What is a Sunny-Side Up Baby? Understanding Occiput Posterior Position

During pregnancy, one of the most important factors for a smoother labour and birth is the baby’s position in the womb. Ideally, babies are born in the anterior position, which means they are head down with their face towards the mother’s back. However, some babies adopt a different position, known as “sunny-side up” or occiput posterior (OP), where the baby is head down but facing the mother’s abdomen instead of her back. This position can influence the labour experience, sometimes leading to a longer or more challenging delivery. This article will explore what it means to have a sunny-side up baby, the implications for labour and birth, and what expectant parents can do to encourage optimal foetal positioning.

Understanding Foetal Positioning

The position of your baby in the womb plays a significant role in the labour process. The optimal foetal position for labour and birth is the anterior position, where the baby is head down and their back is aligned with the front of the mother’s abdomen. This position allows the baby’s head to move easily through the birth canal during labour.

In contrast, when a baby is in the occiput posterior position, their back is aligned with the mother’s spine, and their face is directed upwards. This is commonly referred to as being “sunny-side up” because of the baby’s face-up presentation. While this position is not abnormal, it can lead to certain challenges during labour.

Why is Foetal Position Important?

The position of the baby’s head influences how labour progresses. Babies in the anterior position generally have an easier passage through the pelvis, allowing labour to progress more smoothly. In contrast, a baby in the sunny-side up position may find it harder to descend through the birth canal, leading to:

Prolonged labour: Labour can take longer as the baby’s head may not engage as easily in the mother’s pelvis.

Back labour: Women with sunny-side up babies often experience intense pain in the lower back during contractions due to the baby’s position putting pressure on the mother’s spine.

Increased risk of interventions: Occiput posterior babies may require interventions such as the use of forceps, vacuum-assisted delivery, or in some cases, a caesarean section if labour does not progress efficiently.

You can find more information on the importance of baby positioning in labour through the NHS website: NHS - What Happens in Labour.

Causes of a Sunny-Side Up Baby

Several factors may contribute to a baby being in the occiput posterior position. Some of these factors include:

Shape of the pelvis: The shape of a woman’s pelvis can sometimes influence the baby’s position. Women with a more narrow pelvis may be more likely to have a sunny-side up baby.

Maternal posture: The mother’s posture during pregnancy and in the weeks leading up to labour can affect the baby’s positioning. Spending a lot of time in reclined positions, such as lying back on a sofa, may contribute to the baby settling into the sunny-side up position.

Anterior placenta: If the placenta is located on the front wall of the uterus, the baby might have less room to turn and may adopt the posterior position.

Antenatal Care and Positioning: Can You Turn a Sunny-Side Up Baby?

The good news is that there are ways to encourage your baby to move into the optimal anterior position before and during labour. These techniques are often discussed in antenatal classes, where expectant parents learn about foetal positioning, labour positions, and ways to promote a smoother birth experience.

Some helpful practices include:

1. Antenatal Yoga

Incorporating antenatal yoga or yoga for pregnancy into your routine can help optimise foetal positioning. Certain yoga poses, such as the cat-cow or forward-leaning inversions, help create space in the pelvis and encourage the baby to rotate into the anterior position. Regular practice of yoga during pregnancy improves flexibility and strengthens the muscles used during labour, which can help your body accommodate the baby’s movements.

For more information on how yoga can support a healthy pregnancy and labour, visit Tommy’s: Tommy’s - Yoga During Pregnancy.

2. Prenatal Massage

Prenatal massage can be beneficial in helping to alleviate discomfort and encourage the baby to move into a better position. A professional pregnancy massage therapist can work to relieve tension in the lower back and pelvis, helping to create more room for the baby to rotate. Massage also promotes relaxation during pregnancy, which can reduce stress and tension that may otherwise contribute to baby malposition.

3. Maternal Posture and Positioning

Maintaining good posture throughout pregnancy is essential. Encouraging the baby to move into the anterior position can be supported by spending time in positions that allow gravity to help. Here are a few positions that may help:

Hands and knees position: Spending time on all fours helps the baby’s back rotate towards the mother’s front.

Leaning forward: Leaning over a birth ball or chair while sitting can encourage the baby to move away from the mother’s spine and into a more favourable position.

Standing or upright positions: Walking or staying upright during labour can help the baby move down into the pelvis.

For detailed guidance on how to encourage optimal foetal positioning, visit NCT: NCT - Positioning Your Baby for Labour.

Labour and Birth with a Sunny-Side Up Baby

If your baby remains in the sunny-side up position during labour, it’s important to be aware that labour may take longer and feel more intense, particularly in your back. However, this does not necessarily mean that your labour will be difficult or require intervention. Many women with sunny-side up babies have successful vaginal deliveries.

Techniques to Cope with Back Labour

Back labour is common with babies in the occiput posterior position. The following techniques can help manage back pain and discomfort during labour:

Movement and position changes: Regularly changing positions during labour can encourage the baby to rotate into a better position and relieve some of the pressure on your spine.

Water therapy: Using a warm bath or birthing pool can provide significant relief from back labour and help you relax between contractions.

Massage and counter-pressure: Applying firm pressure to the lower back, particularly during contractions, can help alleviate pain. A support person or midwife can assist with massage during labour.

Use of a birthing ball: Sitting and rocking on a birthing ball can help keep the pelvis open and encourage the baby to move.

For more tips on how to manage labour pain with a sunny-side up baby, check out the NHS guide to labour: NHS - Pain Relief Options in Labour.

When Intervention Might Be Needed

In some cases, the baby may not rotate into the anterior position, and labour may be prolonged. If labour is progressing slowly, your healthcare provider may recommend interventions such as:

Manual rotation: A healthcare provider may attempt to manually turn the baby into the anterior position.

Assisted delivery: If labour is particularly difficult, forceps or a vacuum may be used to help guide the baby out of the birth canal.

Caesarean section: In some instances, if labour does not progress, or if the baby shows signs of distress, a caesarean section may be necessary.

Your midwife or obstetrician will provide guidance based on the progress of your labour and your individual circumstances. You can learn more about interventions during labour from the Royal College of Obstetricians and Gynaecologists: RCOG - Assisted Birth.

Conclusion: What to Expect with a Sunny-Side Up Baby

While having a sunny-side up baby can result in a longer or more uncomfortable labour, it’s important to remember that many women with posterior-positioned babies go on to have successful vaginal births. Through antenatal education and by practising antenatal yoga, using massage techniques, and adopting good posture during pregnancy, you may be able to encourage your baby to move into the optimal anterior position. However, if your baby remains sunny-side up during labour, your healthcare team will provide support and guidance to help you through the process, ensuring the safest outcome for both you and your baby.