Please help me think/act positively about possible posterior positioning

[lilysma]

Can anyone help? I'm 40 weeks plus 5 today, went to see midwife yesterday and was told (for the first time) that DS may be in a posterior position (i.e. back to back) . She wasn't completely sure and said he could be lying with his spine down my right hand side, but from reading that doesn't seem to be good either! His head has been engaged for a couple of weeks now (he's baby no 2 so this surprised me).

I am planning for a home birth so obviously less than delighted with this news as I understand it is likely to be longer, more painful and more difficult for DS to emerge. Midwife's advice for responding to this was rather vague ('keep active' and 'go on all fours when you start labour') and I've been trying to read up online on ways to try to get DS to turn around. So far I'm quite confused by the info - I find the Spinning Babies website fairly baffling and it seems that you really need someone knowledgeable to help you do it. The homebirth.co.uk website recommends crawling around on your hands and knees for more than half an hour (just what I feel like doing right now ). My main confusion is whether he can turn if his head is engaged and whether I could actually make it worse! Any ideas? Also anyone know how likely it is that he just turns as I go into labour given that the head is engaged?

The midwife did a membrane sweep yesterday and I spent much of the night having Braxton Hicks but it didn't develop into anything. DS has never moved around so much though, so I wonder if he was trying to turn.

Sorry this was so long! Any thoughts or experiences muchly appreciated

[PlentyOfPubgardens]

Hi, my second was OP and I had a very easy home birth. I had a couple of days of niggly, back-achy not-quite-contractions but when things started properly it took around 4 hours and I didn't need any pain relief. Being on all fours definitely helped - I wiggled my hips from side to side during contractions which helped a lot too.

I don't think it was any more painful than my first but it was a slightly different sort of pain in a different place IYSWIM.

[lilysma]

Thanks, this is very reassuring! You hear so many horror stories...

[tigana]

I think second or subsequent babies can engage and 'dis-engage' more easily than 1st babies, so you may still be able to shift him about!.

All fours on floor while watching a tv programme and sway about a bit perhaps? I recommend cushions for your knees....

[Secondtimelucky]

I had a hideous OP first birth, but I think a lot of that was to do with not getting the right support, rather than the positioning. My midwife was horrid, and very dismissive of the back pain I had in the early stages (at one point even telling me I had a low pain threshold, the cheeky cow woman). I think that there was a good chance my second was OP or in some other malposition too (although it was never specifically checked, for various reasons), as the pain was in the same place and the early stages were similar. However, it was a homebirth, with a pool and a doula, and was a totally different experience. No pain relief except the water and about 10 hours start to finish (which might sound long to some people, but DD1 was a four day marathon). My memories of DD2's birth (now six weeks' old) are overwhelmingly positive.

Spinning Babies is really hard to navigate isn't it. I think the things you specifically want to look at are inversions and sifting. They are what my doula recommended, both before and during labour. I'm fairly sure it was a couple of really painful inversions in labour that finally budged DD2 into the right position to be born (painful, but it was sooo worth it, because she was born about an hour later and it felt totally different after she shifted).

So yes, I think OP births can be horror stories, but so can any other. I can't guarantee my second labour was OP, but I think it probably was and it was bloody brilliant!

[lilysma]

Thanks everyone.

Tigana, I tried leaning over birthing ball on all fours last night whilst watching TV for about half an hour, but it gave me a crick in the neck and made me feel sea sick! Will try just listening to music so not craning neck up at telly, but not sure how long I can keep it up .

Secondtimelucky did you do the inversions on your own or with doula? I haven't got a doula and it looks like you can get it wrong and make things worse unless you know what you're doing. Glad to hear your second labour wasn't so bad - I have a pool ready to go too - found it really helpful with DD's birth (which was a 3 day marathon! I was really hoping for a shorter innings this time...) Am regretting not getting a doula, but it's too late now .

Has anyone had any positive experiences of midwives being helpful re positioning? It seems wierd that they often seem so unhelpful...

[Secondtimelucky]

With my doula in labour, with DH or on my own (when I will still stable enough!) before. I think it's in labour where you have to be more careful. Beforehand there is a list of counterindications on the website, which are pretty specific, but obviously I'm not a professional.

