Daphne Metland explains how your baby's position can affect your labour.
Daphne: Let's think about the position of the baby in labour, because that's important, too. I've got a couple of teaching dolls here. I'm going to give you this one [hands a doll to Emily]. And I promise you, your baby will be much more beautiful than this teaching doll!
But it's quite useful, just to feel the size and shape of the baby. Now most babies actually get down into a nice head-down position to get born, and they curl up, into what's called a fetal position. They tuck their chin on their chest, which means the smallest diameter is being born, and that way they can really get into the pelvis nice and easily [holds doll upside-down inside the model of the pelvis, head first]. And usually babies do that at about around 36 weeks with a first-time mum. So you'll feel the baby go down into the pelvis, and there's the baby in a nice position, ready to get born [holds baby doll upside-down inside the model of the pelvis].
Occasionally, you get a baby that decides to do it the other way round [turns doll upright]. So sometimes you get a baby that's trying to get born bottom-first, which isn't quite as easy. And sometimes they put a leg down [positions doll's leg so that it points downwards into the pelvis].
And sometimes, if they're really awkward, they put their legs up by their ears [moves doll's legs so that they point up towards head]. And you can see that this really splints the body: it's called a frank breech. And you can see that the baby can't turn as it comes down through the pelvis, and so it's really hard to deliver a breech baby. And usually they're born by caesarean section. Not always; occasionally you get somebody who is having a second baby and has lots of space in their pelvis. But generally speaking, a breech baby is nowadays a caesarean section. Thankfully it's only about four per cent of babies who try to do that.
Most babies [turns baby doll upside-down] automatically get into the head-down position and come down into the pelvis. But sometimes, instead of coming down with the back of their head facing and their back there, they turn themselves around, and try and get down with their spine against your spine. And that's quite an awkward position because there's not as much room that way. It tends to make labour slower and more painful, and you get an awful lot of backache, because your baby's spine is against your spine. And if you're lying down, [tilts baby doll backwards] then the weight of the baby is on your spine. So if you've got a posterior baby, it's very important to turn yourself over, go on all fours or lean over a chair or a table, because then what happens, is the baby drops off your pelvis, it relieves the pressure on you and the pain is so much less. But it also gives the baby room to turn around, and it's easier for the baby to then turn into the right position to get born.
So it's worth asking your doctor or your midwife what position the baby is in in early labour, because that will guide you on how mobile (you need to be) and what sorts of positions to get into to try and help the baby turn.
If you've got a backache labour, this is the worst possible position to be in. Your spine is flat on the floor, the baby's spine is sitting on your spine and all the weight of the baby is on your spine as well. You'll probably find that it's much more painful in this position.
If you can, it's worth turning onto all fours (Emily shifts from lying on her back to being on all fours). Now your pelvis is the other way up. The baby has dropped off your spine, he's free and can turn much more easily and there's much less pressure on your back joint.
The difference between lying on your back and being on all fours, for a woman with backache labour, is completely major. On her back, she might be really struggling to cope with contractions. On all fours, she will suffer much less pain and she'll be much more able to cope.
So, if you get a backache labour, remember this and give it a go.