I have been reflecting on my shift from Monday, and just wanted an answer to something I have been wondering about please.

If a baby is in a posterior position, with and OP presentation, would it help the baby deliver any easier if mum was mobile, or would it still be a difficult delivery?

My mentor said it is possible to deliver a baby in this position, but it isn't easy, so I just wondered if it would be any easier with mum being mobile.

Hope that makes sense, I know what I am trying to say, but can't seem to get the words out right.

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Bless you Mum & Dad x
Student Midwife 2007

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Yes mobility would encourage the baby to turn into a better position, also gravity alones the baby to descent further into the birth canal..
I have delivered one direct OP baby.. Very bizarre delivery as the baby comes out looking straight at you.. But it is possible!

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Duel X
2nd year student midwife
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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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Thanks for the replies, I did wonder if it would have made a difference as mum was on the bed attached to a CTG machine, and so not mobile at all.

Not for one minute saying her care was wrong, just wondered about mobility and it making a difference.

I find it an interesting subject, especially as I could actually understand the terms the midwives were using, which amazed me lol, we had covered it at uni, but it doesn't always make sense then, but when you are exposed to it in practice for some reason it all clicks....well it did for me lol.

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Bless you Mum & Dad x
Student Midwife 2007

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Why was she on the CTG continuously MM?

What high risk category was she?

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To be honest I don't know, other than she had synto running, not sure if that is why, I didn't think to ask at the time.

Other than that she wasn't high risk and was expected to deliver normally.

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Bless you Mum & Dad x
Student Midwife 2007

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As soon as she had a syntocinon infusion put up she became high risk, hence the continuous monitoring then.

Why was the synto up? was it because her contractions went off?

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Ah right, thanks for that, yes her contractions had started to go off before I went in the room with my mentor, and it all went down hill from then on in a way.

What surprised me the most was, that I could tell the mum wasn't progressing despite her best efforts, and I had never even seen a delivery before, but I felt I knew what the outcome would be without being told. It was a wierd feeling, I didn't expect to know anything like that, strange how you just sense these things in a way!

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Bless you Mum & Dad x
Student Midwife 2007

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oh, good subject!
Lots been said before, and as you said MM she was on continuous CTG which deos make it hard to move. But also from the incidences I have seen, OP presentations usually end up with epidurals as the pain is so intense, thus making it hard to be mobile as well. Therefore the cascade of intervention has started as the epidual + OP more often than not means that it ends in a forceps/ventouse delivery (from what i have seen). Whereas if women were given good support from the beginning and encouraged in the right way, maybe these things would not happen?

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See, knew you'd realise you know more than you think!

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