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You might be wondering how your baby is lying in your womb and how that might affect labour. Here's what you need to know about baby positions...

What is the best position for my baby to be in?

"The best position for your baby to be in ready for their birth, is head down, facing your back, with their back against your belly."

In this position, your baby’s head and neck are flexed and their chin is tucked into their chest. This means the narrowest part of their head (the back) presses on your cervix, helping it to open.

The flexible joints in your baby’s skull allow your baby’s head to change shape and make its way more easily down the birth canal during labour. This helps them fit through your pelvis more easily (Simpkin, 2010; RCM, 2012).

What is the ‘occiput anterior’ position?

If your baby is lying head down in your womb and facing your back, like described above, they’re in what medics call the occiput anterior (OA) position. This means that the back of their head (occiput) is at the front (anterior). Most babies lay this way and it’s the best position for birth (RCM, 2012).

Which other positions might my baby be lying in?

  • If your baby is lying in your womb to your left, you’ll see LOA (left occiput anterior) written in your maternity notes.
  • If they are lying in your womb to your right, you’ll see ROA (right occiput anterior) written in your notes.
  • If your baby is bottom down in your womb, you’ll see B or BR (breech) written in your notes – see our article on breech babies
  • Back-to-back – see below.
  • See our article about maternity notes to find out the other abbreviations for baby positions that your midwife might note.

My baby is ‘back-to-back’, what does it mean?

Some babies lie with their back against their mother’s back. This is known as an occiput posterior (OP) position or back-to-back position in the womb.

Labour tends to take longer, be more painful and you’re more likely to have a caesarean or assisted (instrumental) birth if your baby is in a posterior position. This is because they can’t tuck their chin in very easily, which makes getting through the pelvis more awkward. This position often causes backache during labour too (Simpkin, 2010; RCM, 2012; Tommy’s, 2016).

What can I do to help my baby to turn?

Some people think that women with babies in the back-to-back position can use certain positions during the end of pregnancy to turn their babies. Forward-leaning positions like going on all fours have in the past been said to help babies into the best position for birth. Unfortunately, there is no evidence that this works (Guitier et al, 2016).

On the plus side, forward-leaning positions could ease your backache when you’re in the first stage of labour (Hunter, 2007; Guitier et al, 2016).

What position in the womb is my baby in? How to tell whether they’re front or back facing

Your midwife should be able to tell you during an ultrasound which way round your baby is lying. Saying that, babies will move position during pregnancy and birth. So it’s good to know there are some giveaways to how your baby’s lying.

Here are the tell-tale signs you can look out for:

  • You might be able to visualise how your baby is lying from their movements. Tickles might be their little hands waving around, while harder movements could be their elbows, knees or feet.
  • Your baby’s bum will feel squashier than their head, which will be firm and round.
  • If your baby is lying back-to-back (OP position), your bump might feel squashy and you may feel (and see) kicks in the middle of your belly. Another sign of the OP position is a dip around your belly button instead of it poking out.
  • If your baby is head down and facing your back (OA position), you’ll probably feel kicks under your ribs. You’ll also be able to feel the hard, rounded surface of your baby’s back, which will be on one side of your belly.

(Tommy’s, 2016)

My baby is not in the ideal position for labour, should I worry?

No, as there isn’t much chance it will be a problem. Most babies turn during labour to the anterior position. Here are the stats:

  • Between 15% to 32% of women have a baby in an OP (back-to-back) or occipito-lateral position when they go into labour. This happens more often among women who haven’t given birth before (Simkin, 2010).
  • Only five to eight babies out of every 100 will stay in the OP position (Tommy’s, 2016).

Taking an antenatal course could help to prepare you for labour and birth. It could also help to ease any worries you might have about labour and give you the chance to meet other parents in your local area.

This page was last reviewed in July 2018.

Further information

Our support line offers practical and emotional support with feeding your baby and general enquiries for parents, members and volunteers: 0300 330 0700.

We also offer antenatal courses which are a great way to find out more about pregnancy, labour and life with a new child.

Guittier MJ, Othenin-Girard V, de Gasquet B, Irion O, Boulvain M. (2016) Maternal positioning to correct occiput posterior fetal position during the first stage of labour: a randomised controlled trial. BJOG. 123(13):2199-2207. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5132127/ [Accessed 1st July 2018].

Hunter S, Hofmeyr GJ, Kulier R. (2007) Hands and knees posture in late pregnancy or labour for fetal malposition (lateral or posterior). Cochrane Database Syst Rev. (4):CD001063. Available at: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD001063.pub3/full [Accessed 1st July 2018].

RCM (Royal College of Midwives). (2012) Persistent lateral and posterior fetal positions at the onset of labour. Evidence based guidelines for midwifery-led care in labour. Available at: https://www.rcm.org.uk/sites/default/files/Persistent%20Lateral%20and%20Posterior%20Fetal%20Positions%20%20at%20the%20Onset%20of%20Labour.pdf [Accessed 1st July 2018].

Simkin P. (2010)  The fetal occiput posterior position: state of the science and a new perspective. Birth. 37(1):61-71. Available at: https://www.ncbi.nlm.nih.gov/pubmed/20402724 [Accessed 1st July 2018].

Tommy’s (2016) Getting your baby into the best birth position. Available at: https://www.tommys.org/pregnancy/labour-birth/baby-best-position-birth [Accessed 9th September 2018].

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