What is Optimal Foetal Positioning?

Optimal Foetal Positioning (OFP) is a theory developed by a midwife, Jean Sutton, and Pauline Scott, an antenatal teacher, who found that the mother’s position and movement could influence the way her baby lay in the womb in the final weeks of pregnancy. Many difficult labours result from ‘malpresentation’, where the baby’s position makes it hard for the head to move through the pelvis, so changing the way the baby lies could make birth easier for mother and child.

The ‘occiput anterior’ position is ideal for birth – it means that the baby is lined up so as to fit through your pelvis as easily as possible. The baby is head down, facing your back, with his back on one side of the front of your tummy. In this position, the baby’s head is easily ‘flexed’, ie his chin tucked onto his chest, so that the smallest part of his head will be applied to the cervix first. The diameter of his head which has to fit through the pelvis is approximately 9.5 cm, and the circumference approximately 27.5cm. The position is usually ‘Left Occiput Anterior’ or LOA – occasionally the baby may be Right Occiput Anterior or ROA.” Reference Optimal Foetal Positioning

Tips for assisting optimal position:-

• Important to keep your back to be upright, when standing or sitting
• Walking around often
• When sitting, keeping Knees lower than pelvis.
• Tummy slightly forward
• Do not cross your legs or ankles esp. in 3rd trimester – reduces the space at the front of the pelvis, and opens it up at the back- 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.
• Car seats are slanted, and sofas encourage slouching, be aware of your position when you are driving and sitting, going on all fours and polar bear position can assist in getting, and maintain baby in the optimal position, and maintaining good levels of hydration


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