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Questions and Answer

Q. Both of my 2 sons were in a posterior position. My oldest was a section after a very long labor. My second was a VBAC. I had difficulty pushing my second and it was only after an epidural, a couple of hours of pushing and then a request for forceps that my doctor told me that for some reason both of my kids were in the posterior position, which seemed to be a mystery to him. Now, for my question. What are the chances that this baby will also be in the posterior position when it is born? Is this a pattern my body will keep repeating or is it a fluke?

A. Some women have a pelvis shape that better accommodates a posterior presentation. The baby usually tries to come down and rotate in the diameter that will give him the most room. Sometimes a baby will be posterior and will descend abruptly and then be unable to turn anterior (or it may a take a while to turn) - causing the baby to remain posterior. This can cause problems for the mother on occasion, such as you experienced (long labor, forceps, cesarean...)

Your best bet with a history of posterior babies to keep an eye on his position in your last weeks of pregnancy. Is he anterior or posterior? If he turns posterior before labor or in early labor, there are some things you can do to facilitate rotation of the baby. Pelvic rocks, walking up and down stairs and being on your hands and knees are all ways to encourage the baby to rotate to the better-flexed anterior position. Patience may be in order as early labor may be long while the baby turns. Ask your doctor to show you how to palpate the baby's position, or get a book that details how to feel how the baby is lying.

As a word of encouragement I have seen several posterior labors and the women were able to birth without epidurals or forceps. Early labor was longer and their backs did hurt, but the walking and hands and knees position helped the babies rotate into a better position to be born. So this labor still has a good chance to be your best experience yet! You birthed your second son vaginally even though he was posterior, and that could make your pelvis just a little bit more roomy for baby number three.

Karen Klimsak-Ungar, CCE has been a certified childbirth educator for Birth Works® since 1996. She is currently Managing Editor for the Birth Works newsletter, sits on the Birth Works Board of Directors, and serves on their National Trainee Review Committee. A happily married mother of two, she also continues to teach Birth Works classes as well as private classes.

Karen will answer your questions on fertility, pregnancy, birth, breastfeeding and babies. Her advice does not take the place of your practitioner. Personal answers will not always be possible.