Where should I be feeling my kicks?!

After the 30-week mark of your pregnancy, ask your doctor or midwife to check which position your baby is lying in. Most of the time, they'll be able to give you a very good indication of how your little one is positioned. Why is it important? Well, the quick answer is that once a baby is lying in a 'good' position, you will have a shorter and easier labour, as the narrowest part (smallest diameter) of baby's head is coming down through the pelvic rim, and is in great alignment.

What you are looking for ideally, is for baby to be lying with their back towards the front of mama's abdomen, and slightly to the left. The position where baby's body is lying with their back pointing forwards is called OA - Occiput Anterior. The occiput is the lowest bone in the back of the skull. It's important to also note that the cervix is positioned towards the back of the uterus - it's not just a straight chute to the exit ;) So when baby is lying in the OA position, particularly to the left, baby's head is in a wonderful position to press straight down onto the cervix and hence speeding up the dilation.

Some indications that baby is lying in this position would be:

• You've got a good pointy,  'sticky-outy' bump!
• Your 'sticky-outy' bump is forward leaning and nice and big. 
• Your tummy button might be starting to push outwards, as it is being really stretched.
• You are getting your kicks mostly on the right-hand side, roughly between the hip-to-rib space.

Clues that your baba is NOT lying in this lovely position, or that they are in fact lying 'back-to-back', are:

• You are feeling most of your kicks at the front of your belly
• Sometimes very tiny or very neat bumps can be an indication that baby is, in fact, lying 'back-to-back'
• At times, your belly can be a little soft right in the centre - where the back should be 
• You experience frequent lower backache
• Then in labour, you experience most of your contractions in the low back, often along with a constant pain/pressure on the low back

Why is that important to know?

If your baby is lying OP - Occiput Posterior (their back is lying against your back), the widest part of their head is coming first down the birth canal. Their chin is not tucked under. Baby's head tends to press down on the front of the pubic bone, and not pointing towards the back of the womb. As the cervix is more towards the back of the uterus, it is much harder for baby to nicely slip their head down into the pelvic canal. All of this tends to lead to a very long, uncomfortable labour. It would not be uncommon for women to take a couple of days to get to 3 - 4cm dilated. Obviously, it's not the case for all babies in this position, but OP for most women is pretty challenging.

Research also indicates that the use of an epidural can increase the rate of posterior position at the time of birth from about 4% up to about 13% when an epidural is used (Lieberman, 2005). When a women has an epidural, she tends to lie backwards, which encourages baby to also fall back to lying back-to-back.

87% of OP babies tend to turn during labour, but it can take a really long time & can be exhausting. Some women can experience a grinding feeling at the front as baby is pressing down in and around pubic bone, trying to turn.

The incidence of OP babies is actually increasing. But when you think about it, it isn't surprising. Women's lifestyle nowadays versus even 40 years ago have changed dramatically. Now, in our day-to-day lifestyle, we tend to spend significantly LESS time on our feet, or in semi-upright positions. We work more in office-type environments, where we are sitting for the vast majority of the day. Women now drive much more frequently than previous times - and all of these positions tend to be in a relaxed, high knees position. When relaxing, we then tend to slouch back into a comfy chair or couch. Again, a high-knee position (where your knees are higher than your hips), which help to tilt baby back into a less-than-ideal position.

Go back 40 years - not that long ago!! - women were, for the most part, much more physically active. We were predominantly caregivers, on our feet running around all the time. We didn't drive as much, we didn't spend much of the day seated, and the chores in the house tended to be much more physical. Think about it - no washing machines for example, so you'd have to bend over and scrub like mad! In fact, many women would have been in forward leaning positions and on their hands and knees working!

Don't get me wrong - I LOVE women's progress!!! But it hasn't helped our ability to birth easily. SO, what can you do to help?

There are very simple lifestyle changes you can make, and here are my top 5:

• Think about being upright - so if you are sitting at your desk, make sure you take several walks. Drinking loads of water will help with this as you'll need to pee a lot! That's an added bonus!
• When you are seated, ensure that your Hips area HIGHER than your knees. So get a well-pumped exercise ball and sit on that in work or at home. When you are driving, get some cushions to make sure that you are propping those hips up.
• MOVE - seriously, pregnant women need to exercise for a minimum 30 minutes a day x 5 days per week. Please have a read here of everything you need to know about exercising during pregnancy.
• I'd strongly urge you to practice yoga. Yoga will open up the body, reducing stiffness and all sorts of aches and pains. It will also help to get your body into many forward-leaning, upright positions, and loads of hands and knees poses which are tremendous. I can't stress enough just how phenomenal Prenatal Yoga can be for the whole body and mind.
• If you know your baby is in a funky position - either breech, back-to-back, transverse, please do something about it. The ideal time to start working on a baby in these positions are from about 33/34 weeks. Osteopathy and Acupuncture can work wonders, in combination with Yoga.

If you want to keep your body fit and healthy, and get your baby into a wonderful birthing position, then I'd love you to check out my Online Prenatal Yoga course that you can take at any stage of your Pregnancy. There are 5 different sequences available to practice, depending on your needs. So if you want to practice yoga during your pregnancy (which obviously I highly recommend!!) and have me at home with you (you lucky duck;-) ), then click here for my Prenatal Yoga Online Course. 

If you'd like to find out more about my full 7-week online Prenatal Yoga & Birth Preparation Program, which includes all the yoga from the online course, please click here. 

Wishing you lots of love

Helen x

_{Helen Plass is a Pre & Postnatal Fitness Specialist, and Yoga Instructor, working with women and their birthing partners to achieve a comfortable, healthy & happy journey into Pregnancy, birth and Motherhood. She is known for her very practical & non-judgmental approach to pregnancy and the crazy times of motherhood. Check out all her communication at NurtureMamas.com, and if you are in Ireland, her local business MumandBaby.ie}