I just got back from an amazing Spinning Babies Workshop and I’m eager to share what I’ve learned with my students, doula clients, and all of those Mamas out there preparing for birth.

In a nutshell: position matters— your position, baby’s position; in pregnancy and in labor.

“Optimal fetal positioning” has been a bit of a buzz term lately and I have even seen some debate on whether it matters, but let me tell you— it matters, much more than you think! In fact, it may be the single most important factor affecting the length, ease, and quality of your birthing experience.

Why, you ask? This is because two things need to happen for vaginal delivery: dilation (cervix opening from 0-10cm) AND baby’s descent through the pelvis. Relaxation techniques, breathing exercises, and a calm, confident mind will help you dilate… position will help baby descend.

There is so much focus on dilation when it comes to labor that baby’s position often gets lost in the shuffle and disregarded as a sign of labor progress. But the baby’s position in relation to the pelvis is JUST AS IMPORTANT (and maybe even more important!)— the medical term for this is “pelvic station”. Providers will refer to “engagement”, station, baby at -3, -2, -1, 0, +1, +2, and +3.

If baby is not engaged in the pelvis, does not rotate into position and descend, there will not be a vaginal birth… simple as that… and the labor process will likely be long, hard, and quite painful.

[If any of this sounds like gibberish— don’t worry, you’re not alone— find a good childbirth education class in your area; my recommendation is always HypnoBirthing, the Mongan Method.]

So, how does one optimize baby’s position for easier, quicker birth?

1. Start in pregnancy!

I advise my doula clients and HypnoBirthing students to carefully examine their lifestyle and daily routines and to consider how their daily life may be affecting the position of their baby, pelvis, and the muscles, ligaments and fascia that are involved in the birthing process.

Are you sitting in front of a computer for long periods of time? Do you wear high heels regularly? Do you have a regular yoga or stretching practice? Are you slouching on the couch each evening? These activities and positions greatly affect your baby’s position and have a significant impact on your birthing body.

The more you can do during your pregnancy— third trimester being the most important time— to bring balance, flexibility, and suppleness to your birthing body, the better you and your baby will be positioned for an easy birth.

Here are some practices you can start adhering to during your pregnancy:

KNEES BELOW HIPS: When sitting, strive to have your knees below your hips (this means avoiding those bucket seats, slouching on the couch, etc). A firm exercise ball is excellent for this. If your knees are below your hips, gravity will move baby forward into an optimal position (rather than toward your back, into a posterior position). You want to avoid sitting back on your sacrum; instead, sit forward, on those sitz bones.

PRENATAL YOGA: Find a local prenatal yoga class (if money and / or time is tight you can find classes online or buy a prenatal yoga DVD to practice at home). Ideally, you are practicing for 30 minutes each day, but even 2-3 times a week (or once a week) is going to be beneficial to baby, balancing the pelvis, and bringing flexibility and suppleness to the tissues of the pelvic floor.

WALK OR SWIM: Regular, gentle exercise is great to bring balance and flexibility to the body.

DAILY STRETCHES: Especially if you cannot find a regular prenatal yoga class, be sure that you are taking some time each day to balance out that pelvis (forward lunges, squats, butterfly, half bridge, happy baby, seated leg stretches, etc)— anything to keep that body supple!

FIND A CHIROPRACTOR: Ask around within your local community for a chiropractor who is good at working with pregnant women. Make a few appointments in the end of pregnancy to balance out those hips… this is a big one!
2. Bring Movement & Balance to Your Labor!

First, if you have not hired a doula, I strongly suggest you consider one. If you can find a doula who has trained with Spinning Babies, even better!! As a birth doula (having attended over 25 births) and having trained with a variety of organizations (DONA, HypnoBirthing, Gena Kirby Rebozo, etc.), I have to say that what I learned in the Spinning Babies Workshop was the most valuable and I know will have the biggest impact on my client’s birthing process. Thank you, Spinning Babies!

Okay… so you’re in labor (yippee!!)… what can you do to get that baby into the best position?

RELAX AND MOVE: As a firm believer in the practices of HypnoBirthing (the importance of relaxation during labor), it’s essential that you relax, bring your mind and body into a really calm, confident place so that your body can do what it’s designed to do… but don’t stay in one position for more than 20-30 minutes, as this can cause the baby to get wedged into the pelvis or remain in a less than optimal position, stalling your labor pattern and/or leading to a very long second stage (the “pushing” stage).

USE THE BIRTHING BALL: Most hospitals and birthing centers have birthing balls (ask ahead of time and bring your own if they don’t). Make sure the ball is pumped up to capacity (so that your knees are below your hips) and spend some time on that ball during labor. Roll your hips in nice wide circles while sitting on the ball.

DANCE: There’s something in Spinning Babies called “dip the hip”, which your doula can teach you, but basically… any dancing movement that really involves the hips (think super active salsa) is going to be great to help baby move into the optimal position. Have you seen those YouTube videos of women really getting down while in labor? Strive for that! Not only will it be fun and lighten the mood of labor, it will be great for baby and will likely lead to an easier, quicker delivery.

BALANCE: Whatever you do one side, be sure to balance by doing the same on the other side! For example, if you’re comfortable lying on your left side, be sure balance that out by then lying your right side for the same amount of time— but no longer than 20-30 minutes (note: whenever you’re lying down during labor be sure to open those hips with a peanut ball wedged between the knees or a stack of pillows— and get the foot of that top leg BELOW the knee).

There is much more to share, but for fear of overwhelming you, I am cutting myself off here. Please don’t hesitate to reach out to me with questions— as I’m always happy to connect and share the wealth! And if you live in the greater Boston area (north Shore, sea coast New Hampshire) and don’t have a doula… let’s talk!

Check out www.spinningbabies.com for more detailed positions and information related to what you can do during pregnancy and during labor to ensure optimal fetal positioning.

Ellie Lindenmayer is the owner of Joyful Birthing offering doula support to Boston, its North shore, and seacoast New Hampshire.