back-to-back / oblique position - making me terrified about labour

[katster37]

Hi,

I am 34+2 with DC1. Had MW appointment yesterday and apparently baby is slightly oblique, to the right hand side and back to back. So in quite a strange position. He has started to engage, but at a v odd angle. I have googled (silly me) and everything seems to suggest I will have a blo*dy awful labour, definitely need an epidural (which I reeeeally wanted to avoid - was hoping for waterbirth/gas and air) and prob end up with ventouse/forceps and a massive episiotomy. I am now v anxious, even more than before. I know there is time for him to move, and I have been on the birthing ball / on all fours etc but just wondering if anyone has any other advice, or birth stories when their baby was in a similar position? Please help! Thank you.

DD1 was back to back and yes it was awful but that was mostly because I didn't know anything about it until afterwards. DD2 ket going back to back too but the Optimal Foetal Positioning stuff that I did really worked and she popped out very easily at home with just a whiff of G&A.

Most important is your position during labour. Stay off your back and keep active and you've got a very good chance that he/she will turn round to a good position.

Agree with moosy.Mine started off like that. Keeping mobile is vital - so don't be bulldozed into thinking you 'must' have an epidural for back to back. You don't - you'll just end up immobile and with more likelihood of an instrumental delivery.

I've had two back-to-back babies. DD2 surprised us all by coming out 'sunny side up' - the labour wasn't particularly bad. In fact, she was my quickest birth. I didn't have an epidural.

DS was back-to-back until the last minute but turned during labour. Completely unmedicated birth (if a bit long).

The midwife had me going up and down stairs two at a time - lunging and squatting a lot which definitely seemed to bring him into position.

Hope that's some positive news! As the others have said, an active delivery is very important. Personally I'd be fighting against an epidural because that would immobilise you.

Please don't worry - you've got a lot of time for your baby to turn and even if he does it, it might not be that bad.

Thanks everyone for your replies. It's really good to hear stories where the position didn't hugely adversely affect the labour, and I will definitely try and keep as active as poss during labour. Moosy by Optimal Foetal POsitioning stuff, do you mean the keeping mobile and things like being on a birthing ball? Will look into it. Thanks all for replying.

Optimal Foetal Positioning is literally getting the baby into the optimal position () but it is more than just keeping mobile/birthing ball. There is a good small book about it around. Can't remember who wrote it but it's actually called "Optimal Foetal Positioning" and I think it's out of print so try ebay, etc.

It gives lots of information and exercises explaining how to use your body to encourage your baby to engage properly and position itself optimally for delivery. So it's much more than "just" keeping mobile and so on, well worth doing some Googling rather than Googling what could go wrong!

Hope this helps

Epidural. But that is just my humble opinion after a complicated back to back loabour and delivery.

If you can keep active etc please do but Please make sure you have a good back up birth plan in place if things become too much. Trust your instincts.

Optimal Foetal Positioning info is available online, think you can google it and print off.
I spent the last 6 weeks of my pregnancy trying to turn my breech baby using OFP, moxibustion etc. Had a succesful ECV in the end so, hurrah, DS was head first and was allowed to go ahead with planned home birth. He was in a strange position though, kind of side-on back to back so ended up with a v long labour (76 hours)and transferred to hospital at the end as I was really tired and no longer coping very well. I did ask for an epidural but was ready to push by the time we got there so was too late.
It was tough going at times but the following things kept me going: using hypnobirthing relaxation and breathing techniques, would recommend to anyone, great even just for something else to focus on; good support from lovely midwife, my sister & DH (very important to have people tell you you CAN do it when you don't believe you can); and, as I was also desperate to avoid an episiotomy if at all possible... perineal massage. It's a bit rank but it gave me the confidence to say no when the hospital midwife wanted to do one. I just felt sure I wouldn't tear as I been preparing the, ahem, area and in the end got away with a tiny 2cm nowhere near the perineum.
If I was to have another back to back labour I think I'd stay at home again. Gas and air is great stuff, tens machines are good too, I even had the odd glass of wine in the bath during my marathon labour! The main thing is to be as relaxed as possible- I'm not being glib, I'm a really anxious person usually so I know it's eaier said than done. It does help greatly though.
Your baby may well settle into a better position before birth but even if not, I would't say I had a bad birth exerience, just a drawn out one!
You can never predict how it's going to go, just improve your chances of having a good experience by having good support etc.
Best of luck, I'm sure you'll be fine.

Katster, just google "Optimal Foetal Positioning" and you'll find loads of useful stuff, it's mostly rules to stick to, like not leaning back in your chair, lying on your left, things like that.

My main problem with DD1 is that I was naive and did as I was told by the midwives in hospital, so when they said 'lie on your back for this bit' I did, when I should've said 'no, I don't want to' and refused. That might've saved us all an awful lot of bother in the long run! Remember that you're in charge of your birth, the MW's are there to help you not instruct you.