Rebozo sifting is also great, and seems pretty hard to use incorrectly. That really helped in my labour and is something your partner can do to feel really useful. Just practice beforehand. My poor doula was doing it for hours and it's pretty tough on the old arm muscles!

The pool was bliss! I went from real levels of pain to "ooh, that was a contraction" and DD came within about 40 minutes of getting in. One great thing about a homebirth with a posterior baby is that water is great for back pain. In the hospital, they can say "nope, you can't get in the pool until you are 5cm" but at home, they can't really police you like that. I had in my birth plan that if I needed to use the pool for a bit of a rest, I would be doing so, even if I wasn't as far along as was normally recommended. You can then get out and stomp around again to keep things moving.

The midwives at DD1's birth gave no helpful advice on positioning, but they were useless generally. For DD2, I didn't actually meet the definition of active labour until my waters went about 35 minutes before the birth (my contractions were intense, but erratic), and the midwife only made it for the placenta and clean up.

[fraktious]

DS turned OP in labour apparently. Looking back I felt it because the pain shifted. All fours was helpful, as was walking and circling/swaying my hips.

I shifted him from transverse with the stuff on spinning babies so I'd say anything in there is worth a try.

[hollyw]

I find the spinning babies website a bit disorganised. My baby was back to back and on the right a few weeks ago . I scrubbed the floors and spent some time on my hands and knees arching and releasing my back (a bit like a cat) and made sure that I lay on my left side whenever I laid down. Baby is in a decent position now.

[fraktious]

Plus it's almost certainly not too late to get a doula, although you may have a trainee as they're likely to have greater availability and you won't have built up a relationship with them.

[lilysma]

Thanks so much everyone, this is really useful. It's encouraging that you found the water so helpful secondtime - one of the reasons I want a homebirth is exactly as you say - I can use the pool when and how I want to. I will try to understand the rebozo stuff and arching and releasing on all fours sounds easy enough! I have done loads of walking today so we'll see if that helps. Part of the problem is that I can't really work out for myself which way he's facing anyway - everything feels like a bum to me .

[GothMummy]

Oh gosh dont panic, I have had two OP babies, one home birth with gas and air and the second in MW led unit with water birth/gas and air. first birth was horrid and lasted a long time but the second was lovely and once labour was established, took 3 hours. Both mine turned at the very last minute and shot out, hardly any pushing stage. With both I had a few days of stop start labour which was really annoying and uncomfortable, the Midwives said that this was my body trying to turn the baby round.

good luck.

[DitaVonCheese]

Hey OP - I'm 40+4 with DC2 and also planning a home water birth. Had a MW appt on Weds and was also told that baby is "fixed" and had gone back to back, despite being in the perfect position (I think) up to now - though I think he may have turned by this morning, so far as I can tell with my inexpert prodding.

DD was also a b2b labour (and similarly had been well-positioned until then afaik), though I didn't know that until I arrived at hospital (failed home birth due to staffing problems on the night ) 7cm dilated. It was kind of fine - a bit of a shock but I suspect first time labour generally is. It was eight hours from start to finish (including 90 minutes pushing though not sure whether that took so long because of the fact she had to turn or because MW made me push on my back) and I managed on a combination of TENS + paracetamol, then in the bath for a bit, then an hour of G&A at hospital (wouldn't let me in the pool because my waters broke early :().

Obviously I don't have a lot to compare it to but I had a lot of back pain early on (had the TENS on for two days before labour kicked in properly!) and could only really deal with contractions while on all fours or hanging over the headboard of the bed but it certainly wasn't as spectacularly painful as a lot of accounts I've read so it doesn't have to be awful.

My lovely Lazy Daisy childbirth educator friend has suggested doing a daily inversion and the pelvic floor release from the spinningbabies website. All fours/sleeping on your left also good as means gravity will help the heaviest bit of your baby (back) to turn to the left/front. Avoid anything which involves leaning back, like slouching on the sofa typing as I am at present

Hope some of that is helpful/reassuring and good luck :)

[OhThisIsJustGrape]

My 3rd baby was back to back and I had a home birth. I had nearly a week of niggles and stop/start but when it eventually kicked off the whole labour was only 2hrs from start to finish.

