall
• Supta Baddha Konasana (at the end of class)
• Supported bridge for a long period of time
It is advisable to do any “belly down” pose like child’s pose, cat/cow, body circles and a brief downward facing dog. (Please exclude downward dog if the baby was once in a breech position and has finally turned head down.) I also encourage women to sit on a birth (exercise) ball or sit upright or leaning forward in chairs. If the mother has access to a pool, swimming is a fantastic activity for the last trimester since the mother is belly down for a prolonged period of time, and immersing the body in water can help reduce swelling.
During the last trimester I encourage the mothers to spend as little time on their backs as they can. This includes asking them to check in with the way they recline at home as well as in the yoga studio. It is so easy (and desirable!) to come home and drop back into the couch or comfy chair. They should avoid doing so, however, since it creates a hammock-like shape for the back and invites the baby to settle into a spine-to-back position.
Another reason that the baby may present posteriorly is that the mother’s uterine ligaments and pelvic floor muscles are tight and somewhat twisted, preventing her baby from settling into a good position. Luckily, many poses we do in prenatal yoga encourage the pelvic and uterine ligaments to gently open and relax. Exercises that relax and tone the pelvic floor muscles are also included in class.
Specific asanas for preparing the pelvis for labor and delivery:
• Baddha Konasana (cobbler’s pose)
• Supported or unsupported squats
• Upavistha Konasana (wide angle pose)
• Janusirasana (head to knee pose)
• Pigeon pose
• Virasana (hero’s pose)
If the baby is malpositioned and the mother is aware of what side the baby is laying on, she can help correct this by arranging her body to encourage the baby to shift during savasana or while asleep. If the baby is OP, the mother should use “pure side lying” as opposed to semi-prone. The mother should lie on the side towards which the occiput is already facing, with the baby’s back toward the bed.
If the mother would prefer to rest in a semi-prone position, she needs to lie on the side in which the baby’s occiput and back are facing towards the ceiling. For example, if the baby is ROP, the mother would be on her left side in a semi-prone position and on her right side for “pure side lying”.
Breech Position
• Breech
o Footling breech
o Frank breech
o Complete breech
o Kneeling breech
Another issue some mothers face is the baby being in a breech position. This could mean the baby is standing straight up in the womb (footling breech), presenting butt first (frank breech), sitting cross- legged in the womb (complete breech) or the baby is kneeling inside (kneeling breech). Either way, very few doctors will deliver a breech baby vaginally. If a mother finds out her baby is breech, she is often anxious to help turn the baby around. Luckily, there are some yoga poses that can assist with this.
Poses to help turn a breech baby:
• Prolonged inversion like downward dog
• “Butt up” child’s pose
• Supported bridge pose
• Right angle handstand at the wall ***advanced practitioners only
• AVOID squatting, as it opens the outlet of the pelvis and invites the baby to wedge itself deeper down.
Beyond these specific yoga poses, acupuncture has been known to help. Also, you can try placing ice at the fundus since the baby will likely move away from the cold. Or, place music or light down at the pelvic opening since babies will go toward sound and light.
In general, mothers should be mindful of the baby’s position as she nears her due date and tailor her practice accordingly. Yoga can have a powerful effect on these last few weeks and days of pregnancy!
Entry Filed under: Explanation of Fetal Positions; What Poses Are Benefici
17 Comments Add your own
1. Lauren | April 30th, 2008 at 7:33 pm
Hi,
I am wondering if/when/how a baby is determined to be in a posterior position. I was told by my OB that OP is discovered once you are dilated to 4-5 cms, not before, and thus this provides little time to try and move the baby into a better position. Is this true? I seem to recall that women at the yoga studio knew they were posterior. How did they know? Did they have a late ultrasound I didn’t have?
I am curious and thank you.
2. Deb | May 3rd, 2008 at 1:29 pm
Hi Lauren
I am a little surprised to hear that your doctor can not determine a posterior baby until 4-5cm. A typical back labor will present itself as intense back aches, strong frequent contractions, signs of labor progressing further then it actually is, and the urge to urinate during the contraction. When I have encountered this with clients, we go in expecting to hear that the mom is pretty far along since her contractions are close together and strong and get informed that she may only be 1-2cm. That is a tell tale sign that the baby is most likely in a posterior position.
Another way to figure out where your baby is in your body is “belly mapping.” (check out spinningbabies,com for further details). This method helps you figure out your baby’s position by paying attention to where you are feeling the kicks and the bulges and firm spots. You can also look at your belly and if there is a depression under the belly buttom, that could possibly indicate that the baby’s spine is towards your back and it’s head and feet are facing outward.
