When it comes to childbirth, our focus goes to areas we may not have thought about before, like optimal fetal positioning exercises that can help us ensure proper orientation.
When I decided to start a career as a doula in 2014, a big focus in my training was getting the baby in a good position. But what does that really mean and why is it so important?
Poor fetal position is one of the main reasons for a C-section. If having a vaginal birth is your preference, or you are trying for a VBAC, fetal positioning matters.
The good news is there is a lot you can do to encourage your baby into a good position for vaginal birth, during pregnancy and labor.
This article is all about optimal fetal positioning exercises and what you can do to help. Whether you want an unmedicated birth or an epidural, these movements can help get your baby into the best possible position.
Can exercises help with fetal positioning?
Doing the right exercises during pregnancy can help fetal positioning by creating balance in the pelvis. A balanced pelvis is important because it helps babies find the best way to navigate down and out.
When labor begins, a balanced baby can help the cervix dilate faster, with the right amount of pressure against the cervix. It can also help babies come down in a nice, easy way to be birthed.
In the past, doulas and parents have been taught that it is KEY for a baby to be on the left side with their back against mom’s belly, in what is called left occiput anterior or LOA position. It was highly encouraged to get your baby in this position before birth.
It has also been taught that posterior position, with the baby’s back against the mother’s back, is NOT okay for vaginal birth. The reason why this position is considered less ideal is that it can cause longer and harder labors, and it can make vaginal delivery more difficult.
Although less ideal, posterior may be the position a baby needs to enter the pelvis for birth. (Check out this podcast episode about a HBAC with a posterior baby.)
After all is said and done, these positions don’t matter as much as once believed. It’s more beneficial to focus on creating space and balance for the baby to find the best way to navigate through the pelvis. That’s why this article is focused on fetal positioning exercises to release tension and balance the pelvis.
One of the hardest parts about fetal position is that it can change all the time! And even if you are working hard to get your baby into a certain position, it may not be the best position for the baby at that time.
When I was pregnant with my VBA2C baby, I found myself hyper-aware of his position, and what I was doing with my body every day. In fact, I didn’t sit on a couch for the entire nine months because I was so scared that he would go posterior.
It really didn’t matter if I sat on a couch or not. However, it did matter that I was keeping my pelvis balanced. And I could have been using a lot of other positions and exercises to help with fetal positioning.
When the baby has found their most ideal spot, it can create a more comfortable pregnancy. But sometimes the baby’s position can also cause discomfort. This may mean that your baby likes to hang out in a posterior position or even in your hip.
When should you start exercises during pregnancy?
There are different times during pregnancy to start different methods of fetal positioning.
It is very important to discuss any fetal positioning techniques and exercises with your healthcare provider before you begin. With my first pregnancy, my provider told me that when it came to physical activity, I could do anything I was doing before I became pregnant, but to check with him before introducing anything new.
For fetal positioning exercises like Spinning Babies’ Three Sisters, you can start early on in pregnancy. Others, like the Miles Circuit, or intended for around 37 weeks.
With approval from your healthcare provider, you can use some of these common exercises throughout pregnancy to encourage good fetal positioning:
- Prenatal Yoga
- Pelvic rocks
- Bouncing on a Yoga ball or birth ball
Optimal fetal positioning exercises for pregnancy and labor
Because there are many things we can do during pregnancy that may affect how our little one sits in our pelvis, my biggest message to you today is to not stress over it.
Before I knew better, I did not sit on a couch for an entire pregnancy because I was so worried about where my baby may end up. I was uncomfortable for many months, only to have a baby that still needed to enter my pelvis in the posterior position.
Finding balance in the pelvis is THE MOST IMPORTANT thing you can do. Prior to labor, doing stretches and the exercises above are encouraged to help create that balance.
When labor is happening, there are a ton of things you can do to help encourage your baby to find the best path through the pelvis and out through the birth canal.
Below we have listed a few ideas that you can use during labor to help encourage progress.
Walking is easily one of the best things you can do to encourage labor to progress and the baby to come down. Gravity brings the baby down, but the movement that happens through the pelvis can help the baby get nice and cozy in the spot they need to be.
Moving around can also be a great way to cope through labor and encourage an empowering birth experience.
Walking the curbs creates balance in the pelvis and can also help labor progress. Start by walking up the curb with one leg, and then stepping down with the opposite leg.
You can do this for as long as you would like but the MOST important thing is that you do it on both sides to create equal balance.
Proper sitting position
When you are in labor, it is hard to really find a “proper” position to sit. More often than not, sitting is simply not comfortable.
However, if you can sit during labor, check into your posture and try to avoid slouching. This can help prevent a baby from going posterior and also encourage good positioning.
If you have an epidural, sitting up in the throne position is a great way to allow gravity to do its work and keep your baby out of the back of the pelvis.