It did hurt, I won't lie to you, and the pain was all in my back. However, I didn't have time to fill the pool and I had no pain relief as the midwife had no mouthpiece for the gas and air so, had I actually been given something to help the pain it wouldve been so much easier.

I also laboured and delivered on all fours, I spent most of it leaning over my birthing ball. Midwives had no idea DD was back to back until her head turned as it was being born. I then got lots of 'oh my goodness, you did well considering' comments from them, I got the feeling they thought I was making a lot of fuss about nothing during my labour

[lilysma]

Wow, thanks again for all these reassuring messages - it sounds like it isn't necessarily a sentence to doom and gloom and loads of interventions. Good luck with your birth Dita - hope it all works out well. It is hard to avoid slouching/leaning back when you're knackered and carrying around a beach ball in your abdomen though, isn't it?

Ohthisisjustgrapejuice I will be very if the midwives turn up without the ability to give me gas and air - can't believe that . And as for judgemental attitudes about 'making a fuss' - doesn't that make your blood boil?? . Why can't we just rely on them turning up, bringing the right stuff and being nice to us?? Is it really so much to ask?

Cheers again! Will keep you posted...

[BeautifulBirths]

Ok. Don't panic and don't worry. You can help turn baby. And/or when your contractions start they will help turn baby too. And/or s/he will be born back to back. Babies can come out that way. I have causght / delivered posterior babies in the water, all fours, standing etc. So.... your excersises to help

1. All fours positions. When playing with you little one go on all fours. Avoid sitting crossed legged. When reading put book on floor and go on all floors. Sweep floors with a dustpan rather then broom. Play chasing games with your little one on all fours. In the evening go on all fours and let hubby give you a massage.
   
2. Lie on left hand side. When watching tv lie on left side not slouched on back. Sleep on left side. Have a bath and turn on left side.
   
3. Avoid sitting with knees higher than hips. If your sofa dips put extra pillows or cushions so you are sitting up and knees are sloping down. Cushions on car seats so you are higher. No crossed leggs on floor or sitting with feet tucked under bottom.
   
4. Avoid lying on back or semi recumbant
   
5. If you do all these but a posterior position persists it may be useful to see an osteopath. Sometimes tight muscles in certain areas can hinder him turning. You need to make sure the practitioner is fully registered, regulated and specialises in pregnancy.
   

As I say you may find with contractions and these techniques baby turns in labour. My 3rd was ROP which is what your midwife has described and he turned in labour.

Even if he remains posterior stay calm and relaxed. Don't be fearful. Yes it can be longer and have backache but it may not. Believe in yourself.

Good luck. You can contact me on my facebook page facebook.com/beautifulbirths if I can help further.

[mamadoc]

I had my DS at a midwife led unit 4 weeks ago.(2nd child)
On getting there I was horrified to be told he was OP but the midwife was not fussed at all and thought he'd probably just turn in labour.
As it was he didn't turn and was born OP but I didn't need any pain relief or intervention at all and it was much easier than my 1st who was OA and half the size! I don't even really recall the pain being in my back particularly. I used the birthing ball, knelt/squatted and delivered him on a birthing stool.
So my experience is that being OP didn't make much difference and I'm glad I didn't find out before or I would have worried for no reason

[camdancer]

I've had 3 OP babies - all born at home, all turned during labour (DS wasn't OP before labour started, he just turned the wrong way.) With DD1, she got stuck on an anterior lip. I am convinced if I'd been in hospital it would hae ended in a c-section, but at home with 2 experienced midwives, they knew how to sort it out.

Keep changing positions - every 30 mins if possible. OP isn't necessarily a problem. All the best.

[lilysma]

Thanks so much for all this very helpful advice and reassurance - it really does help! I am very touched and grateful .

Had fairly proper contractions for about 4-5 hours in the night and the pain wasn't all in my back so am wondering if he's turned already. Now they have stopped . I'm wondering how many nights this is going to go on for . Even if he has turned I assume I should take all the advice anyway beautifulbirths?