Another way for your care provider to identify your baby’s position is to palpate your belly. Last summer when I attended a week long program at The Farm Midwifery Center, the midwives taught us a technique called the “Leopold’s maneuver”. This is a technique of feeling the belly and identifying the hard bulge (head), less firm bulge (butt) and the firm, convex, smooth. resistant mass (the baby’s back).
One final way a care provider can asses how the baby is positioned is by using an ultra sound. This is something in the last several years I have seen used upon arrival in triage. I am guessing they want to make sure the baby is not in a breech position.
Babies do however move and rotate during labor. So do not feel totally discouraged should your baby be “sunny side up”.
Hopefully this clarifies determining baby position a bit more.
Good luck!
3. Margot | March 4th, 2009 at 7:52 pm
Hi and Namaste… I am curious as to the reason for avoiding/omitting any poses in which lying prone on the ground is required, such as cobra or upward facing dog, during pregnancy.
I am also confused, I have heard some experts promote spinal twists, others say avoid them during pregnancy. I would like to know your view and reasoning.
Thanks!
Margot
4. Deb Flashenberg | March 10th, 2009 at 8:26 am
Hi Margot,
It is advised to avoid lying on your belly during pregnancy because it is too much pressure and weight on your uterus and growing baby.
As for your question about backbends and deep twists, some schools of yoga teach cobra and upward facing dogs with support under the pelvis. At the Prenatal Yoga Center, we omit those poses because we believe it is not safe to stretch the belly that deeply. If the rectus abdominis muscles (the 6 pack muscles) are stretched too much it can lead to a separation of this muscle group called diastasis. While it is normal to have some separation of the rectus abdominis muscles during pregnancy, more extreme diastasis can be prevented by avoiding backbend and deep twists.
We do include gentle backbends since the chest opening is so beneficial for the pregnant body. However, we avoid deep backbends because the pregnant belly pulls the body forward and the mother is extending strongly to counteract this pull, the back muscles can get overworked, strained and tightened and the vertebrae can get compressed. So instead of adding to the already over-flexed pregnant back, it would be more beneficial to to try strengthen these muscles and balance out the overuse in certain areas with safe extension, gentle flexion, side-bending and gentel twisting.
As I had said, many places and practitioners continue to keep these poses in their practice and the poses may feel good for the individual. At the PYC, we try to teach poses that we feel will aid in the comfort and give strength and stability to the pregnant body.
Hope that helps!
Keep practicing!
Take care,
Deb
5. Margot | March 16th, 2009 at 5:51 pm
Thank U so much, Deb! I wish I was close enough to attend classes at PYC!
Sincerely,
Margot
6. marie-pierre julien | March 19th, 2009 at 6:19 am
Hi,
I’m 33 weeks pregnant and my baby is breech. I practice yoga very regulary and concentrate on the poses that could help turn the baby.Meanwhile,I would like to consult a doctor specialized in acupuncture . Do you have anyone you know to recommend ?
Also I attend the prenatal yoga one Saturday and the teacher mentionned a doctor nearby the upper west side studio who is an expert in turning babies.
Thanks in advance
M.
7. Deb | March 21st, 2009 at 5:24 am
Hi Marie-Pierre,
I am so glad that you are doing poses that concentrate on turning your baby. Many women have had success turning their baby this way.
As for seeing an acupuncturist, I have been working with Frances Goodwin, LAc for about 7 years. She is extremely knowledgeable and patient. However, she is not on the UWS, she is down in Union Square. Her phone number is 212 414 0388.
Take care,
Deb
8. Priya | August 6th, 2009 at 12:01 am
Hi
I am trying to find out if I can do baddakonasana and trikonasana during the very first weeks of conception. Would really appreciate your reply as I am confused when some say you can and some say you cant.
Thank you.
9. Deb Flashenberg | August 13th, 2009 at 7:52 am
Hi Priya,
The best advise is to listen to your body during pregnancy. That said, there are several poses I don’t recommend doing during pregnancy, deep backbends, arm balances, most inversions, deep twists and stomach down poses.
We regularly do baddakonasana and trikonasana in class. I feel they are completely safe. You can always modify these poses so that you don’t work too deeply if you are feeling strained in the asana.
Hope that sheds so light on what to do and what to avoid. Keep practicing!
Take care,
Deb
10. Molly | September 24th, 2009 at 11:24 am
I’m at 31 weeks and am recently working on the poses to get a baby out of the frank breech position, One thing I noticed is that when in child’s pose with butt up, the pelvis opens.
My want is not to open the pelvis and have his bum stuck further in, does gravity eliminate this issue, while in child’s pose.
Any tips?
Is there a recommended way to sit (e.g. leaning forward vs. leaning back, cross legged vs. knees spread)?
