Optimal Foetal Positioning
Natural birth is the best possible outcome from a psychophysical (physical and emotional) and social perspective for mother and child. The mission of The Mumma Movement is to prepare mothers for natural birth with the knowledge that her baby is an active participant in labour.
Optimal Foetal Positioning (OFP) describes the best position for a baby to be in before he/she is born; head down with baby’s back between the mother’s left hip and belly button (Left Occiput Position/LOA). There is much that a mother can do to encourage her baby into this position, and training should be modified to consider OFP.
Regular physical activity during pregnancy may have a beneficial effect on multiple aspects of labour and delivery. (Szumilewicz A, Wojtyła A, Zarębska A, Drobnik-Kozakiewicz I, Sawczyn M, Kwitniewska A. Influence of prenatal physical activity on the course of labour and delivery according to the new Polish standard for perinatal care. Ann Agric Environ Med. 2013; 20(2): 380–389.)
It increases prenatal energy levels, helps to decrease constipation, increases the size of the placenta, prepares the body to adjust to changes during pregnancy, decreases the incidence of gestational diabetes and aids recovery after delivery. Dr James (James F. Clapp, M.D., Catherine Cram, M.S. 2012. Exercising Through Your Pregnancy, Second Edition: Addicus Books) also found that exercise may decrease labour by up to 90minutes, can decrease the stress on the baby during labour, decreases intervention by 30%, decreases caesarean birth by 30%, and reduces the incidence of post natal depression.
The Norwegian (Le Zhou, Chun‐Tang Sun, Lin Lin, Yao Xie, Yan Huang, Qiao Li, Xinghui Liu. Acta Obstetricia et Gynecologica Scandinavica. 2018) found that women whom exercised for at least 35 minutes at a moderate to vigorous level in the third trimester had decreased caesarean delivery as compared to women with the lowest physical activity levels. There has been no “safe” upper limit to exercise at this time.
The Australian Guidelines for exercising during pregnancy include 150 minutes of moderate to vigorous activity each week at no more than 75% of maximal heart rate. Women should aim to maintain their fitness, participating in aerobic and strength conditioning while avoiding contact sport or activities with a high risk of falling. From about four months gestation, lying supine can slow the return of blood to the heart and is not recommended.
To exercise safely and facilitate OFP it is recommended that a mother walks, spending as much time with her knees away from her spine as possible. Whilst sitting, maintain an upright position with the pelvis slightly forward, not crossing your legs or slouching backwards. When watching TV is a great time to turn a chair backwards and lean over it, any leaning is encouraged and cat-cow on all fours is a great activity to encourage a good position for baby. The knees should be lower than the hips when sitting and neutral positioning during pregnancy involves a slight anterior tilt of the pelvis. Sitting cross-legged or in a butterfly shape on the floor can allow the pelvis to open and promote good positioning of baby. If your baby is not LOA towards the final weeks of pregnancy, avoid movements like squatting, which encourage the baby to descend further into the pelvis. If your baby is LOA, then squatting with good form (hip crease below knee crease) is a great idea and can help the mother build strength and stamina for an active labour.
Always aim to sleep on your left side.
Prenatal actions and exercises can have a significant effect on labour outcomes, especially in regard to OFP. From 36 weeks gestation, women should do all they can to encourage the optimal position. If baby achieves this then labour can be a straight forward event that leads to a positive birthing experience for all.