Статья "Как помочь ребенку правильно повернуться до родов"
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In an anterior position, your baby fits snugly into the curve of your pelvis. During labour, your baby will curl his back over, and tuck his chin into his chest. Your labour and birth should progress easily if your baby is in this position, because:
Most back-to-back babies are born vaginally. But this position can make labour more difficult for you, particularly if your baby's chin is pushed up, rather than tucked in:
Most posterior babies rotate to an anterior position during labour, with the right support. When your baby gets to the bottom of your pelvis, he'll need to turn through almost 180 degrees (halfway round a circle) to get into the best position.
This can take quite a while, or your baby may decide he's not going to turn at all, which means that he will be born with his face looking up at you as he emerges. He may need to help him out.
If your pelvis is oval or heart-shaped, rather than round, your baby is more likely to settle in a back-to-back position at the widest part of your pelvis. This is because he can rest his head more easily in this position.
When you relax on a comfortable armchair watching TV, or for hours, your pelvis is tipped backwards. This encourages the back of your baby's head and his spine (the heaviest part of him) to swing round to the back. In this position, he'll end up lying against your spine.
If you do a lot of upright activities, your baby is more likely to go down into your pelvis in an anterior position, because your pelvis is always tipped forwards.
Also try the following:
Don't worry about getting your baby into the right position when you lie down to sleep. Your baby is not being pushed down into your pelvis when you're lying down. However, lying on your side, rather than your back, is the best position for .
Even so, your midwife may not recommend OFP in pregnancy because of the lack of written evidence. But she may still encourage you to try the positions, as you may be more comfortable adopting those positions once your labour starts.
You could try to stay in upright or forward postures regularly in everyday life, rather than for short bursts.
Unfortunately, OFP doesn't seem to have an effect on how your baby lies at birth. If you try OFP during pregnancy, but your baby stays in a posterior position when , it may be because of the shape of your pelvis, rather than your posture.
You may feel slight niggling pains for several days before . This can be wearing, but may be a sign that your baby is trying to turn into an anterior position.
You may find that one of the best positions is on all fours. In this position, your baby drops away from your spine, helping to relieve backache and hopefully helping him to turn, too. Here are some tips for coping with pre-labour and early labour:
When you're in active labour, try to vary your positions and movements, and use whichever of the following is most comfortable for you as your labour progresses:
What is the best position for my baby to be in?
If your baby is in a head-down position, with the back of his head slightly towards the front of your tummy (anterior position), your labour is likely to be shorter and easier. Most babies get into this position by the end of pregnancy.In an anterior position, your baby fits snugly into the curve of your pelvis. During labour, your baby will curl his back over, and tuck his chin into his chest. Your labour and birth should progress easily if your baby is in this position, because:
- The top of your baby's head puts rounded, even pressure on the neck of your uterus (cervix) during contractions. This helps your cervix to widen and your body to produce the hormones you need for labour.
- During the , your baby moves through your pelvis at an angle, so that the smallest area of his head comes first. Try putting on a tight polo neck without tucking in your chin and you'll understand how this works!
- When your baby gets to the bottom of your pelvis, he turns his head slightly, so that the widest part of his head is in the widest part of your pelvis. The back of his head can then slip underneath your pubic bone. As he is born, his face sweeps across the area between your vagina and back passage (perineum).
What's a posterior position?
A posterior position is where your baby has his head down, but the back of his head is against your spine. By the time , about one baby in 10 is in this back-to-back or posterior position.Most back-to-back babies are born vaginally. But this position can make labour more difficult for you, particularly if your baby's chin is pushed up, rather than tucked in:
- You may have backache, as your baby's skull is pushing against your spine.
- Your in .
- Your labour may be long and slow, with bouts of contractions starting and stopping.
- You may feel like pushing before your cervix is fully dilated.
Most posterior babies rotate to an anterior position during labour, with the right support. When your baby gets to the bottom of your pelvis, he'll need to turn through almost 180 degrees (halfway round a circle) to get into the best position.
This can take quite a while, or your baby may decide he's not going to turn at all, which means that he will be born with his face looking up at you as he emerges. He may need to help him out.
Why are some babies posterior?
