During much of pregnancy, you’ll feel your baby practicing all kinds of kicks and full body flips in the womb. As your due date draws nearer, you’ll most likely find that the baby instinctively settles in a head-down position. What you may not realize, though, is that which way your baby faces plays an important role in the kind of delivery experience you may have. An occiput posterior, or “sunny side up” baby is a common abnormal position for labor and delivery.
What Is Occiput Posterior?
In an ideal birthing position, the baby is head-down and facing the mother’s back. This position presents the smallest head diameter to the cervical opening. If the baby faces the mother’s front, the head is angled differently, which can lead to a greater surface area that needs to cross that cervical barrier first. This can slow down progress of dilation and descent during labor. What’s more, the hard back of the baby’s head can create painful pressure against the bonier areas in the back of the mother’s pelvis. While few people would describe giving birth as a walk in the park, it’s considerably easier to deliver a baby who’s positioned in an anterior presentation than posterior.
How Can I Change My Baby’s Position?
The good news is that even if you go into labor with a sunny-side-up baby, there’s a strong chance the baby will turn before he or she is born. In a study on maternal posturing during labor, about 76%-78% of babies rotated to the anterior position on their own.
The not-as-good news is that the same study didn’t find a link between maternal position and the chance that the baby would change position. Lying on your back or laboring on your hands and knees appear to have more or less the same probability that the baby will rotate into a more optimal position to be born. It can be a little frustrating to think that your baby’s position is out of your control, but it’s important to know this so you don’t blame yourself for “not doing enough” if you have a persistently posterior baby.
The mothers whose babies did turn were much more likely to end up having a spontaneous vaginal birth. One possible way to turn the baby is for the doctor to (literally) lend a hand. Your doctor may be able to nudge the baby into a better position manually. This procedure has been demonstrated to be successful in 74% of women in one study, and 90% in another. Manual rotation was linked with a dramatically reduced c-section rate, and lower rates of several other complications.
Will I Need a C-Section for a Sunny-Side-Up Baby?
The decision to delivery a baby via c-section is typically influenced by a number of factors. Persistent posterior position may become one of these factors, although it is possible to deliver a sunny-side-up baby vaginally.
If you’re hoping to avoid a c-section, one of the best things you can do is find a healthcare provider as early as possible in your pregnancy who is committed to this goal. Discuss options with your doctor if it looks like you have a high chance of laboring with a sunny-side-up baby. He or she may suggest an assisted vaginal delivery with forceps or vacuum, or rotating the baby manually during delivery.
The more you know about potential outcomes during labor and delivery, the more chance you have to prepare for and accept your baby’s unique birth experience. Discussing options with your doctor can help you feel more confident in the medical team who will be there when your baby is born.