Oohhh love this subject!

Obv am still learning so hopefully lots of knowledgable replies to come, but being mobile certainly helps application of the fetal head onto the crevix and thus facilitates rotation into an occipitoanterior or lateral position, enabling an easier birth. And strong, regular effective contractions are needed to help this also. I have seen an OP baby born once, they also call it face-to-pubes presentation (pls don't mod, that is really called that, yuk)

Some women are encouraged to change onto an all four postion to facilitate rotation, however current evidence does not support that this has any effect on fetal position (see RCM evidence based guidelines for midwifery care in labour)

Unfortunately the incidence of persistent OP position seems to be on the increase, thought to be due to the sedentary lifestyle women currently have and this is affecting the fetal lie in-utero (Denis Walshes' book, 'Evidence Based Care in Normal Labour and Birth' has some good stuff on this)

Great thread topic missy, it's a good diss subject as it often affects birth outcomes (In my limited experience anyway)

I have seen quite a few now, one of the worst aspects for the women is the increased rectal pressure and severe back pain experienced, often they have premature urges to push and struggle to cope with the intense pain. One of my earliest experiences was with a woman who was screaming with the pain and just could not cope, she was VE'd to be 4 cm after she said she had to push, she went onto have pethidine, then an epidural, these slowed the contractions down, compounding the problem, then syntocin infusion to bring them back, then ARM and finally forceps many hours later. She was my first experience of OP and when I was trying so hard to support her my mentor came and got me and told me off for spending too much times there, he said she obv had a low pain threshold!!

I finshed my shift and went and read alot about it and realsied she was siffering so much because of the baby's position, not because she was a wimp!

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