By: Midwives from Cork University Maternity Hospital
The baby too is preparing and usually gets into the ‘best’ position to be born. The baby’s head goes down into your pelvis and his back is facing out along the front of your tummy. This is called head down position (Optimal Fetal Positioning).
This ‘head down into the pelvis’ position is also called engagement or you may hear it described as ‘dropping’ or ‘lightening’. This is especially true if this is your first baby, though with your next babies, this engagement may not happen until you actually go into labour. Don’t worry if this does not happen as sometimes the baby’s head does not ‘go in’ or engage until you are in labour.
To encourage your baby to adopt this ‘best’ position there are a few things that you could try from 34 weeks onwards.
The best way to do this is to spend lots of time kneeling upright, or sitting upright, or on hands and knees.
- When you sit on a chair, make sure your knees are lower than your pelvis, and your trunk should be tilted slightly forwards.
- Watch TV while kneeling on the floor, over a beanbag or cushions, or sit on a dining chair.
- Try sitting on a dining chair facing (leaning on) the back as well.
- Use yoga positions while resting, reading or watching TV – for example, tailor pose (sitting with your back upright and soles of the feet together, knees out to the sides).
- Sit on a wedge cushion in the car, so that your pelvis is tilted forwards. Keep the seat back upright. Don’t cross your legs! This reduces the space at the front of the pelvis, and opens it up at the back. For good positioning, the baby needs to have lots of space at the front.
- Don’t put your feet up! Lying back with your feet up encourages posterior presentation.
- Sleep on your side, not on your back.
Avoid deep squatting, which opens up the pelvis and encourages the baby to move down, until you know he/she is the right way around. We recommend squatting on a low stool instead, and keeping your spine upright, and not leaning forwards.
Swimming with your belly downwards is said to be very good for positioning babies – not backstroke, but lots of breaststroke and front crawl. Breaststroke in particular is thought to help with good positioning, because all those leg movements help open your pelvis and settle the baby downwards.
- A birthing ball can encourage good positioning, both before and during labour.
- Various exercises done on all fours can help such as wiggling your hips from side to side.
All fours position
If the baby’s back is positioned to your back, getting down on the floor on your hands and knees (all fours position) in late pregnancy or labour is helpful. Please be aware that this may not be suitable for all pregnancies or for all women so always ask your midwife or doctor first. Only do this if there is just one baby and it’s coming head first.
This article was written for the CUMH Booklet ‘Information on Preparing for Birth and Parenthood’ by CUMH Midwives, Margaret Murphy **, Mary Jeffery, Cathy O’Sullivan, Jane O’Connor, Valerie Dennehy, Monica O’ Regan, Olive Long and Rebecca O’Donovan. **Margaret Murphy is a Midwifery Lecturer at UCC
See full booklet at