What is Occiput Posterior and How Does It Affect Labor?

Pregnancy is yet another beautiful stage in the life of a woman, who’s awaiting to step to a bigger phase called motherhood. Anticipating for the baby during pregnancy is a delightful feeling and for that it is highly important to know the importance of baby positions in your stomach and how it’s going to affect labor.

What is Occiput Posterior?

An Occiput Posterior is a common fetal malposition. In this position, the baby’s head faces downwards, but it faces the mother’s front instead of her back. Although it is easy to deliver a baby in this position, but it gets harder for the baby to come out from the pelvis. Sometimes a baby in this position rotates itself during labor, creating an Occiput Anterior position with the head staying downwards and the body facing the mother’s back.

The mother can rock, walk, and try various delivery positions during labor to encourage the fetus to turn. However, if the baby does not turn, labor can take a longer time. In some situations, the doctor may use forceps or use a vacuum device to get the baby out. Nonetheless, a baby’s posterior position matters during labor as there are a spectrum of possibilities with such a baby.

In some cases, mothers will be unaware that their fetus is in an occiput posterior position unless someone mentions it. It’s because the doctors didn’t notice it or didn’t know. If the labor moved along, it’s possible that they may have overlooked the fetal position clues since there was nothing left to deduce about why labor wasn’t progressing. It’s usually uncommon of a baby to be born in less than 8 hours in a posterior position, while some babies are seen to be born in less than 36 - 48 hours without the need for interventions. Some posterior babies are easy to be draw out because the mother is well supported, mobile, and eats and drinks freely when needed. Although, some occiput posterior delivery require extra support that a well-trained and experienced labor coach can provide. In some odd cases of a posterior labor, it’s seen to have progressed with the help of a skilled pregnancy bodyworker which otherwise would end up with a medical intervention. Some posterior labors happen with the pelvic floor relaxing, allowing the baby to rotate and come out, while in some cases, the epidurals make it extremely hard for a woman to finish the birth vaginally. This results in cesarean births and that here refers to as a spectrum of possibilities.

Now let’s look at what a left occiput posterior and a right occiput posterior is –

Left Occiput Posterior

By now we know that when the baby is facing forward, it is in an occiput posterior position. If the position of the fetus is facing forward and slightly to the left (looking towards the mom’s right thigh) it is in the left occiput posterior position. This kind of a presentation may lead to severe back pain, which at times is referred to as back labor, and slow movement of labor.

Right Occiput Posterior

In the right occiput posterior presentation, the baby is usually seen to be facing forwards and a little to the right (looking towards the mom’s left thigh). In this kind of a presentation, the process of labor maybe slower and may cause more pain.

Thus, occiput posterior position may not ideally cause severe complications during delivery, but there are cases that require attention of a doula for a successful birth of a baby. Thus, let us look at how having an occiput posterior may affect labor:

  • Long early labor

  • Long active labor

  • Prolonged pushing stage

  • Back pain (in certain cases)

  • Longer duration of pregnancy

  • A start and stop in labor pattern

  • The water breaking before labor

  • Highly expected to be a cesarean

  • Pitocin can be used when labor stalls

  • More likely to require forceps or vacuum

  • Labor gets longer, stronger and less rhythmic

  • Even during the pushing stage, baby may not engage

  • Untimely labor even before an induction is scheduled

  • A woman may go through three stages of labor which sometimes is lengthened by the Occiput Posterior labor

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