OPTIMAL MATERNAL POSITIONING

I am so thrilled to be hosting Ginny Phang of OMP here in Auckland on November 16th. Ginny is a powerhouse of information and a phenomenal speaker who left quite an impression on me when I attended her spinning babies workshop, since then she has branched out on her own and i've received amazing feedback from my colleagues in Australia so I had to bring her to our shores.

There continues to be much discussion about optimal foetal positioning, and rightfully so because it is often the key to obtaining healthy vaginal births. The subject of ‘which way the baby’s face is facing’ and how it can impact labour, has been documented in the medical literature over the centuries by midwives and doctors alike. If the baby's face is up, or at woman's symphysis pubis, it often is cited as a reason for doing a C-section.

With more than enough medical evidence and research to show how babies born in the posterior position or have been in a posterior position during labour has led birth workers worldwide to teach “Optimal Foetal Positioning” (OFP) - a handbook by New Zealander’s Jean Sutton and Pauline Scott – to pregnant women where they are taught to understand how the baby moves during labour, which positions to avoid, and which positions help turn a posterior baby.

OFP tips include not sitting in the bucket seat of a car for too long. They rely on the woman understanding why the advice has been given and then being willing to change her patterns or habits such as sitting more upright. However, the emphasis on having babies positioned in the Left-Occiput-Anterior (LOA) position before or at the start of labour can also trigger other insecurities, fears, exhaustion, and interventions for the woman and subsequently her baby.

Many women come to me for a VBAC (vaginal birth after caesarean) because their previous birth team missed classic signs of a posterior before and during labour including: going past due dates, the woman feeling lots of limbs in front during her pregnancy and back pain during pregnancy, slow-to-start early labour, irregular contraction patterns, slow dilation with slow progress, or even rapid dilation with a slow and often difficult, if not excruciating second stage of pushing, or continuous back ache during labour - where the backaches are more intense than the contractions itself.

Whilst OFP has contributed to the knowledge of both pregnant women and birth attendants alike in enabling smoother births, it also has its flaws that have not been taken into consideration. For example, that research shows that 67% of mothers start labour with the baby in Left-Occiput-Transverse (LOT) and not Left-Occiput-Anterior (LOA).

Also, when we assume that LOA is the most favourable position, we do not take into consideration the different types of pelvises there are amongst women. In addition, even if the woman has the type of pelvis that majority of women have, imbalances within the pelvis can also hinder the progress of labour.

Having a baby pass through the pelvis is a complex process that is impacted by a multitude of factors (maternal and fetal). The good news is there are many things that pregnant women can do to create space within her pelvis, for the baby to pass through.

This is where ‘Optimal Maternal Positioning’ (OMP) comes in. OMP is an equally important concept which has a direct impact on optimal foetal positioning. Creating a smooth path for the baby to navigate through the pelvis during labour and birth depends on the ability for the baby to work through the cardinal movements during the processes of descent and dilation. And because of this perspective, the teamwork between the mother and her baby will give her the best chance of a swifter easier birth.

Optimal Maternal Positioning focuses on creating space within the keyhole, where the pregnant mother and birth providers learn about:

1. Balancing concepts during pregnancy

2. Move smart and rest smart positions during pregnancy

3. Functional positions during pregnancy to be used during labour and birth

4. Empowering pregnant mothers to be more aware of the baby’s position and movements during pregnancy, which increases prenatal bonding

5. Other complementary alternatives such as bodywork adjustments to help align the mother’s pelvis to create space for the baby

6. Recognising labour patterns so both the pregnant mother and her birth providers are aware of what is normal, and when to intervene with using techniques that enables labour to progress

7. The importance of balancing concepts during labour & birth, before gravity and movement are being utilized

8. Maternal positions during labour and birth that optimizes the pelvis to enhance a smoother delivery process

About the Presenter

Ginny Phang-Davey is an international speaker who has taught over 1000 workshop participants in more than 20 cities worldwide since 2015, former Spinning Babies Approved Trainer, a DONA certified Birth & Postpartum Doula, President of International Birth Professionals Association (IBPA)(www.ibirthprofessionals.com) - an online mentoring and educational platform and a midwife who runs Four Trimesters Birth Sanctuary (www.fourtrimesters.com) in Singapore.

Recognised by the ACM for 8.75 hours