Pregnant individuals report that babies in the womb move around often, and they are not wrong! It is perfectly normal for a fetus to move every which way throughout pregnancy. Most babies do not go and stay head down until upwards of 36 weeks gestation. When getting an ultrasound or palpation of your belly, your care provider might say something like "LOA position" or "ROP position." These acronyms describe where your baby is currently in the womb. But let's dive in.
What are some of these positions called, and what do they mean for pregnancy and potential labor?
Anterior vs. Posterior Positioning
First, let's talk about posterior versus anterior positioning. Posterior positioning describes a fetus whose back is hammocked into the birthing parent's back. This position is not optimal for birth as it can make it much more difficult and is the leading cause of back labor. Still, it is possible for a vaginal birth. Some babies will wait and turn during labor, while others will never turn. If you want to work on turning your posterior baby, Spinning Babies has excellent resources for that. The anterior position is the optimal position for childbirth. The anterior position is when the infant's back is hammocked into the pregnant individual's belly.
Vertex, Breech, & Transverse Presentations
Next, let’s discuss the vertex, breech, and transverse presentations. Vertex presentation describes a baby whose head is in the pelvis or head down and whose head will be the first thing born through the birth canal. Vertex presentation is the most optimal presentation for a vaginal birth and also the most common presentation. Breech presentation is when the baby's bottom or feet are in the pelvis and first exit the vaginal canal. There are many doctors and midwives who cannot and will not perform a vaginal breech birth, but it is possible to have a safe breech vaginal birth in the hands of a trained care provider. It is common for care providers to guide pregnant individuals to turn their breech babies to a vertex position. Some of the ways this can be done are through Spinning Babies techniques, chiropractic care, swimming, and a manual version.
Transverse is the only of these three presentations that cannot be delivered vaginally. The transverse presentation describes an infant who is lying sideways in the womb. In the case of transverse presentation at or near term, a version can be performed like it is often performed with a breech birth. This procedure attempts to turn the baby into a more optimal vertex presentation. Manual versions often work, and the fetus can be turned more optimally. Still, sometimes it is unsuccessful, and either a breech vaginal birth occurs, or a cesarean section must be performed for breech or transverse presentation.
The Most Common Positions
The most common positions for babies at term are left occiput anterior (LOA) and right occiput anterior (ROA). These positions describe a baby head down or vertex presenting, with their backs hammocked into the pregnant individual’s stomach or anterior positioned on either the left or right side of the uterus. Both of these positions are optimal for vaginal delivery. From there, we have left occiput posterior (LOP) and right occiput posterior (ROP). These positions describe a baby who is head down, or vertex presenting, with their backs hammocked into the pregnant individual’s back or posterior positioned, and either on the left or right side. There are other positions that a baby can take, such as right occiput transverse (ROT), left occiput transverse (LOT), right mentum anterior (RMA), right mentum posterior (RMP), left sacrum anterior (LSA), and left sacrum posterior (LSP) to name a few.
Don’t Be Afraid to Ask for More Information
If your doctor or midwife describes any of these as positions of the baby, you can ask them to show you a picture or draw out where your baby is located on your abdomen for a better visual.
In some instances, attempting Spinning Babies techniques to acquire more optimal fetal positioning can be beneficial, and your care provider will likely let you know what your options are in doing so. As mentioned above, most babies move around the womb in different positions until 36 weeks and sometimes beyond. There have been many pregnant individuals whose babies were breech up until they went into labor or were about to get a manual version performed.
Takeaway
Sometimes a baby’s position tells a story about who they are and how they need to enter this world. It could be that baby is breech because they have a tight cord that won’t allow them to head down. Other times, a baby just lets their parent know what kind of child they might be. Whatever the reason, it is vital that we listen to these wise children, and if none of our attempts at achieving optimal position work, trust that they know the way their journey is meant to go.