Also had a show this morning so I guess it is all starting to happen. I didn't have all this start-stop business with DD so wonder if it is because he's trying to turn. Or maybe it is because of the sweep. Who knows...

[PipCarrier]

lilysma I was in exactly the same position as you a couple of months ago. DC2 was OP and I started to doubt my home birth plans. However, I decided to go for it and she turned during labour. I had a 90 min labour at home, it was amazing. It didn't hurt any more than my first DC who was OA. Hope that helps and good luck.

PS. The midwife arrived without gas and air for me too but you get through it!

[Firkytoodle]

I found this helpful.

DD was back to back all the way through and was born back to back. Labour was long (22 hours) and I was slow to dilate, but the pain was very manageable (can recommend TENS) and I entered hospital at 8cm. DD was born 5 hours later-pushing stage recorded at 3minutes. I walked and walked and walked with her and gave birth leaning over the back of a hospital bed, pains got agonising lying on my back. Birth ball helped too.

DS was back to back but turned just as he was born. Labour was long again (19 hours) and I had very irregular contractions which got stronger and more regular when I was upright. Walking didnt feel right and I didn't enter established labour until I lay on my left side for some reason and relaxed. I gave birth 30 minutes after a VE said I was 6cm dilated, but I couldnt fight the pushing urge. Contractions were manageable and then all of a sudden it felt like my pelvis was being ripped apart, but the pain completely disappeared when I pushed and once I pushed I didn't (couldn't!) stop. In retrospect I had an anterior lip and I automatically moved onto my back to deliver. According to a midwife friend anterior lips are more common in OP babies, no idea whether she is right or not though- I had one with DD too. DS was breathed out at home in about 5 minutes and it was an astonishing experience that I would do again tomorrow if I could.

Good luck and ignore as many of the horror stories as you can, OP labours can be different, but it doesnt make them all awful and much worse, I found the pain very manageable with both of mine.

[BeautifulBirths]

Yes, follow the advice anyway. It will keep him in a good position. It is likely the stop start is your body giving him a hand to turn into the right position. DOn't worry. Let the tightening happen. Relax and enjoy it if you can. Mobilise, sleep and rest (all at once! LOL!) Don't be disheartened i it all stops again. That's normal and gives your body time to rest. Good news is in my experience if you have a long latent phase (this stop start, irregular contractions phase) then the cerivx is nice and soft, already brought to the front and thinning so when established labour starts all that's left to do is dilate. SO shorted establised labour for you! Please don't worry yourself too much. Babe will either turn or be born. Look at all the testimonials you have been given. Good luck!!

[PelvicFloorOfSteel]

DS1 was OP, I'd done everything 'right' during pregnancy and labour, sat on ball, loads of all fours, kept active and no-one realised until he came out facing the wrong way.

When I was pregnant with DS2 I fully expected labour to hurt a lot less because he was the right way round, but in the end it was pretty much exactly the same pain wise. I didn't have any G&A to speak of though because the MW didn't turn up until just under an hour before DS2 was born (only 4 hours after we called - apparently I sounded too calm to be in labour!).

Keep doing all the things you can to help with positioning but don't panic, OP is doable if you have to.

[lilysma]

Thanks again everyone, all this reassurance and advice really does help!

Nothing at all happened last night and I got some sleep (apart from the hourly toilet visits ). I did seem to be leaking wee in the night (sorry if TMI!) whenever I turned over, and was worried it might be amniotic fluid, but it seems to have stopped now I'm up and moving about. So I guess I'm just incontinent too now . Great !

So I guess it is now back to the waiting game and will keep trying all the positioning stuff...

[Firkytoodle]

lilysma it might be worth having the fluid checked out just in case. Your waters might have broken but the baby's head might be stopping them from leaking out further when you are upright. When you are lying down the head sort of floats off the cervix enough to let more liquid out. If your baby is still OP its head will be in a different position on your cervix compared to an OA baby.

My waters just 'popped' and leaked very gently with both DC, but it was worse when I was lying down.