Natural Birth and Baby Care.com

Baby Position in the Womb

Baby position in the womb is important. How your baby is positioned, called his presentation, may influence your birth plans.

In some areas and with some midwives only vertex babies can be delivered at home. In some hospitals breech babies are considered for automatic cesarean section. Babies who are transverse cannot be delivered vaginally.

Your baby is also classified in two other ways: lie and pelvic position.

There are several methods to try and turn baby position around to a vertex position. There are a few recommended positions for you to sit in or to lie in for a certain period of time daily. There is also a procedure called external version.

Bottoms Up or Bottoms Down

Vertex: If your baby is head down and curled in the "fetal position," he is considered vertex. His head will be in your pelvis and his chin to his chest. This is considered the optimal position for birth. Most babies are in the vertex position when labor begins. Some will move to the vertex position during labor.

Breech: If your baby's bottom is down then your baby is breech. Many mothers worry if their baby is breech in the second trimester. But you really shouldn't worry as your baby has plenty of time to turn.

There are three types of breech positions:

• A complete breech baby is sitting "tailor style" or "Indian style," with both feet crossed. He is in the fetal position and his bottom is down in your pelvis. The baby illustrated is a complete breech.
• A frank (also called incomplete) breech baby is sitting with his legs crossed and fully flexed up to his shoulders. His bottom is in your pelvis.
• A footling breech baby has one of or both of his feet down. This is rare. Even more rarely he may have his knees down. His foot, feet, or knees are in your pelvis.

In some states it is illegal for midwives to assist with a breech delivery at home. Some midwives do not feel comfortable assisting in breech deliveries at home. If you are planning a home birth and your baby is breech, ask your midwife how much experience she has with breech babies. You will want to choose a skilled midwife. You may also want to have strong obstetric backup.

Many women move instinctively into good positions for birthing breech babies. Your body will probably know what it is doing. Squatting or hands-and-knees positions widen your pelvis and allow more room for your baby to come through. Most breech babies can be born vaginally.

You can read more about turning your breech babe.

Lying Around

There are three different ways a baby can "lie" in the womb. The lie is judged by the baby position in relation to your pelvis.

Your baby is longitudinal if his body is straight up and down from your pelvis (your baby could be either breech or vertex).

This is the position you'll probably be able to feel your baby in. Ask your care provider how to feel out your baby's position and presentation.

Your baby is oblique if her body is situated at an angle. Her head will be more against one side of your pelvis and her shoulder will be towards the birth canal.

Babies in an oblique lie will turn to one of the other positions for delivery.

Finally, your baby could be transverse which means he is laying completely side-to-side over your pelvis. A transverse baby cannot be delivered naturally.

If your baby is transverse, he may be able to be turned to ensure a natural delivery. According to Ina May Gaskin in Spiritual Midwifery (read my review), 99% of babies are longitudinal at term.

About Face!

Your baby is also classified by what direction she is facing in relation to your front and back. There are actually eight different classifications for baby position in relation to your front and back.

Anterior and posterior are the basic positions.

Your baby is anterior if he is facing your back. So your baby's spine is curled along the front of your belly and his face is towards your spine. Your baby is "anterior" if his spine is straight up against your belly. If baby position is turned slightly to your right, he is "right anterior;" if he is turned slightly to your left, then he is "left anterior."

Anterior is the favored baby position. It allows the baby to most easy maneuver through your pelvis and out into the world.

If your baby is facing your front, she is posterior. Her spine will be along your spine and her face towards your front. If your baby is turned slightly to your right then your baby is "right posterior." If baby position is slightly to your left then she is "left posterior."

If you baby is facing directly to your right, then he is "right transverse." If he's facing directly to your left, then he is "left transverse."

You may be interested to know these positions, but your care provider may only mention them if your baby is in one of the posterior positions. Posterior babies are the ones who can create "back labor." Back labor is a backache during labor. It is often relived by very hard counter-pressure of the spot where the backache is felt. Most posterior babies will turn during labor, but a very few will be born face up - called "sunny side up!"

If the baby position is persistently posterior, avoid sitting back in chairs. Try to adjust yourself so that your belly is hanging in front of you, or lay on your side leaning slightly forward. This will encourage your baby to flip with his spine to the front.

All artwork is courtesy of Curtis Hart