Abdomen strengtheners to get baby to turn?
Is cat pose better than cow pose?
Thanks, love your class!
Thanks,
Molly
11. Deb | September 29th, 2009 at 11:07 am
Hi Molly,
At 31 weeks, I would not be too concerned about a breech baby. If your baby is still by week 34 or 35, you can start trying to turn your baby around.
To answer your questions, you are fine in “butt up child’s pose” since gravity is helping to turn your baby. That is actually one of the best positions to be in to help turn your child. Don’t worry that it is opening your pelvis.
I would also put a cold pack at the top of your belly and light and music at the bottom. Acupuncture can also be helpful to turn your little one. As for body positions, it is recommended to invert your hips for abut 15-20 minutes several times a day. Abdomen strengtheners or cat/cow will not really have an effect on rotating your baby.
Hope this helps!!
Take care,
Deb
12. Daisy | July 28th, 2010 at 12:04 am
Hi,
I am 30 weeks pregnant with my first child and hoping to have a natural childbirth. I have been practicing yoga for three years. While I am pregnant, I have been doing mainly pre-natal yoga (some beginner level hatha and flows classes too) and swimming.
I am now in my third trimester and I know from my last ultrasound that the baby has turned head-down. I wonder if I can still continue with my downward facing dogs. I asked one of my pre-natal instructor but she wasn’t sure. She finally suggested that I do not stay in a downward facing dog for long. But in my flow classes, the instructor would sometimes hold downward facing dog for as long as three minutes. Yesterday after a three minute downward facing dog, my little girl kicked actively during the pose and remained very active after the class. I worried she was trying to turn!
Just wondering what you think of this. Does the time held in a pose matter or should I avoid inversion pose completely?
Many thanks in advance and namaste,
Daisy
13. Deb | August 12th, 2010 at 7:34 am
Hi Daisy
I tend to take a bit of a more conservative approach when it comes to inversions. In prenatal yoga, at the Prenatal Yoga Center, we do not include headstand, handstand, shoulder stand or forearm stand in class. Our inversions are downward dog, uttanasana, prasrita padatonasana and legs up the wall with support under the pelvis.
If you are going to do downward facing dog in your third trimester, I would suggest limiting the time to 3-8 breathes. I think 3 minutes is not a great idea if you already have the baby head down. For moms with a breech baby, I usually suggest downdog or any pose with the butt in the air for 3-10 minutes to help encourage the baby to rotate into a more optimal “head down” birthing position.
Hope this helped a bit!
Take care
Deb
14. Nene | October 27th, 2010 at 5:48 am
I have just been to see my doctor and informed that my baby is breech. This saddened me and my partner as we are first time parents. My lower back aches all the time,my fet swell and i cannot seen to handle the pain any longer.
Can you kinldy recomments any kind of excercises. or even breathing ones.
15. Nene | October 27th, 2010 at 5:52 am
Hi.. I’m 31 weeks pregnant and just foung out my baby is breech. Can you recomment any exercise that my partner and i can use to ease the pack pains and the tension as well. Where do i start looking for assistance for this… Can you recommend anyone?
16. Debra Flashenberg | November 8th, 2010 at 8:19 am
Hi Nene
Here are some poses and ideas to turn your baby:
Poses to help turn a breech baby:
• Prolonged inversion like downward dog
• “Butt up” child’s pose
• Supported bridge pose
• Right angle handstand at the wall ***advanced practitioners only
• AVOID squatting, as it opens the outlet of the pelvis and invites the baby to wedge itself deeper down.
Beyond these specific yoga poses, acupuncture has been known to help. Also, you can try placing ice at the fundus since the baby will likely move away from the cold. Or, place music or light down at the pelvic opening since babies will go toward sound and light.
Also- you may consider doing counterpressure on the lower back or using a hot water bottle to relieve your lower back pain.
You may also consider a prenatal massage. I like Laurie Dawson at 212 864 8641 or Anne Heckheimer at the Prenatal Massage Center at (917) 359-8176.
Good luck!!
Deb
17. Debra | March 29th, 2012 at 2:13 pm
I’m 38 weeks and my 4th baby has been breech since at least 35 weeks. I’ve tried acupuncture, moxabustion, even an external version two days ago at the hospital. My first three were wonderful vaginal deliveries and I’m just devastated at the thought of a C-section in 12 days. I plan to go swimming tonight because my friend, a yoga instructor, said doing somersaults in the water may help.
ANything you can suggest at this point or am I too far along?
My OB was surprised the version didn’t work bc baby’s butt isn’t that far down, I have lots of amniotic fluid, it’s my fourth baby and the baby is small.
HELP!!!
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