Your baby's position is fundamentally about the relationship
between your body and yourself, and your baby and you. Your
body gives you clues as to the positioning of your baby, some
of which you can begin to learn to interpret yourself, although
you may need an experienced and skilled midwife to help. It
is the sensations that you feel that guide you through your
progress in the exercises. And getting your baby into an optimal
position for labor is one of the most important aspects of your
relationship with your baby as you approach birth together.
At a time when medicalization of labor can act all too often
to reinforce our natural fear and apprehension as we approach
labor, when a lack of confidence in our abilities to give
birth is paramount, perhaps we should start by trying to get
the basics right, starting with the position of our babies.
And as with the rest of motherhood, it often takes a lot of
hard work to get the fundamentals right.
Defining A Baby in a Posterior Position "Posterior" usually refers to an "occiput
posterior" birth
Posterior is when the baby is facing out your tummy, not
out your back. Anterior (or what medical people consider "normal")
presentation is when the baby is facing your backbone; Posterior
is when the baby is facing your front. So, if you were looking
between your legs as you birthed, a posterior baby would be
looking right at you, where an anterior presenting baby would
be looking through to your butt. Posteriors are often called
"star gazers" or "Sunny-side-up" by midwives.
Breech is butt-first. Vertex is head down. Many if not most
babies who start out labor this way end up rotating during
labor to birth occiput anterior or occiput to left or right.
About 1 in 4 babies is posterior or “sunny-side-up.”
This can cause longer labor and severe back pain in labor,
although this is not necessarily so!
Posterior Positioning - Signs and Symptoms
In working with many VBAC women, I am amazed at the sheer
number of cesarean births attributed to Failure to Progress
or CPD, Cephalo-Pelvic Disproportion. In reality, these women
have prolonged labours not because of their babies inability
to fit through their pelvises, but rather because their babies
are posterior.
 
Pictured above is an excellent view of a posterior baby.
Note the indentation at her belly button. This is caused by
the gap between the babies arms ,the bump below her belly
button, and his knees and feet above her belly button. This
baby is posterior and asynclitic (his head is crooked as he
tried to negotiate her pelvis). This photo was taken after
6 hours of complete dilation, 4 hours of pushing and shortly
before her cesarean birth.
Signs of Posterior positioning prenatally
Lots of Prodomal or Braxton-Hicks contractions, often felt
as lower back ache or pain that is strong during the day and
stops at night. My theory is baby is trying to turn before
labour begins, thus the seemingly ineffective contractions
The feeling that the baby has too many hands and feet, and
the moving limbs may be easily felt and seen up front.
Frequent urination due to the baby’s brow pressing against
her bladder. Incontinence may be felt as baby wiggles against
the bladder, forcing out urine and often it feels like a urinary
tract infection because of the constant pressure on the bladder
and accompanying backache.
Fetal hear tones may be difficult to detect, or tones are
indistinct.
It will be difficult or impossible to feel the babies back,
and the head may appear to be engaged
Signs of Posterior positioning during labor
Along with the symptoms above, the most distinct sign is
persistent backache, which even in early labour may be severe
enough that the pain of contractions are secondary. As a backache
may be present even in normal anterior presentation, it is
important that a vaginal examination be done to correctly
assess the baby’s position by the fontanels.
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