Your baby may be posterior because of the type and shape of pelvis that you have. Some women have a pelvis that's narrow and oval (anthropoid pelvis) or wide and heart-shaped (an android pelvis), rather than round-shaped.If your pelvis is oval or heart-shaped, rather than round, your baby is more likely to settle in a back-to-back position at the widest part of your pelvis. This is because he can rest his head more easily in this position.
When you relax on a comfortable armchair watching TV, or for hours, your pelvis is tipped backwards. This encourages the back of your baby's head and his spine (the heaviest part of him) to swing round to the back. In this position, he'll end up lying against your spine.
If you do a lot of upright activities, your baby is more likely to go down into your pelvis in an anterior position, because your pelvis is always tipped forwards.
How can I help my baby into an anterior position?
Try to tilt your pelvis forward, rather than back, when you're sitting. Check that your knees are always lower than your hips. This is called optimal fetal positioning (OFP) and it encourages your baby into an anterior position. It changes your posture, particularly when you're sitting down.Also try the following:
- Check that your favourite seat doesn't make your bottom go down and your knees come up. If it does, try turning the chair round, kneel on the seat pad, and lean forwards over the back of the chair.
- Try scrubbing the floor! When you're on all fours, the back of your baby's head swings to the front of your belly.
- Move around if your job involves a lot of sitting, and take regular breaks.
- Sit on a cushion in your car to lift up your bottom.
- Watch TV leaning forward over a birth ball, or sitting on the ball. If you are sitting, make sure that your hips are higher than your knees.
Don't worry about getting your baby into the right position when you lie down to sleep. Your baby is not being pushed down into your pelvis when you're lying down. However, lying on your side, rather than your back, is the best position for .
Can I really make my baby get into the right position for birth?
Adopting a hands-and-knees position for 10 minutes, twice a day, can help to move your baby into an anterior position in late pregnancy. This technique is tried-and-tested.Even so, your midwife may not recommend OFP in pregnancy because of the lack of written evidence. But she may still encourage you to try the positions, as you may be more comfortable adopting those positions once your labour starts.
You could try to stay in upright or forward postures regularly in everyday life, rather than for short bursts.
Unfortunately, OFP doesn't seem to have an effect on how your baby lies at birth. If you try OFP during pregnancy, but your baby stays in a posterior position when , it may be because of the shape of your pelvis, rather than your posture.
How can I improve my baby's position during labour?
If your baby is in a posterior position when labour starts, you can still use postures and movements to try to help your baby to turn, and to . It's common for posterior babies to change position during labour, and most get themselves into an anterior position by .You may feel slight niggling pains for several days before . This can be wearing, but may be a sign that your baby is trying to turn into an anterior position.
You may find that one of the best positions is on all fours. In this position, your baby drops away from your spine, helping to relieve backache and hopefully helping him to turn, too. Here are some tips for coping with pre-labour and early labour:
- Get plenty of
- Vary your daytime activities from walking and moving around, to adopting all-fours or knees-to-chest positions. So you'll be on your knees with your head, shoulders and upper chest on the floor or mattress, with your bottom in the air.
- Lean forwards during contractions, and try pelvic rocking on a .
- to keep your strength up and stay hydrated.
- Try to stay relaxed and positive.
When you're in active labour, try to vary your positions and movements, and use whichever of the following is most comfortable for you as your labour progresses:
- Adopt all-fours or knees-to-chest positions, where you're on your knees with your head, shoulders and upper chest on the floor or mattress and your bottom in the air.
- Lean forwards during your contractions by using a birth ball, beanbag, your partner, or the bed.
- Ask your birth partner to .
- Rock your pelvis during contractions to help your baby turn as he passes through the pelvis. A is great for pelvic rocking.
- Adopt lunge positions, either when standing on one foot, kneeling on one knee, or when you're lying on the bed. The side that is most comfortable to lunge is likely to be the side that gives your baby more room to turn.
- Lie on the side that encourages your baby to turn the right way.
- Walk or move every now and again. Don't stay sitting in a chair, or on a bed in a leaning-back position, for too long.
- Try not to have an too early on in labour if you can, as epidurals may increase the chance of your baby being in a posterior position at birth. Epidurals also increase the likelihood of you having an .