Posterior position, also known as “sunny side up” or “OP” for occiput posterior baby positioning, occurs when your baby is head down in the womb with the back of their skull and their spine toward your back. Read on to learn more about posterior baby positioning and what you can do if it’s something you’d like to avoid.
The Posterior Baby
Posterior babies, who hang out with their face toward the front of your body and the base of their skull toward your back, are more likely to take a long time to be born. From this position it can be harder for baby to move down into the pelvis and put pressure on the cervix to dilate, and baby’s chin is less likely to be tucked, which makes for a larger part of their head that must make its way through your cervix and vagina.
Here are a few things that might suggest that your baby is posterior:
- You have a lot of low back pain or pressure.
- You feel fingers low in your pelvis and in the front.
- You feel baby kick nearer the middle of your belly than to one side or the other.
- Your belly looks slightly flattened out through the middle, rather than rounded.
- During labor, your contractions start and stop and/or you have what’s called back labor, where much of the pain and pressure you experience is in your back.
What can I do about a posterior baby?
First, don’t worry. Plenty of people birth posterior babies vaginally every day. Even if baby starts in the posterior position, they are likely to rotate to have their back toward your front by the pushing phase of labor. Plus, with modern medicine, if you need interventions to bring baby safely into the world, you will likely have access to them.
Second, check out Spinning Babies, which is a website with a wealth of information about optimal fetal positioning. This resource offers tons of things to try during your pregnancy and during labor to get baby into the best position to be born with the greatest ease for both of you.
If you know that your baby is posterior, start with your own posture. Leaning back and relaxing into the couch can encourage baby’s heavy backside to settle toward your back. Do your best to sit relatively straight—you can do this in a supported way with lots of creativity and pillows—with your knees below your hips. Sitting on a big yoga ball can be good, too.
There are also some things that are fairly straightforward to do at home and can help baby turn their body. The first is two yoga postures strung together, often called cat-cow. Start on all fours with your hands about as wide as your shoulders and your knees about as wide as your hips. Inhale and lengthen through your spine. Exhale and draw your baby to your spine as you round your back like a turtle. Repeat on each inhale and exhale for however long it works in your body. This movement of the hips may combine with the force of gravity exerted by leaning forward to help baby’s back rotate toward your front. Another thing to do is to try to rest and sleep with your belly down or sideways and down, with pillows around you for support. It might feel good to have a pillow under one bent knee, one behind your back, and one under your head.
In labor, there are a number of things to try to get a posterior baby to engage in the pelvis. Side lunges that open the hips while leaning slightly forward could help baby turn. On the Spinning Babies site, you can check out the section on open-knee chest position, which is a little bit like being on all fours, but with your arms stretched out along to floor to make a downward slope from your hips to your shoulders to your head. Other types of inversions, positions in which your head is lower than your heart, might also help a posterior baby turn. Interestingly, pain medication like epidural anesthesia might help baby turn and engage in the pelvis because you are likely to be more relaxed if you are experiencing less pain, which could give baby more room to turn.