The left occiput anterior (LOA) position is the most common in labor. In this position, the baby’s head is slightly off-center in the pelvis with the back of the head toward the mother’s left thigh. The right occiput anterior (ROA) presentation is also common in labor. In this position, the back of the baby is slightly off-center in the pelvis with the back of the head toward the mother’s right thigh. When the baby is facing outward toward the mother’s left thigh, the baby is said to be right occiput transverse (ROT). Like the previous presentation, ROT is halfway between a posterior and anterior position. If the baby was previously in a posterior position, ROT is a sign the baby is making a positive move toward an anterior position.
Tips to Reduce Discomfort
There are several labor positions a mother can try to alleviate pain and encourage the baby to continue rotating toward an anterior position, including:
LungingPelvic tiltsStanding and swaying
A doula, labor nurse, midwife, or doctor may have other suggestions for positions. In the right occiput posterior position (ROP), the baby is facing forward and slightly to the right (looking toward the mother’s left thigh). This presentation may slow labor and cause more pain.
Tips to Reduce Discomfort
To help prevent or decrease pain during labor and encourage the baby to move into a better position for delivery, mothers can try a variety of positions, including:
Hands and kneesLungesPelvic rocking
Mothers may try other comfort measures, including:
Bathtub or shower (water) Cold packs Counter pressure Massage Movement (swaying, dancing, sitting on a birth ball) Rice socks (heat packs)
Once labor begins, a nurse, doctor, or midwife will be able to get a more accurate sense of your baby’s position by performing a vaginal exam. When your cervix is dilated enough, the practitioner will insert their fingers into the vagina and feel for the suture lines of the baby’s skull as it moves down in the birth canal. It’s important to ensure the baby is head down and moving in the right direction. For example, the position of your baby’s legs can be determined by asking questions about the location and strength of the kicking you feel. The spots where you feel the strongest kicks are most likely where your baby’s feet are. Other landmarks you can feel for include a large, flat plane, which is most likely your baby’s back. Sometimes you can feel the baby arching his or her back. At the top or bottom of the flat plane, you may feel either a hard, round shape (most likely your baby’s head) or a soft curve (most likely to be your baby’s bottom).
