September 3, 2019

Occiput Posterior Presentation


Occiput Posterior Presentation

Occiput posterior is a common fetal position that is associated with labor dystocia. That means labors that stall or have trouble progressing normally. It has been reported to range of 10% to 25% in first stage of labor. The OP position is associated with a higher rate of prolonged labor, increased intervention into physiologic birth and cesarean sections. The rates of spontaneous vaginal delivery can be under 27% for first time mothers whose babies persist in this position.

In physiologic birth, the fetal head makes many twists and turns in its path earth side. As it meets resistance from the maternal bony and muscular structures it should navigate the pelvis and find its way. This all happens without intervention as a normal part of the miraculous process of birth.

At times the shape of the mothers bony pelvis may influence the fetal head to turn to the OP position. Mothers who are in labor with babies in persistent OP position may find that the contractions are less efficient and the first stage with take longer. Midwives may report an anterior cervical lip or swelling of the cervix because of the orientation of the fetal head.

So what can we do to help prevent babies in the persistent OP position? Studies are conflicting on whether entering labor in a left occiput anterior position is associated with decreased persistent OP at delivery. There is some attention and investigation in the positions that women lounge in during their pregnancies. Reclining has long been thought to contribute to OP babies. Several prominent authors on the subject suggest that women should avoid reclining and crossing their legs.

The recommended positions to facilitate rotation and maintain anterior positioning include:

  • Hands and knees
  • Birthing/ exercise ball
  • Swimming
  • Yoga
  • Spinning babies
  • Upright and forward postures
  • Slow pelvic rocking
  • Move your body for 30-60 minutes a day or purposeful movement

In labor, one of our favorite positions is hands and knees . This position works to align the pelvic inlet and the fetal head. It makes the interior transverse diameter of the pelvis larger! It also makes hip movement easier which can adjust the sacroiliac joint and leads to an elevation of the coccyx and sacrum helping baby move down and out.

Prevention and early management of an OP baby can help you to have a low interventional birth. Try the tips and movements we discussed earlier this article. Please also spend some time on or further information on body movement.


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