What is this?



It is a theory developed by a midwife, Jean Sutton, and Pauline Scott, 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 labors result from ‘malpresentation’, where the baby’s position makes it hard for the head to move through the pelvis


Why it is important?

Changing the way the baby lies and promoting optimal position of the baby could make birth easier for mother and child. Position ideal for birth is when the baby is lined up so as to fit through your pelvis as easily as possible. To be in this position baby needs to be 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’, i.e. 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. This position is called “occiput anterior” (OA).


The “occiput posterior” (OP) position is not so good. This means the baby is still head down, but facing your tummy. Mothers of babies in the ‘posterior’ position are more likely to have long and painful labors as the baby usually has to turn all the way round to facing the back in order to be born. He cannot fully flex his head in this position, and diameter of his head, which has to enter the pelvis, is approximately 11.5cm, circumference 35.5cm. This means that often posterior babies do not engage (descend into the pelvis) before labor starts. The fact that they don’t engage means that it’s harder for labor to start naturally, so they are more likely to be ‘late’. Braxton-Hicks contractions before labor starts may be especially painful, with lots of pressure on the bladder, as the baby tries to rotate while it is entering the pelvis.