Getting your baby into the best birth position

The ideal position for your baby to be in for labour and birth is head down, their back towards the front of your stomach.

The best position for your baby to be in for labour and birth is head down, facing your back - so that their back is towards the front of your tummy. This is called the occipito-anterior position. It allows them to move more easily through the pelvis.

If your baby is head down (cephalic) but facing your tummy (their back to your back), this is called the occipito-posterior position.

If your baby is legs and bottom down, this is called the 'breech' position.

Research shows that these the main benefits of the anterior position are that you are:

Why is the anterior position the best for giving birth?

In this position, your baby will fit through your pelvis more easily. The back of his head will be pressing more evenly on your cervix, helping it to open and your labour to progress.

Your baby’s back is the heaviest part of its body so it will naturally move towards the lowest side of your abdomen. That’s why upright, forward-leaning positions may be helpful during the last few weeks of your pregnancy (from 34 weeks if it’s your first, or 37 weeks for subsequent pregnancies).

What exercises can I do to move my baby into the ideal position for birth?

Unfortunately there is little research to show that specific exercises are effective in moving the baby into the ideal position before birth.

You may have heard that spending time on your hands and knees or doing other exercises could help encourage the baby to change position. But this is not shown in research studies into this topic. A 2005 review of research into going on hands and knees to move the baby found that it was not effective and shouldn’t be recommended for this. However, it did find that the position helped to ease back pain.

A more recent 2016 research study looked at whether the position helped to move the baby in the first stage of labour. It was not shown to be effective, but again women reported that it was a comfortable to be in while giving birth.

How do I know what position my baby is in?

Ask your midwife to help you work out the position of your baby.

When you feel your baby wriggling, try to visualise which body part is moving. You could even note down where you’re feeling the kicks. Little tickles are probably tiny hands, while more definite movements could be a knee, elbow, or foot.

Your baby’s head will feel hard and round, while bottoms usually feel a bit softer.

Anterior baby: You will probably feel kicks under your ribs. Your baby’s back will feel hard and rounded on one side of your tummy. Your belly button might poke out. This is the ideal position for baby to be in.

Posterior baby: You’ll probably feel more kicks on the front of your tummy, your belly-button might dip and the tummy area feel more squashy. When the baby is in a posterior position, labour can be longer, more painful and is more likely to end with caesarean or instrumental deliveries.

Should I be worried if my baby is not in the ideal position for birth?

No, most babies turn during labour to the anterior position. Only 5-8 babies out of every 100 will stay in the posterior position.

You can read more about birth position and pregnancy in the Royal College of Midwives' document (written for midwives) Evidence Based Guidelines for Midwifery-Led Care in Labour, Persistent Lateral and Posterior Fetal Positions at the Onset of Labour.

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Sources

Ahmad A et al (2014) Association between fetal position at onset of labor and mode of delivery: a prospective cohort study Ultrasound in Obstetrics & Gynecology 43.2 (2014): 176-182. 

Hunter S, Hofmeyr GJ, Kulier R. 2007. Hands and knees posture in late pregnancy or labour for fetal malposition (lateral or posterior). Cochrane Database of Systematic Reviews (4):CD001063 onlinelibrary.wiley.com

Stremler RHodnett E et al (2005) Randomized controlled trial of hands-and-knees positioning for occipitoposterior position in labor Birth. 2005 Dec;32(4):243-51.

Guittier M-J, Othenin-Girard V et al (2016) Maternal positioning to correct occiput posterior fetal position during the first stage of labour: a randomised controlled trial. BJOG 2016; 123:2199–2207.

Simkin P (2010) The Fetal Occiput Position: State of the Science and a New Perspective. Birth 37(1): 61-71

RCM (2012) Evidence Based Guidelines for Midwifery-Led Care in Labour, Persistent Lateral and Posterior Fetal Positions at the Onset of Labour. Royal College of Midwives, London, England

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Last reviewed on April 1st, 2016. Next review date April 1st, 2019.

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