Optimum birthing positioning; movements to help!
As you come towards the end of your pregnancy, there's a lot less space for baby to move around and position itself for birth. This means it can sometimes be tricky for baby to get itself into what is known as the optimum foetal position; the ideal position for baby to make an easier entrance into the world (making for a much smoother labor for you Mama!). The good news is that there are lots of very simple, gentle pelvic movements that we can do to encourage and facilitate optimum foetal positioning!
Ideally, we want to encourage baby to get in to a head down and what is known as an occipito anterior (OA) position, which gives the best chance of an intervention free labor and birth (Sutton and Scott 1996*). In this position, the baby's back would be towards the front of your abdomen and the front of the baby's skull would be facing your back ('front to back'). This position helps baby to flex it's head so that the smallest part emerges first, making a much smoother exit (and less pain for you Mama)!
Often, due to pregnancy posture and the lack of space available at the front of your belly and pelvis, baby will get itself into a head down but posterior presentation (the occipito posterior position). In this position, the baby's back would be towards the back of your abdomen ('back to back'). Baby can find it e difult to flex it's head in this position and the wider part of it's head has to pass through the pelvis first, potentially making delivery prolonged and more difficult (often with instrumental intervention to help get baby out safely).
If your baby is not positioned head down, it may be breech (when baby decides to present bottom or legs first!) or transverse (when baby is lying in a sideways position!). Both of these positions add complications to labor and often a caesarean section is recommended for a safe delivery of your baby. If your baby is breech or transverse, take your doctor/midwife's specific advice on how to help turn them into the head down position. Kneeling up and the four-point kneeling position (and gentle pelvic movements in these positions) as well as walking every day can, potentially, help the baby to turn head down. It's also advisable to avoid any squatting after 35 weeks, so that you don't encourage baby to engage in a breech/transverse position.
It's important to note that most babies that are positioned (head down) posteriorly will rotate naturally into the anterior position during the first stage of labor. But there are certain positions and movements that you can practice (in the last few weeks of your pregnancy) that can help encourage baby to turn. These positions/movements help by creating the best angles and dimensions of the pelvis and, combined with the weight of the baby and gravity, can encourage the baby's head to descend and rotate. Here's our top movements/positions:
1. Anterior Pelvic tucks on the fitness ball - sitting tall on the ball with your feet hip width (or wider) apart and your hands on your hips, breathe in to prepare, breathe out to tuck/roll the pelvis underneath you (this is an anterior tilt of the pelvis) and breathe in to release back to a neutral pelvis (sitting right on top of your sitting bones).
2. Pelvic circles on the fitness ball - sitting tall on the ball with your feet hip width (or wider) apart and your hands on your hips, circle your hips around in a clockwise direction (moving through as full a range of movement as feels comfortable for you hips and lower back). Take 6-8 circles in a clockwise direction and then reverse for 6-8 circles in an anti-clockwise direction.
3. Four-Point kneeling position - take your knees underneath your hip joints, your hands underneath your shoulder joints and lengthen your spine. Gently draw (or 'hug') your baby bump up towards your spine to help you activate the deep abdominals of the core and stabilise your position. To find a neutral pelvic position, imagine you have lights on the ends of your sitting bones and shine the lights directly behind you! Try not to allow your lower back to over arch (drawing /hugging bump up towards your spine can help prevent this). Breathe deeply in this position, feeling your sit bones 'open' and widen with each out-breadth (imagining baby moving downwards and out as your pelvis widens).
4. Anterior pelvic tucks in a four-point-kneeling position - in the same (above) position, breathe in to prepare and, as you breathe out, tuck/roll the pelvis underneath you (this is an anterior tilt of the pelvis - imagine you are moving your pubic bone towards your belly button) and breathe in to release back to a neutral pelvis. Repeat x8-10 repetitions. If it feels good for your back, you could then take 8-10 reps of a full cat/cow stretch - rolling the pelvis underneath you and curving the whole spine and then tilting the pelvis in the opposite direction (this is a posterior tilt - imagine you are shining your tailbone lights up towards the ceiling) and gently arching the whole spine (look up and shine your breastbone forwards). Keep the cow stretch very gentle - don't over arch your lower back and you shouldn't feel any pulling in you bump.
