Optimal Fetal Positioning - Part 1

There are good positions and there are not so good positions. A smooth labor and delivery depends highly on the baby being in a good position. A pregnant woman can affect and change the position of her baby with normal everyday posture and few simple daily exercises. This is really something to pay attention to, as I know I want the best birthing I can possibly have.

I think I'll write this in a three part series, considering there is so much information on the subject. In part one, I'll go over the different positions, which is best and why. Part two will address how to figure out what position your baby is in (you don't need an ultrasound to tell you!), and Part three will be how baby gets to the proper position in the first place, what YOU do everyday to affect baby's position, and how to move your baby, if need be.

But first, my disclaimer: I'm just a normal person with a desire to have the best birth possible. The information I want to share is based on my research, largely found at www.spinningbabies.com.

Part 1 - What is Optimal Fetal Positioning (OFP)?

The best fetal position for birthing is Left Occiput Anterior (LOA), or Left Occiput Transverse (LOT). This basically means that the baby is on the mother's left side, head down, and is either facing the mother's back or facing the mother's hip. Having an LOA baby allows for an easier birthing than other positions because the baby's head is usually tucked to fit easier through the pelvis and birth canal, the baby's back curves most effectively in this position, allowing the baby to slide down easily, and LOA makes engagement (settling deep into the pelvis) likely, which is what starts labor. The difference between an LOA and an ROA (Right Occiput Anterior) baby is that the uterus naturally tilts to the right, and a baby sitting ROA is more likely to go posterior due to gravity. So, a baby who is on the right needs to turn 180 degrees to get into birthing position, while a baby on the left only has to turn 90 degrees. Turning the 90 degrees from the left side is much more easily done, working with contractions, gravity, and the shape of the uterus and pelvis.

Left Occiput Posterior (LOP) or Right Occiput Posterior (ROP) means that the baby is sitting on the mother's left or right side, with his back to your back. LOP or ROP babies have a hard time engaging in the pelvis because their chin usually does not tuck (because of the shape of the uterus), thus not presenting the smallest part of the head first. This prevents the baby from dropping and engaging the cervix, which could delay spontaneous labor. Baby's back against the mom's back also causes back labor as the baby is not "pointing" in the right direction and all the force of the contractions are going into the mom's back.

We all know what breech means - the baby's head is up. Although, in modern days, this is an automatic C-section, an experienced midwife could deliver a breech baby. Although difficult, there are ways to turn a breech, which will be Part 3.

There is also transverse, which means the baby is laying horizontal. I don't think that even needs an explanation of why that is bad news!


A pregnant woman should really start being concerned with OFP six weeks before the due date. Before this time, the baby is still flipping and swimming around. After this time, the baby does not need to be totally still, but should spend a good majority of its time in the correct position. The bigger the baby becomes, the harder it will be to move, so being in the correct position about a month out from birth makes things easier.

There is an entire book on optimal fetal positioning, how to ensure your baby is in the correct position, and how to move your baby. I have not read it, but I heard it is really great. It is Sit Up and Take Notice by Pauline Scott.

I'll now start working on how to know your baby's position. Stay tuned for Part 2!