Nearing the last few weeks? Baby also knows that a journey has to be made soon and (s)he has started preparing for it.  Firstly, the baby flips over so that it's head down in your uterus. 

Then begins a slow but sure journey downwards, towards the birth canal.

The birth canal is made up of your cervix (immediately outside of your uterus), vagina and vulva. It’s like a tunnel that can stretch.

During labour, your contractions work to stretch this space so that the baby can pass through it during childbirth.

What are different foetal positions and how are they determined?

The Best Foetal Position for Normal Delivery is called the Occipito-Anterior position.

In this position, the baby is positioned head-down, facing the mother’s back with the chin tucked to its chest and the back of the head ready to enter the pelvis. This position is called cephalic presentation. Most babies settle into this position within the 32nd to 36th weeks of pregnancy.

This position is best because it allows for the smoothest delivery, as the baby's head can easily move down the birth canal and under the pubic bone during childbirth.

Sometimes the baby doesn’t get into the perfect position before birth. There are several positions that the baby can be in and each of these positions could come with complications during childbirth. These foetal positions can include:

Occiput or cephalic posterior position: In this, the baby is positioned head down as it should be, but it is facing your abdomen. With the head in this position, the baby’s eyes are directed towards looking at the back of your head. 

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Can your posture cause Occiput or cephalic posterior position?

Yes, how you sit can affect your uterus during pregnancy. It does not matter much till about Week 25, but post that, how to stand and sit can affect the position of the baby. In the 3rd trimester, as the baby moves down lower to your pelvis, your sitting position can affect it.

When you slouch, that is, lean forward while sitting, and your hips are in a rolled position, it can encourage the baby to enter the pelvis in a posterior position on their back. This is the occipito-posterior (OP) position. 

Why is this a problem? When the head is in the posterior position, its circumference measures larger than the anterior head circumference.

This could lead to a complication: because the head is bigger in this position, it is more likely to get stuck against the pubic bone. This leads to a longer and painful labour as there is pressure placed on the spine and sacrum.

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• Frank breech: In a frank breech, the baby's buttocks are the first body part to enter the birth canal. The hips are tensed, the knees extended (in front of the abdomen). This position increases the chance of forming an umbilical cord loop that could come before the head through your cervix.
• Complete breech: In this position, the baby is positioned with the buttocks first and both the hips and the knees are flexed (folded under themselves). Like other breech presentations, this position increases the risk of forming an umbilical cord loop that could precede the head through the cervix and injure the baby if delivered vaginally.
• Transverse lie: The baby lies crosswise in the uterus, making it likely that the shoulder will enter your pelvis first. Most babies in this position are delivered by caesarean section.
• Footling breech: In this position, one or both of the baby's feet are pointed down toward the birth canal. This increases the chances of the umbilical cord slipping down into the mouth of your uterus, cutting off blood supply to the baby. The doctor monitors closely and gets the baby out surgically in time.

What are some techniques to encourage the Occipito-Anterior position?

• Sitting with your hips higher than your knees. You could use an exercise ball for this.
• Breathing deep to lift your rib cage. 
• Brief Forward-Leaning Inversions, once a day.
• Anterior pelvic tilts with knees bent (work gradually up to where you can squat with your feet flat on the floor for 2-5 minutes).
• Holding your shoulders back, and pulling your chin back so your head is over your hips while you walk briskly.
• Talking to the baby and affirmations - Asking the baby and talking about moving the position after meditation. Yes, trust the power of the mum-baby bond.
• Yoga Asana - Setubandh asana can be performed with deep breathing.

1. Lie down on your back.
2. Bend both the knees and bring your feet near your hips.
3. Place your feet and palms flat on the ground.
4. Breathe in gently and lift the pelvic up.
5. Don't hold your breath in the position.
6. Stay there for 2-3 long deep breaths.
7. Come down slowly, breathing out and squeezing your inner thighs and hip.

Can your doctor change your baby’s foetal positioning?

Closer to your due date, your doctor will check on your baby’s position in the womb. If your baby hasn’t dropped into the best position for birth, your doctor might use a few techniques to gently guide them into place for vaginal birth.

Foetal version or changing baby’s position in the womb is most commonly done if:

• You’re about 36 to 42 weeks pregnant.
• Labour hasn’t started yet.
• Or, you’re in labour but your water has not yet broken.
• Your baby is swimming in plenty of amniotic fluid.
• Your baby isn’t touching the entrance to the birth canal.
• You’re having a single baby (not twins or other multiples).
• You’ve had a baby before (stomach muscles are — understandably — less tight).
• You’re delivering in a hospital — so you can be taken in for a C-section quickly if needed.

The medical name for the technique used to coax a baby into place inside the womb is called external cephalic version (ECV):

• external — because it’s mostly from the outside of your stomach
• cephalic — meaning into the head down position
• version — otherwise known as turning the baby

Your doctor will use gentle massaging and firm pressure to get your baby to move into the OA cephalic position. If it works, it can help you avoid having an unplanned caesarean delivery.

The ECV procedure

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• You might be given an injection of medicine that helps to relax your womb.
• You may be given a numbing (epidural) medication to keep you comfortable.
• Your heart rate and other vitals will be checked.
• Your doctor will make sure there’s plenty of fluid around your baby to make it easier for them to move.
• Your provider will use baby heart monitoring to make sure your baby’s heart rate stays normal during the procedure
• Foetal ultrasound can be used to see exactly where your baby is and if nudging is working to turn them
• Your doctor will massage and press on your stomach with both hands

Getting ready for labour is like one of those phone games and a number of factors have to align for it to begin and go on smoothly. Those factors are related to both mind and body.

Having a fear of labour is pretty common in women. But, it can be managed well with activities such as becoming well informed and learning about birth. attending antenatal classes. practising relaxation techniques, preparing a birth plan and practising meditation or yoga.

The iMumz Womb Care Program offers all of the above. We are just a call away.