5. Four-point kneeling to child's pose - Beginning in the four-point-kneeling position (as above) but with your knees even wider than hip width. then sit back onto your heels, stretching your arms out and feeling length through your spine. Breathe in to gently pull yourself forwards back into the four-point-kneeling position and breathe out to sit back into the child's pose position, feeling your sit bones open and widen every time you sit back into child's pose. Move slowly and smoothly. Take 8-10 repetitions of this movement and then stay in the child's pose for several slow breadths, feeling your sit bones open wide and allowing your pelvic floor muscles to fully release, imagining baby moving downwards and out.
6. Squats - Take your feet wider than hip width (or as wide as you need to accommodate bump and feel comfortable in your hips when you squat) have your feet either pointing forward (parallel legs) or slightly turned out if this feels better for your hips. Breathe in and, keeping the weight in your heels, squat down as low as you feel comfortable and only as far as you can keep your heels down and maintain a still and stable torso. Breathe out to stretch the legs and return to standing. You can use your arms (stretching them forwards as you squat) or leave your hands on your hips and hold onto the back of a chair or a surface if you're struggling to keep your balance as you squat. Please note that we do not recommend squats if you are suffering with any kind of pelvic girdle pain or if you are 35 weeks or more pregnant and your baby is in the breech or transverse position (as you are encouraging baby to engage in these positions).
Other general movement advice
In addition to the above exercises, any gentle stretches that you can do for your lower back and hips as well as walking every day can also help. Walking briskly with a full range of motion can help gently stretch and lengthen the muscles of the lower back, pelvis, hips and legs, lengthening tight muscles in your body (often caused by pregnancy posture) and making space for baby to move into an optimum birthing position.
Follow us on Instagram @WellMomMovement or Facebook @TheWellMomMovement for further tips on pregnancy & postpartum fitness and wellness!
References
*(Sutton J & Scott) P (1996) Optimum Foetal Positioning Bay Print Ltd New Zealand
Ideally, we want to encourage baby to get in to a head down and what is known as an occipito anterior (OA) position, which gives the best chance of an intervention free labor and birth (Sutton and Scott 1996*). In this position, the baby's back would be towards the front of your abdomen and the front of the baby's skull would be facing your back ('front to back'). This position helps baby to flex it's head so that the smallest part emerges first, making a much smoother exit (and less pain for you Mama)!
Often, due to pregnancy posture and the lack of space available at the front of your belly and pelvis, baby will get itself into a head down but posterior presentation (the occipito posterior position). In this position, the baby's back would be towards the back of your abdomen ('back to back'). Baby can find it e difult to flex it's head in this position and the wider part of it's head has to pass through the pelvis first, potentially making delivery prolonged and more difficult (often with instrumental intervention to help get baby out safely).
If your baby is not positioned head down, it may be breech (when baby decides to present bottom or legs first!) or transverse (when baby is lying in a sideways position!). Both of these positions add complications to labor and often a caesarean section is recommended for a safe delivery of your baby. If your baby is breech or transverse, take your doctor/midwife's specific advice on how to help turn them into the head down position. Kneeling up and the four-point kneeling position (and gentle pelvic movements in these positions) as well as walking every day can, potentially, help the baby to turn head down. It's also advisable to avoid any squatting after 35 weeks, so that you don't encourage baby to engage in a breech/transverse position.
It's important to note that most babies that are positioned (head down) posteriorly will rotate naturally into the anterior position during the first stage of labor. But there are certain positions and movements that you can practice (in the last few weeks of your pregnancy) that can help encourage baby to turn. These positions/movements help by creating the best angles and dimensions of the pelvis and, combined with the weight of the baby and gravity, can encourage the baby's head to descend and rotate. Here's our top movements/positions:
1. Anterior Pelvic tucks on the fitness ball - sitting tall on the ball with your feet hip width (or wider) apart and your hands on your hips, breathe in to prepare, breathe out to tuck/roll the pelvis underneath you (this is an anterior tilt of the pelvis) and breathe in to release back to a neutral pelvis (sitting right on top of your sitting bones).