Almost instinctively, birthing moms find themselves doing some version of a forward leaning inversion. There can be more subtle and more dramatic versions.
Forward-leaning inversions are sometimes recommended to help turn a breech baby. For this position, you would place your knees higher up on a couch or table, and place your elbows down on the floor, taking deep breaths to create space in the abdominal wall. This can give the baby space and gravity to help them turn.
You can also do forward-leaning inversions to progress labor or even help a baby reset and find a better way to navigate through the pelvis. In that case, you can simply be on your hands and knees and lean down, with your bottom up in the air.
Tight jaw release
Labor can bring tension all over the body, but one of the first places we tend to hold tension is in the jaw.
Your VBAC doula or birth partner can gently massage your jaw, starting from your ears all the way down towards your chin. They can remind you to have a soft and open jaw as you are coping through your contractions.
Practicing this even before labor can help you remember to relax your jaw when you are in labor.
Once in a while it is a good idea to let your neck hang heavy and just rock back and forth. You can even do full circles, taking deep breaths in and out feeling everything release.
Forward lunges can open the hips and change the mechanics of the pelvis. You can do this during or in between having a contraction.
I love suggesting these in early labor for my clients, especially if they feel like they need to switch things up. If you can do 5 contractions in a forward lunge, then switch to the other side, it can truly help progress labor and encourage the baby to rotate and come down as needed.
Just like our upper body needs to be stretched and released from tension, so does our lower body. This includes our calves. Calf stretches can help release the tension in the lower body.
Spinning Babies® suggests adding calf stretches into your daily routine during pregnancy. This stretch elongates the muscle that leads all the way up to the pelvic floor.
Doing squats before and during labor can help progress things along by bringing the baby down into the pelvis. However, it is important to be mindful of how you perform squats.
If your baby is really high in the pelvis, which is typical before labor begins or in early labor, it is more beneficial to perform squats with your knees open.
As your baby navigates down into the pelvis, you will actually want to focus your squats with your knees inward, to allow the outlet of the pelvis to open.
Anything we can do to open our hips in labor is going to help progress things along and create space for our sweet babies to arrive.
All of the fetal positioning exercises above are moves that will open the hips. You can also work on doing small and even large asymmetrical movements that can open the hips during labor.
Try placing one foot up on a bed or stool while your other foot is on the ground. Labor in that position for a minute or two, and then switch legs.
If you would like to be on your hands and knees, you can lean over a birthing ball or bed, or even just plant your hands on the floor. Pick up one leg and place it out to the side, like the image below.
Try this position for five contractions on each side.
Pelvic tilt exercises are something you can do both before labor begins and during labor. You can choose to do it standing, sitting, or even lying on a ball.
We have a step by step tutorial on how to perform pelvic tilts, so you can start practicing those right away.
What exercises to avoid
It is very important to make sure you check with your health care provider before doing any new exercises when you are pregnant. Any fetal positioning exercises you should avoid depends on your individual circumstances.
When you are exercising, make sure to follow your body’s lead and listen to it. If you feel pain or something doesn’t feel right, it is likely your body telling you it is not good for you to continue.
Here are some answers to frequently asked questions about fetal position.
How can you encourage optimal fetal position?
The best way to encourage optimal fetal positioning is by creating balance in the pelvis. Make sure to do everything equally if there are ways to perform a movement on both sides. By creating balance in your pelvis, you are encouraging your baby to get into the best position for them.
How should you sleep for optimal fetal position?
Sleeping can be hard during pregnancy, especially the further along you get. Sleep where you feel comfortable. Health care providers suggest sleeping on the left side to encourage good blood flow through the uterus and to the baby. Gather all the pillows you need, and sleep in the best way that makes you feel comfortable.
What is optimal fetal positioning?
Optimal fetal positioning is when your baby is in the position in the pelvis that is best for them to navigate down through the pelvis. Left occiput anterior (LOA) position, when the baby is on the left side with their back against the mother’s belly, is considered ideal for birth. However, the position is less important than creating space and balance in the pelvis, for the baby to find the best way to navigate down and out.
As doulas ourselves, we highly suggest checking out Spinning babies®. They offer wonderful resources to help prepare your body for labor and delivery. Spinning Babies teaches a technique called Three Sisters, a wonderful series of optimal fetal positioning exercises for helping your baby find balance in the pelvis.
We also suggest checking out The Miles Circuit. This is something that you can start around 37+ weeks, with the support of a partner or doula. It is a three part series that helps create balance in the pelvis and allows babies to find their way down.
With our doula clients who experience prodromal labor, we often suggest The Miles Circuit, and have seen it help many of these women move into active labor. It can also allow the body rest after finding balance, and helps labor begin more efficiently when it is ready.
Looking for more ways to support birthing parents as they prepare for vaginal birth after cesarean? We have a course just for doulas: Advanced VBAC Doula Certification Program