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Episode 155 Content and Overview

Your baby’s position in the womb seems simple on the surface. You want your baby head down in the third trimester and you are good to go, right? It is a bit more complex than that, and while baby position can be confusing, this episode simplifies how to understand your baby’s position. After listening to this episode, you will know what it means when your doctor or midwife says your baby is LOA. More importantly, you will know exactly what your baby’s position means for you and your baby in birth.

Included in This Episode

• Your baby’s presentation
  • Cephalic: head down
    • Vertex: the most common, crown (or the top) of your baby’s head is down
    • Sinciput: forehead down, can also be the brow, face, or chin
  • Breech: buttocks down
    • Complete breech: buttocks down with legs crossed
    • Frank breech: buttocks down with their legs straight, as if they were bent in half, or in a pike position
    • Incomplete breech: a combination of the different positions, or a footling breech where one foot is down and one is up
  • Transverse: sideways, their behind is on one side of your belly, with their head at the other
  • Compound or complex presentation: a limb is presenting with another part, most commonly a hand or arm along with the baby’s head
• Breech and cesarean birth
• Breech Baby & External Cephalic Version
• 3 different ways your baby can be facing
  • Anterior: their back is against the outside of your belly, facing your spine
  • Posterior: their back is against your spine, facing your belly
  • Transverse: facing directly left or right, for example if your baby is facing directly right, then their back would be facing left
• Occiput: refers to the back of your baby’s head
  • For breech presentations instead of occiput we use sacrum, which refers to the bone at the base of the spine
  • For shoulder presentations we use dorso, which refers to the scapula (shoulder blade)
• Occiput Anterior: the back of their head is directly to your belly button, like they are looking directly to your spine. This would be 12:00, so the hour of the clock is aligned with the back of your baby’s head.

The 6 positions:

• (ROA) Right Occiput Anterior: the back of their head is against your belly, and the back of their head is to the right of your belly button, you can think of this as 1:30 on a clock.
• (ROT) Right Occiput Transverse: the back of their head is directly facing the right side of your belly, this would be 3:00

• (ROP) Right Occiput Posterior: the back of their head is against your spine, and the back of their head is to the right of your spine, this would be about 4:30

• (OP) Occiput Posterior: the back of their head is directly to your spine, 6:00

• (LOP) Left Occiput Posterior: the back of their head is against your spine, but is facing to the left of your spine, this would be about 7:30

• (LOT) Left Occiput Transverse: the back of their head is directly facing the left side of your belly, this would be like 9:00

• (LOA) Left Occiput Anterior: the back of their head is against your belly, facing the left of your belly button, this would be 10:30 on a clock

• How to tell what position your baby is in
• Challenges to finding your baby’s position
• The position of your baby’s head and neck:
  • Flexion/Flexed: head is tucked to heir chest
  • Extension/Extended: head is looking up
  • Neutral or military: head is straight forward, not flexed or extended
• The ideal position
• Effect of fetal position on second-stage duration and labor outcome
• Association between fetal position at onset of labor and mode of delivery: a prospective cohort study
• The evolution of fetal presentation during pregnancy: a retrospective, descriptive cross‐sectional study
• Changes in fetal position during labor and their association with epidural analgesia
• Manual rotation of the fetal occiput: Predictors of success and delivery
• The fetal occiput posterior position: state of the science and a new perspective
• Twins
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