2. Pelvic circles on the fitness ball - sitting tall on the ball with your feet hip width (or wider) apart and your hands on your hips, circle your hips around in a clockwise direction (moving through as full a range of movement as feels comfortable for you hips and lower back). Take 6-8 circles in a clockwise direction and then reverse for 6-8 circles in an anti-clockwise direction.
3. Four-Point kneeling position - take your knees underneath your hip joints, your hands underneath your shoulder joints and lengthen your spine. Gently draw (or 'hug') your baby bump up towards your spine to help you activate the deep abdominals of the core and stabilise your position. To find a neutral pelvic position, imagine you have lights on the ends of your sitting bones and shine the lights directly behind you! Try not to allow your lower back to over arch (drawing /hugging bump up towards your spine can help prevent this). Breathe deeply in this position, feeling your sit bones 'open' and widen with each out-breadth (imagining baby moving downwards and out as your pelvis widens).
4. Anterior pelvic tucks in a four-point-kneeling position - in the same (above) position, breathe in to prepare and, as you breathe out, tuck/roll the pelvis underneath you (this is an anterior tilt of the pelvis - imagine you are moving your pubic bone towards your belly button) and breathe in to release back to a neutral pelvis. Repeat x8-10 repetitions. If it feels good for your back, you could then take 8-10 reps of a full cat/cow stretch - rolling the pelvis underneath you and curving the whole spine and then tilting the pelvis in the opposite direction (this is a posterior tilt - imagine you are shining your tailbone lights up towards the ceiling) and gently arching the whole spine (look up and shine your breastbone forwards). Keep the cow stretch very gentle - don't over arch your lower back and you shouldn't feel any pulling in you bump.
5. Four-point kneeling to child's pose - Beginning in the four-point-kneeling position (as above) but with your knees even wider than hip width. then sit back onto your heels, stretching your arms out and feeling length through your spine. Breathe in to gently pull yourself forwards back into the four-point-kneeling position and breathe out to sit back into the child's pose position, feeling your sit bones open and widen every time you sit back into child's pose. Move slowly and smoothly. Take 8-10 repetitions of this movement and then stay in the child's pose for several slow breadths, feeling your sit bones open wide and allowing your pelvic floor muscles to fully release, imagining baby moving downwards and out.
6. Squats - Take your feet wider than hip width (or as wide as you need to accommodate bump and feel comfortable in your hips when you squat) have your feet either pointing forward (parallel legs) or slightly turned out if this feels better for your hips. Breathe in and, keeping the weight in your heels, squat down as low as you feel comfortable and only as far as you can keep your heels down and maintain a still and stable torso. Breathe out to stretch the legs and return to standing. You can use your arms (stretching them forwards as you squat) or leave your hands on your hips and hold onto the back of a chair or a surface if you're struggling to keep your balance as you squat. Please note that we do not recommend squats if you are suffering with any kind of pelvic girdle pain or if you are 35 weeks or more pregnant and your baby is in the breech or transverse position (as you are encouraging baby to engage in these positions).
Other general movement advice
In addition to the above exercises, any gentle stretches that you can do for your lower back and hips as well as walking every day can also help. Walking briskly with a full range of motion can help gently stretch and lengthen the muscles of the lower back, pelvis, hips and legs, lengthening tight muscles in your body (often caused by pregnancy posture) and making space for baby to move into an optimum birthing position.
Follow us on Instagram @WellMomMovement or Facebook @TheWellMomMovement for further tips on pregnancy & postpartum fitness and wellness!
References
*(Sutton J & Scott) P (1996) Optimum Foetal Positioning Bay Print Ltd New Zealand
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