Labor and Delivery Fetal Positions for Labor and Birth Knowing your baby's position can you help ease pain and speed up labor By Robin Elise Weiss, PhD, MPH Robin Elise Weiss, PhD, MPH LinkedIn Twitter Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor. Learn about our editorial process Updated on November 18, 2021 Medically reviewed by Brian Levine, MD, MS, FACOG Medically reviewed by Brian Levine, MD, MS, FACOG Brian Levine, MD, MS, FACOG, is board-certified in obstetrics-gynecology, as well as reproductive endocrinology and infertility (REI). He is the director and founding partner of CCRM New York and was named a rising star by Super Doctors from 2017 to 2019. Learn about our Medical Review Board Print In the last weeks of pregnancy, determining your baby's position can help you manage pain and discomfort. Knowing your baby's position during early labor can help you adjust your own position during labor and possibly even speed up the process. Right or Left Occiput Anterior Illustration by JR Bee, Verywell Looking at where the baby's head is in the birth canal helps determine the fetal position.The front of a baby's head is referred to as the anterior portion and the back is the posterior portion. There are two different positions called occiput anterior (OA) positions that may occur. 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. In general, OA positions do not lead to problems or additional pain during labor or birth. Right or Left Occiput Transverse Illustration by JR Bee, Verywell When facing out toward the mother's right thigh, the baby is said to be left occiput transverse (LOT). This position is halfway between a posterior and anterior position. If the baby was previously in a posterior position (in either direction), the LOT position indicates positive movement toward an anterior position. 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. When a baby is in the left occiput transverse position (LOT) or right occiput transverse (ROT) position during labor, it may lead to more pain and a slower progression. 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. Right or Left Occiput Posterior Illustration by JR Bee, Verywell When facing forward, the baby is in the occiput posterior position. If the baby is facing forward and slightly to the left (looking toward the mother's right thigh) it is in the left occiput posterior (LOP) position. This presentation can lead to more back pain (sometimes referred to as "back labor") and slow progression of labor. 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) How a Doctor Determines Baby's Position Leopold's maneuvers are a series of hands-on examinations your doctor or midwife will use to help determine your baby's position. During the third trimester, the assessment will be done at most of your prenatal visits. Knowing the baby's position before labor begins can help you prepare for labor and delivery. 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. Labor and delivery may be more complicated if the baby is not in a head-down position, such as in the case of a breech presentation. How You Can Determine Baby's Position While exams by health practitioners are an important part of your care, from the prenatal period through labor and delivery, often the best person to assess a baby's position in the pelvis is you. Mothers should pay close attention to how the baby moves and where different movements are felt. A technique called belly mapping can help mothers ask questions of themselves to assess their baby's movement and get a sense of the position they are in as labor approaches. 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). 10 Positions to Make Labor More Comfortable 6 Sources Verywell Family uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Guittier M, Othenin-Girard V, de Gasquet B, Irion O, Boulvain M. Maternal positioning to correct occiput posterior fetal position during the first stage of labour: a randomised controlled trial. BJOG: An International Journal of Obstetrics & Gynaecology. 2016;123(13):2199-2207. doi:10.1111/1471-0528.13855 Gizzo S, Di Gangi S, Noventa M, Bacile V, Zambon A, Nardelli G. Women’s Choice of Positions during Labour: Return to the Past or a Modern Way to Give Birth? A Cohort Study in Italy. Biomed Res Int. 2014;2014:1-7. doi:10.1155/2014/638093 Ahmad A, Webb S, Early B, Sitch A, Khan K, MacArthur C. Association between fetal position at onset of labor and mode of delivery: a prospective cohort study. Ultrasound in Obstetrics & Gynecology. 2014;43(2):176-182. doi:10.1002/uog.13189 Nishikawa M, Sakakibara H. Effect of nursing intervention program using abdominal palpation of Leopold’s maneuvers on maternal-fetal attachment. Reprod Health. 2013;10(1). doi:10.1186/1742-4755-10-12 Choi S, Park Y, Lee D, Ko H, Park I, Shin J. Sonographic assessment of fetal occiput position during labor for the prediction of labor dystocia and perinatal outcomes. The Journal of Maternal-Fetal & Neonatal Medicine. 2016;29(24):3988-3992. doi:10.3109/14767058.2016.1152250 Bamberg C, Deprest J, Sindhwani N et al. Evaluating fetal head dimension changes during labor using open magnetic resonance imaging. J Perinat Med. 2017;45(3). doi:10.1515/jpm-2016-0005 Additional Reading Gabbe S, Niebyl J, Simpson J et al. Obstetrics. Philadelphia, Pa.: Elsevier; 2012. By Robin Elise Weiss, PhD, MPH Robin Elise Weiss, PhD, MPH is a professor, author, childbirth and postpartum educator, certified doula, and lactation counselor. See Our Editorial Process Meet Our Review Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit