Spinning babies: promoting favourable birthing positions

30 Jun, 2018

Finally, the Spinning Babies workshop came to Sydney last weekend, and what a timely and great workshop it was! As a chiropractor specialising in pregnancy care and being 20 weeks pregnant with my first baby myself, I was particularly interested in how positional changes of pregnant or labouring woman can impact the birthing experience and prevent undue stress and intervention.  

The Spinning Babies Workshop, which was taught by Ginny Phang-Davey under Gail Tully from USA, was amazing. Surrounded by midwives, obstetricians & doulas, I was the only chiropractor in the room and loved sharing tips and ideas in this collaborative opportunity – everyone learning from each other and sharing what works and what doesn’t work in their fields.  

I came away with the understanding of the malposition of a baby inside a pregnant woman, and learned to help prevent malposition through education and positional manoeuvres.  

Interestingly, I learnt that structurally, the first time a woman is pregnant, her uterus is more pear shaped than apple shaped (like those 2nd & 3rd time pregnant women), and this is why a L-O-A (left, occiput, anterior) position of baby is most favourable. On the left hand side of the body we have the descending colon, which is softer than the right, and doesn’t have the hard liver in the way. The softer left side allows the baby to be more flexed and rounded (which is what we need for an easier birthing process), to then begin the cardinal movements of labour (as opposed to the straight and hence extended baby position on the right-hand side of the uterus).   

Further, one study showed spontaneous vaginal delivery occurred in 76% of OA positions and only 17% in OP positions. (Most of these OP positioned babies ended in C-section births).  

Another common positional change I hear a lot in practice is a posterior positioned baby. This position comes about via our lifestyle – we sit at work all day and on our phones at night, work up until 39 weeks pregnant and expect bub to be in the anterior position. Some small tips I give my clients to promote favourable positioning is to lean forward for 10 minutes a night at the end of the day, either with elbows on the lounge or on a Swiss ball while you watch TV. Ginny also added that we should make sure that our knees are lower than our hips when we are sitting, so we aren’t jamming up our sacrum posteriorly during the pregnancy – and this is true for everyone from a generalised ergonomic standpoint too! 

So how do you know if bub is in a posterior position? You can map bub's kicks around your belly, check the positioning during ultrasounds, or you can find out in labour when back labour is more intense than the actual uterine contractions, and you have a fast, furious and haphazard contraction pattern. Fortunately, spinning babies has some positional manoeuvres for the labouring or pregnant woman, that can be performed easily and comfortably, to help open up the pelvic cavity and encourage bub to rotate out of the posterior position.  

Another common positional change is a breech baby position.  

When bub is still breech by 30 weeks, that’s when bodywork needs to be done and the exercises don’t work as well. It’s often a twisting of the ligaments and soft tissues, which in turn twists and turns the pelvis. This then torques the uterus and prevents bub from responding with natural reflexes to get their head down & bum up for labour! 

The big tips for midwives and birth partners (including doulas and husbands) was what they call “The 3 Sisters of Balance”, which are 3 positional exercises to do daily from 2nd trimester and during labour anywhere from 10-15 minutes.  

These included: 

  • Rebozo Sifting 
  • Forward Leaning Inversions and  
  • Side Lying Release

I would direct you to the Spinning Babies website for videos of each and for further information: www.spinningbabies.com 

To all my fellow pregnant women – I recommend that you check out the website with lots of free exercises. Get squatting and get upside down early! 

Kelly Ryan is a chiropractor based out of Health Space Coogee-Randwick & Rozelle, and specialises in pregnancy and paediatric chiropractic care. For more information about Kelly, or to direct her any questions or enquiries, call Health Space Rozelle on 9810 8769.