The child’s birth position refers to the position in which an unborn child lies in the mother’s body just before birth. Its birth position determines how it is born and can provide clues to possible complications during natural birth.
What is birth position?
The child’s birth position refers to the position in which an unborn baby lies in the mother’s body just before birth. Its birth position determines how it will be born. During pregnancy, the child constantly changes its position. This happens especially at the beginning, before the maternal abdomen even bulges, because then the embryo still has a lot of freedom of movement in the uterus. The bigger it gets, the less it can move. Around the second trimester, the baby moves into what is probably the final birth position, although this can sometimes still change. The birth position is not observed more closely until the third trimester, since the child can hardly move in the womb by now and a change in its position is unlikely. If the child is still in an unfavorable birth position at this time, decisions can be made to make the birth easier or to reduce a possible risk for mother and child at birth. Depending on the specific birth situation, this can also be changed later.
Function and task
Possible birth positions include the optimal anterior occipital position and the posterior occipital position, which can already lead to complications. Both are subtypes of the so-called cranial position, which the baby can already assume during pregnancy. In this position, the baby is upside down in the womb, so that it is pushed head first through the birth canal. This birth position prevents the baby’s extremities, which are already quite mobile, from getting stuck. In the optimal birth position, the anterior occipital position, the baby lies with its back toward the mother’s abdomen. It can turn during birth without the umbilical cord wrapping tightly around its neck or getting stuck. This is why this birth position is considered optimal and promises an uncomplicated birth. In the posterior occipital position, the baby lies with its back facing the mother’s back. Since the head is still down and sees the light of day first, these births are also usually easy. However, this birth position can also result in a longer birth, and in the worst case, complications can occur as a result. The baby may wrap the umbilical cord around its neck, the birth may stop, or it may be necessary to intervene in the birth. The posterior occipital position may continue to bring worse labor pain. The far more complicated birth positions include positional anomalies, which, strictly speaking, are no longer birth positions because the baby can only be born this way under difficult circumstances. The cranial position is thus the only true birth position. Up to the 37th week of pregnancy, women have the option of having their baby turned from the outside if there is no medical reason not to do so. This allows them to give birth naturally.
Illnesses and complaints
While the cranial position with its variations is the only true birth position in which most babies also lie, there are some positional anomalies that make birth more difficult or even impossible. If the child lies in the breech presentation, he or she lies with the head up and the feet down. Since the limbs, not the head, enter the birth canal first, the baby can get stuck. Also, it cannot start breathing on its own right away because its head comes out at the end. In total, breech presentation has seven exact positions that determine whether the baby is more likely to sit or stand, have its limbs close to its body or stretched further away from it. Although natural birth is not impossible with breech presentation, it must be attended to by experts. Vital signs of both mother and baby require constant, close monitoring, the risk of perineal laceration increases, episiotomies are more common, and emergency cesarean section may be required. For this reason, many women are advised to have a planned cesarean section in the case of breech presentation in order to avoid risks. A cesarean section is a necessity in transverse position. In this case, the baby lies transversely in the mother’s abdomen, which is usually caused by too much amniotic fluid or a present placenta. The pregnancy was then usually already problematic.The transverse position is very rare and the baby can still move into a birth position in the last trimester. However, if this does not happen, a natural birth is out of the question, as the damage to the health of mother and child would be too great. The mother could suffer severe injuries to the uterus and high blood loss. The baby could have the umbilical cord wrapped around its neck and suffer from severe oxygen deprivation during or soon after birth. Even with a good birth position, the baby may go into a deflexion position during birth. It stretches its head away from the breast or its limbs away from itself in the birth canal. This causes the birth to stall and the baby could suffocate in the birth canal. In these cases, despite a good birth position, an emergency cesarean section is performed at the beginning of labor to avoid risks of lifelong harm to the baby.
