Optimal Fetal Positioning

What is it?

Optimal Fetal Positioning (OFP) is a theory developed by a New Zealand midwife, Jean Sutton and childbirth educator, 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. The idea is that many difficult labors (and cesareans) result from "malpresentation", where the baby's position makes it hard for the head to move through the pelvis, so changing the way the baby lies could make birth easier for mother and child.

In the last trimester of pregnancy we can generally palpate a woman's belly and tell her how her baby is lying relative to her pelvis.  Anterior is considered "optimal" for a good fit for birth. Posterior is generally associated with longer or more painful labor.  Some babies fit very nicely in the posterior position and maybe just need to come out that way.  We don't insist on perfect positioning, but generally feel like it is a good idea to make an effort to turn posterior babies to the anterior prior to labor if at all possible.

Books

Understanding and Teaching Optimal Foetal Positioning
by Jean Sutton and Pauline Scott.
Currently out of print but we have a copy in our office.

Sit Up and Take Notice! Positioning Yourself for a Better Birth
by Pauline Scott

Essential Exercises for the Childbearing Year: A Guide to Health and Comfort Before and After Your Baby Is Born
by Elizabeth Noble
Not specifically about OFP, but covers the basics on posture and exercise as the best way to achieve it.

websites

Each of the following midwives' websites have fabulous articles about OFP and how to achieve it:
Spinning Babies
Home Birth UK
Birth Angels
Better Birth Partners