Posterior Positioning
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Signs and Symptoms

In working with many VBAC women, I am amazed at the sheer number of cesarean births attributed to Failure to Progress or CPD, Cephalo-Pelvic Disproportion. In reality, these women have prolonged labours not because of their babies inability to fit through their pelvises, but rather because their babies are posterior.

Pictured above is an excellent view of a posterior baby. Note the indentation at her belly button. This is caused by the gap between the babies arms ,the bump below her belly button, and his knees and feet above her belly button. This baby is posterior and asynclitic (his head is crooked as he tried to negotiate her pelvis). This photo was taken after 6 hours of complete dilation, 4 hours of pushing and shortly before her cesarean birth. 

Signs of Posterior positioning prenatally

bulletLots of Prodomal or Braxton-Hicks contractions, often felt as lower back ache or pain that is strong during the day and stops at night. My theory is baby is trying to turn before labour begins, thus the seemingly ineffective contractions
bulletThe feeling that the baby has too many hands and feet, and the moving limbs may be easily felt and seen up front.
bulletFrequent urination due to the baby’s brow pressing against her bladder. Incontinence may be felt as baby wiggles against the bladder, forcing out urine and often it feels like a urinary tract infection because of the constant pressure on the bladder and accompanying backache.

Fetal hear tones may be difficult to detect, or tones are indistinct.


It will be difficult or impossible to feel the babies back, and the head may appear to be engaged.

Signs of Posterior positioning during labour

bulletAlong with the symptoms above, the most distinct sign is persistent backache, which even in early labour may be severe enough that the pain of contractions are secondary. As a backache may be present even in normal anterior presentation, it is important that a vaginal examination be done to correctly assess the baby’s position by the fontanels.

Copyright Mother Care, 1999. Written by Connie Banack, CD.

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