Good luck and let us know how it goes. I shall be starting to stick to the rules soon too as I'm 32 weeks with DC3 and she's back to back at the moment - [sigh]

At 34 weeks please don't get anxious about the position of your baby (and DON'T google), he/she still has plenty of room to lie in odd positions. It is not until about 36+ weeks that your baby will start to get into a stable birth position, but you can do a lot up to then to ensure your baby gets into, and stays, in the optimal position: birth ball, not 'reclining' on seats, walking, hip rocking, etc.

And even if you do enter labour with an OP (back-to-back) baby, using upright positions or positions that specifically encourage baby to rotate round, means that babies do go on to be born OA (back uppermost). Hard work...but it can, and is, done.

And Jean Sutton is the OFP guru.

ds2 8 weeks old was back 2 back for most of labour and turneed at last minuite, it was allot less painful actually than ds1 birth and it only took gas and air to help me through! all i will say though is that you should walk around and use birthing ball as much as possible and try your best to stay off your back as i KNOW thats what speeded things up and made things easier for me! you dont HAVE to have an epidural either so if they try to persuade you its your choice!

Hi,

I had this (sort of - DD was facing sideways) and didn't have a great labour. It ended with Synotcin to speed things up, then forceps when DD became distressed as soon as I began to push. However, I hope I might have a couple of tips for things I wish I had done.

Firstly, think about ways to cope with the pain before you get to the point that they'll let you in the water. Like you I wanted a waterbirth and I hadn't really prepared for this as much as I should have, and for me this bit was long. Think about hot showers, massage, etc.

Secondly, and this is a bit controversial, think about getting your husband/partner to sleep as much as possible in the early stages. From what I understand, these labours do tend to be longer, and he (or she) will be much more use to you properly rested.

Three, and related to two, do not underestimate how compliant you become when tired. I had missed two nights' sleep by the time I got to the hospital and simply was not capable of pushing for many of the things I should have been - including for a midwive who was supportive and didn't basically wander off and leave me for six hours. When we go for number two, I plan on writing a birth plan for my husband, including things like circumstances when I would like him to kick up a fuss about the midwife's attitude, what I would like him to do if they try and get a trace 'just for half an hour'.

Finally, if I did it again I would strongly resist the monitoring that they kept wanting to do 'just for half an hour'. My pain was all in my back and upright I could cope. Lying down I was in agony from quite early on. I think I used up valuable reserves meekly lying down to be monitored when I was told 'we need to check that baby's ok'. Next time I'll tell them to get the handheld monitor out and put some effort it, not slope off for tea and a gossip at the nursing station (sorry, did I say I didn't like my midwife?)

Sorry, bit bleak, but I'd like to think I could help someone out there have a bit of a better time.

Oh, sorry, a p.s. If it doesn't go to plan, be kind to yourself. You didn't fail.

Hi,

agree with everyone, you have loads of time to get baby to turn - in fact at this point s/he's probably turning round a fair bit anyway.

Have just found this spinning babies website that has lots of ideas for pregnancy and labour. Thought it might be useful

Hi Katster,

I had a back-to-back labour with DS1. My waters broke with a gush at 6.40pm, no contractions or pain of any kind. I got in the bath thinking I had ages to go yet. My DP called the maternity unit who said to come in for 8pm. About 10 minutes later the contractions started so I got out the bath and put on the tens. They got quite intense quite quickly and were coming 4/5mins apart. We got in the car and drove to the hospital. During the car journey I remember thinking 'if this is the easy bit of labour then I am a bloody wimp'.

By the time we got to the hospital 10 minutes later I was in agony. I was panicking a bit as we were shown to a bed in Triage and left alone. I had to really kick up a fuss and, er, swear a bit to get a midwife to come and check me.... thank goodness I did though as it turned out I was 7cm dilated! I was taken straight away to the birthing pool room.

At no stage during the labour, up until pushing, did I lie down, it was physically impossible. The only position I could cope with was on my knees leaning forward against the bed. The midwife frequently checked the baby's heart beat while I was in this position.

In all honesty, for me, the contractions were incredibly painful in my back, like being tortured. I'm sorry to be grim but just being honest. I had pethidine at some point which helped me to relax a little and I went in the birthing pool.

I had a really strong urge to push probably around 9pm, and in hindsight I wished I would have been more forceful in requesting the midwife check me again to see if I was 10cm dilated. However, the midwife refused to check me until 12pm (to this day I don't know why- I can only assume that she didn't expect a first labour to go any quicker- despite dilating to 7cm in a hr).

I got on the bed to push at the midwife's suggestion, despite my fear that I wouldn't be able to lie down during a contraction. Pushing seemed to completely take the pain out of the contraction so I could manage in this position. After 3 hrs of pushing, despite being able to feel my baby's head between my legs, there was no further progress. I just couldn't push him out. I burst blood vessels in my face with the effort. The midwife told me I wasn't pushing hard enough.

A consultant was called in who examined me and realised that DS was back to back and that was why he was stuck.

