Optimizing Baby Position in Preparation for Birth

As your estimated due date gets closer there can be a lot on your mind—getting your home ready for baby, having all of the supplies you’ll need to care for baby, preparing for the postpartum, and all of the excitement of finally holding your baby on the outside! Many people also find themselves wondering when labor will start and how labor will go. It is such an unknown!

Even after all the years I’ve done this work, labor is still unpredictable and no one knows when or how it will happen, if it will go smoothly or have complications. But what I do know is that there are ways for you to prepare and “stack the deck” in your favor for an uncomplicated delivery. One of those is to help baby be in an optimal position for birth before labor starts. How do you know? And how do you do that? Great questions! Let’s talk about it…

There are many positions your baby can be in when you reach full term. Your care provider is hopefully checking at every visit and you may hear him or her use abbreviations like, “LOT” or “ROA” to describe how your baby is lying in your belly. The image below is a visual of how your baby is positioned for these various terms.

chart of optimal birth positions
right occiput anterior (ROA)Right occiput transverse (ROT)right occiput posterior (ROP)left occiput anterior (LOA)left occiput transverse (LOT)left occiput posterior (LOP)right mentum anterior (RMA)right mentum posterior (RMP)left mentum anterior (LMA)left sacrum anterior (LSA)
left sacrum posterior (LSP)

What Is The Optimal Position?

Ideally, when labor starts your baby will be in the LOT or LOA position, meaning their head is down in your pelvis and their back is on the left to left-forward side of your belly. Some babies will be born with their back on the right side of the mother’s belly, as this can also put the baby’s head in a good position to navigate through the pelvis, but most babies will rotate themselves around to the left-lying position either before or during the birth process.

How Can You Tell What Position Your Baby Is In?

This is usually less complicated than it may seem! Before you start, you’ll want to spend a couple of days paying attention to where in your belly you are feeling both big and little baby movements. Then, find a comfortable place to lie down and imagine you have a large plus sign drawn on your belly, which essentially divides your abdomen into 4 quadrants.

mother checking for baby's position

Start in one of the upper quadrants and feel around. Do you feel a firm bulge there? Is this a place where you are usually feeling strong kicks? If you feel a bulge, it is likely your baby’s bum. If this is a place where you generally feel strong kicks, this is probably where your baby’s legs and feet are and sometimes you can even feel baby’s knees or feet moving around and away from your hands!

Feel around on the other upper quadrant, you should feel whichever you did not feel on the other side. Next feel the lower quadrants. One side will probably have little arms and hands (should be the same side as the feet) and the other side will have a shoulder and/or head. The head feels like a softball in your tummy, it is super firm and will bounce away from your fingers. Sometimes it helps to use a baby doll to visualize what you are feeling, especially if it’s your first time trying this! Compare what you are feeling to the chart above to decide which position you think your baby is in—voila! Now you know how your baby is lying in your belly!

What If Baby Isn’t In An “Optimal” Position? What Should You Do?

First, I want to remind you that your baby has the space to move. The position you felt your baby in today might change in an hour or a day, so relax in knowing that this may not even be an issue. Second, there are some really simple habits you can start that will encourage your baby to get in a more optimal position and they all have to do with your posture. Both of the things I’m going to mention have to do with your pelvis, particularly the position of bony structure in relation to your spine, so I want you to take a minute and think about that part of your body and how it moves.

There is a way for your pelvic bones to be “tucked” and “untucked.” If you aren’t sure what that means, think about being on your hands and knees. In a natural, relaxed state your pelvis is “untucked.” By dropping your belly down and sticking your bum up in the air, you can extend your pelvis and by arching your back and clenching your bum muscles you can “tuck” your pelvis. Spend a couple of minutes moving your pelvic bones and see if you can start to tuck and untuck your pelvis without arching your back. This movement is good for your pelvic floor muscles and can also help relieve low back aches and pains.

Daily Habits That Can Help

Many of us spend a large portion of the day sitting and the position of your pelvis while you are sitting has an impact on the position baby chooses. If you sit with good posture, a straight back and an untucked pelvis (up on your “sit bones”), you are creating space in the forward part of your pelvis, which encourages your baby to settle into a head down, LOT/LOA position. If you sit with your back slouched and your pelvis tucked, or reclined back on the couch, the space is created in the back of your pelvis and makes it more comfortable for baby to be in one of the OP positions.

OP positions can lead to dreaded “back labor,” so we definitely want to avoid that! How we sit is very much a habit, though, and it is one that can be hard to break. Switching from a typical chair to a birth ball or birth ball chair will help you maintain good posture, because they keep you up on your sit bones. Using a pregnancy support garment can also help by giving gentle compression to your back to keep you sitting up straight.

sitting on exercise ball can help achieve optimal birth position

The second habit that can affect a baby’s position is how you bend over. This is easiest to figure out by thinking about your back. When something is on the floor, the majority of people will pick it up by arching their back to bend over and reach the ground. While you are pregnant, it is far better to squat, keeping your back straight, as this allows baby to comfortably stay in the forward positions in your belly.

Again, it will take effort to change this habit, but this small movement, done several times a day will help your core stay strong and allow your baby to be in an optimal position for labor. Doing 5 practice squats 2 to 3 times a day can help create this habit, as can wearing a pregnancy support belt.

Babies can be born in most any position, so try not to worry if your baby is stubbornly staying in a position that is not considered “optimal.” Your body and your baby know what they are doing and with a tincture of time, these things usually work themselves out.

For more information and daily exercises aimed at repositioning baby, visit www.spinningbabies.com.

Rebekah Mustaleski, Certified Professional Midwife

About the Author

Rebekah Mustaleski is a Certified Professional Midwife with Roots & Wings Midwifery in Knoxville, TN, where Rebekah promotes evidence-based maternity care for families seeking an out of hospital delivery. She is working to improve maternal outcomes during the childbearing year and to promote a sustainable business model for midwifery practices across the country. Rebekah is co-owner of Roots & Wings Midwifery, LLC as well as Treasurer for the Tennessee Midwives Association.

Read more blogs by Rebekah!

All content published on the Motif Medical site is credited for information purposes only. This information should not substitute as medical advice, diagnosis, or treatment. Always consult your doctor or qualified health professional with any questions regarding the health of you or your baby.