NaturalChildbirth.org

[Alison]

One of the most important factors in a good labor progression is the baby's postion. The hallmark for a baby in a non-ideal position is that labor is hard, very painful even sometimes, and yet there is no progress, sometimes for days. This is generally due to the fact that the presenting part is not providing enough pressure to the cervix to open it.

To get a mental image, imagine that your baby is lying head down, top of the head inside the upper part of the pelvis and his back down the middle or slightly to one side. This is a representation of a really good position for labor. If the baby is lying with his back on your back, his head doesn't generally readily slide deep enough into the pelvis to put adequate pressure on the cervix.

If your baby is doing this and is not down very far into the pelvis, getting onto your hands and knees and doing "angry cat" exercises (pelvic tilts) is often all it takes to rotate the baby around.

I've also had good success with a technique called "Diaphramatic Release." This is a technique where the mother lies on her back with the midwife (or whoever is doing this) at her side with one hand on the mother's sacrum and the other hand resting just above the mother's pubic bone. No pressue need be applied. Just wait. The practitioner will begin feeling movement under their hands and the baby tends to roll right around into a back-out position. Diaphramatic Release does NOT work well if the baby is already tightly into the pelvis.

Getting into a swimming pool and floating belly down also can work wonders at rotating the baby around. This is also a great argument for a water birth!! (My posterior baby's birth was in the water.)

If all else fails, as the baby is descending, the midwife or doctor can place their fingers on the baby's head and rotate them around as if dialing an old fashioned rotary phone. The baby tend to follow the movement.

What if the baby doesn't turn? Most babies can be born vaginally this way, though it is a more painful and usually much longer labor than if the baby were facing back. Sometimes, the entering diameter of the baby's head is simply too great and a c-section does become necessary. However, there's no reason to jump right to that conclusion. A little effort and sometimes some very timely intervention can bring the baby out.
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"And the time came when the risk to remain tight in a bud was more painful than the risk it took to blossom"