I was moved to theatre, given a spinal block (heaven), an episiotomy, and after a failed venthouse, DS was delivered with forceps at 4.21am.

Violethill has good advice: stay mobile. Even if still back to back when labour starts.

I had a back to back which moved during labour to the right way round as I continued as mobile as possible. No pain relief except gas and air.

However it was my second and I vaguely remember that subsequent babies don't engage as early as the first. I don't know if a baby can twist round if engaged but mine did, quite far on into labour.

Would also say that if you are back to back up to going into labour, try to stay at home as long as possible.

Posterior labours do last longer but in a tiring rather than painful way (ime -- I had two). So being at home is easier for moving, resting, eating and drinking. AND (bonus) you have no doctor looking at a watch.

Don't be scared, be confident.

Ds1 was back to back, I knew nothing and was totally compliant with the hospital, mw etc ended up with a labour that lasted days, followed by an epidural and kiwi ventouse (no episiotomy though).

Ds2 was also back to back, but I was wise to it, kept active and mobile in the last couple of weeks in particular and spent most of the labour standing and walking around, leaning on walls to breathe through contractions. Only went into hospital an hour before he was born and had just a bit of gas an air at the end - I was so pleased with myself I wanted to do it all over again!

(Oh yes, forgot to say, he turned during labour.)

Dd this year, was breech! Several times actually. They discovered it at about 36 weeks, but she turned on the day they were booking me in for cs. She turned breech again at about a week overdue and was turned by ecv the afternoon before she was born. She wasn't tiny either 7lb 8oz.

So please don't be frightened on three counts:

1. You baby still has loads of time to wriggle about and change position.

1. A tough labour is not a given for a posterior baby. By taking control and remaining as upright and active as possible in the last few weeks and during labour you stand every chance of having a positive experience like I did with ds2. I would also recommend looking into OFP though, as there is a lot of useful advice on the website.

1. If you do end up needing an epidural, its not the end of the world and it doesn't mean you have failed and its better to accept help than suffer on because you feel you have to.

I've had three totally different labours, but once I had my babies in my arms each time, the labour just paled to insignificance and all three of them were absolutely worth every minute of their labours.

Good luck

powdoc - tehhey wouldn't check you untill 12 because there is no point in doing it more regularly than 4 hourly (thats what i was told by my midwife)(who was allot better than yours by the sound of it!!!!)
just thought id let you know so you dont have to go on wondering forever!

Dear Supercherry

With OP labours, there is sometimes an early urge to push, and often it is before you are fully dilated. That is why with OP labours, MWs often get you to fight off - as hard as you can - the urge to push until it is overwhelming.

The rate of dilation is not consistent esp in OP labours and it's disheartening for a women who has an urge to push to be told she is not fully dilated.

DS - back to back and had a natural delivery with only gas and air. It was loooooooooooooong though. He didn't turn but i kept active as much as i could and during labour (walked, squatted etc)

DD - born 10 days ago . She was back to back on the day i wnet into labour but she turned during labour which was just 7 hours from start to finish and waterbirth with gas and air

it is possible - you also have a few weeks for baby to turn. DD was breech until 37 weeks!

OFP is definitely the way forward. it is all about not sitting back and trying to keep your knees lower than your hips etc. My midwife, yoga teacher and NCT leader have all mentioned it, so there must be something in it!! Try googling that and info should be useful. Hope it helps.xxx

Thank you for the clarification Spillage. The thing is though, my midwife wasn't aware that DS was back to back. I will never know if I was ready to push earlier will I? I know it makes no diffrence now but it always bugs me that I could have been ready to push sooner and then I wouldn't have been as tired and I wouldn't have to have breathed through intense contractions for 5hrs. As I said, the pushing really took the pain away.

I'm due my second baby in 2 weeks and this time I am planning on being more assertive and following my instincts more. DS2 is lying on his side at the moment, head down, and I'm really hoping and praying he gets into a good position for birth.

Katster, despite my back-to-back labour not being ideal, it didn't put me off having another Although I am dreading the labout to put it mildly.

Almost idneticle experience as Moosemama:
DS1 back-to back, long labour with the final 24 hours strapped to a bed being constantly monitored, epidural & resulting in pretty awful internal & external tearing.

DS2 back to back quick labour I stayed completely mobile & upright & he was delivered without any pain relief & not a single stitch needed.

Neither of mine turned in labour & both were a decent size (8lb7 & 9lb10) but I can honestly say being mobile & upright made all the difference & my 2nd labour was really not that bad at all.
LCN

supercherry - my EDD for no.2 is Nov 1. Are you obsessively checking the childbirth board too?

And thanks for the reassurance that even if the baby turns, staying active will make the labour more bearable, lechatnoir - that's good to hear

Mangostrickyrice, you have me sussed

DS1 was back-to-back all the way through but I didn't need an epidural and gave birth in an upright position. No ventouse/forceps etc no perineal tear.

HTH