Optimal Fetal Positioning

Childbirth educator Pauline Scott coined the phrase Optimal Fetal Positioning to describe the work of Midwife Jean Sutton.  These two women published Understanding and Teaching Optimal Fetal Positioning in 1996.  Two facts will help you to understand why fetal position is important:

  1. Baby's rotate through the pelvis to emerge from the womb.
  2. Fetal position effects the relative ease of fetal rotation and descent. 

Get the back ground on Midwife Jean Sutton's approach with OFP :


Optimal Fetal Positioning aims to help a fetus into the easiest birth positions for labor by giving the mother guidelines for her posture and movement (maternal positioning) in pregnancy and during labor.

Jean Sutton advises good maternal posture to help baby settle in an optimal fetal position (or, in New Zealand terms, Optimal Foetal Position). She suggests positions that keep the pelvic brim open - away from the spine. Good posture includes standing and letting your belly hang freely to be a hammock for the baby and sitting up and letting your belly come forward. Pauline Scott discusses Jean Sutton's recommendations in Sit Up and Take Notice. Janet Balaskas wrote the book inspiring Jean and Pauline's exciting information, Active Birth


The angle of the baby's head changes the diameter of the head. 

So that a baby facing the mother's back most often fits the pelvis more easily than a baby who faces the front. The back of baby's head is the landmark (occiput bone):

The baby facing mother's back is in the "anterior" position because the baby's occiput is towards mother's anterior (front). 

The baby facing mother's front is in the "posterior" position because the occiput is towards mother's back. 

The baby facing the right hip and coming into the pelvis from the left fits more easily than the baby whose back is on the mother's right.

Now this last detail is a clue. If the pelvis was the only factor in fetal positioning concerns, then left and right would simply be mirror images and of equal ease (or challenge) during birth. But Midwife Jean Sutton reminds us that other anatomical features play a part in fetal position. 

The mother's liver and spine can make the baby's whose back is on the right have a more extended chin. This puts the top of the head at the pelvic brim. The top of the head is longer than the crown of the head. The baby can't help with the birth as well as the baby whose chin is tucked close to the chest.

The optimal fetal positions are considered to be: 

  • Left Occiput Transverse (Left Occiput Lateral, top circle)
  • Left Occiput Anterior (middle circle)
  • Occiput Anterior (bottom circle)

The baby in the Right Occiput Anterior position may or may not be optimal:

The Right Occiput Anterior (Right Occiput Lateral) baby may have to rotate further to the left to fit through the pelvis

The ROT/ROL baby may be more likely to have his or her chin up making the head circumference larger than with the chin tucked.

Both of these two maybes, may increase the chance of the ROT/ROL baby needing more interventions for birth. A first time mother may have a longer labor with a Right Occiput Anterior baby than she would with a Left Occiput Transverse baby when rotation is effected by fetal position. If flexion is good, and the mother's pelvic floor is relatively balanced, the ROT/ROL baby probably won't present any problems at all.

More on fetal positions and how they effect labor in The Belly Mapping Workbook or the Belly Mapping article on this site.



Spinning Babies approaches Optimal Fetal Positioning with more focus on the mother's body balance than her posture.

Posture is important, I agree. I describe potentially good maternal postures in Rest Smart. Good posture will help a baby into a more optimal position unless there is a twist or significant tightness in the broad ligament, pelvic floor, or other soft tissues of the mother's reproductive anatomy. In other words, some women need more than gravity to help the baby into a good position.

Spinning Babies starts with Balance as the first Principle of Spinning Babies.

Optimal Fetal Positioning begins with gravity-friendly, maternal positioning to open the pelvic brim. Gravity is Spinning Babies' second principle.


 Amy Hoyt has a series on Optimal Fetal Positioning with great photos on her blog:  Natural Birth in Kitsap



A co-venture video experience with Spinning Babies and Blooma Yoga! Coming Soon!

Spinning Babies; Daily Essentials Video.

Sarah Longacre and Gail Tully present a Spinning Babies and Blooma Yoga collaboration in a three video series for pregnant women preparing for easier childbirth through body balancing, maternal positioning and yoga.Together Sarah Longacre, international prenatal yoga instructor and birth doula, and Gail Tully, yours truly, created a unique instructional video for flexibility and comfort in pregnancy and to support better fetal positioning in time for birth.

Here are daily activities for stretching and balancing a pregnant body. Start early in pregnancy to prepare to make the most space for baby's best birth position and the most ease for mother's opening during the birth process.

We begin the program for women of average flexibility (or just plain stiff to start with) and beginner tips.  But soon, you'll be ready to move freely! That's when Sarah brings the stretches all together into her easy to follow, playful, sensual, and flowing "Blooma Style" daily routine.

Sarah's "dance of opening," moves joints and ligaments to come alive under the delightful melody and percussions of Carin Vagle. This isn't about core strength; its about freedom of movement and creating space in the body.

Sarah plays along with Gail's little game of "Flashlight" to show pregnant women how to evaluate their own posture and positions. Smart Maternal Positioning helps baby snuggle their backs into the front of the womb for Optimal Fetal Positioning. 


Daily Essentials includes tips for using Maternal Positioning around the house. Actual scenes in the bedroom, living room -and even the bathroom- gives practical instruction like no other video. You will be sleeping more comfortably immediately when using these tips. Within a week or two many pregnancy discomforts of the pelvis and lower back may be reduced when all these nurturing techniques are integrated into your daily lifestyle. Spinning Babies and Blooma Yoga-- a natural collaborative!


Spinning Babies Childbirth Preparation Class.

Soon pregnant parents around the world can take a Spinning Babies class from their own monitor! Join six couples as they learn the reason why Spinning Babies works and how it can enhance your labor and birth.

See techniques to do daily or weekly. Actual, real consultations with two couples right at our class location, one with a breech baby (head up) and one with a baby in a transverse lie (lying sideways).

Couples do the techniques together and show you how to do these at home.

Used alone or with the Daily Essentials, Spinning Babies Childbirth Preparation Class goes beyond the basics. Simple props show complex concepts sweetly. Little-known anatomy is linked to childbirth and the role of fetal positioning.

The Creation of the Spinning Babies Childbirth Preparation Class, due Dec 2013

The section on labor discusses two labor patterns- the one "promised" in other books and the unexpected one associated with the posterior labor. Learn the common causes of long labor and techniques to help baby through the pelvis.

Be empowered; be prepared. After using this video throughout your pregnancy, while we can't promise, of course, you may not need the tips for labor progress. You can use that knowledge to help your neighbor.  This video is all Spinning Babies.




Blooma Yoga Prenatal Yoga for AM and PM.

Warm up in the morning and cool down in the evening in two 30-minute sequences. Sarah Longacre shares her own blossoming pregnancy, Blooma style, to the exquisite music of Carin Vagle.  Sarah's affirmations will carry you through labor with emotional strength and encouragement. Bring your hormones into harmony with the day. Begin your day with serious play. Cool down at night with a sleep enhancing stretch before bed. This video is all Blooma!

Sarah's video is ready for you now! Get Blooma's AM/PM Yoga  here


All three videos are professionally produced by Melissa Koch of Grey Duck Productions, with stills by Tanya Villano Photography, each of these three videos are dynamic on their own. Together they will enhance your pregnancy and labor experience with fun and empowerment in the most practical manner. Feel hope for your birth abilities, this is support for your journey. Gain the confidence and flexibility to fully bloom. I believe these videos carry the potential to bring your best birth dreams into the gentle reality.  

Compassionately priced. Estimated Due Date for Daily Essentials April 2014; for Spinning Babies Parent Class, Fall 2014.