Sometimes the gorgeous design for fetal positioning is tampered with by cultural habits (slouching on the couch), poor nutrition (low iodine), or even the mistaken habits of the health practitioner or other helper (over use of epidural, esp. before 5 cm dilation; occasionally, restricting a woman to her back).
A good, ideal, or optimal fetal position is flexed (curled), and facing the mother's right hip or mother's back. These positions are called anterior or left occiput transverse.
Malpositions are "military" presentation, or a baby with an extended (lifted) chin; posterior; direct posterior; right occiput posterior; right occiput posterior; oblique lie; transverse lie; and, in modern culture, breech. There are various reasons babies may end up in a less than ideal position. Some babies will face more than one factor reducing their chance at a good fetal position.
Cultural habits include:
- Slouching on the couch
- Crossing our legs
- Driving frequently, which causes an imbalance between the right and left leg and hips
- Too little walking and exercise or over exercise (super strong "core")
Trauma reasons might include
- Sports injuries
- Injuries to the pelvis, neck, jaw, or sacrum
- Fender benders
- Long term or acute fear without an ability to say, "No!" as this may constrict the psoas muscle pair.
Poor nutrition might lead to
- Low thyroid function
- Low Vitamin D (hormonal health)
- Calcium Magnesium imbalance (muscle tone)
- Lifeless foods (function!)
Labor management habits that encourage malposition
- Restricting mothers to bed by monitoring, medications, or epidural (this might be more problematic for babies starting labor in the OP or ROT/ROL positions)
- Epidurals which may soften the pelvic floor (and occasionally this softening is helpful but not always, especially not for a first time mother before 5 cm)
- Ignoring signs (because they aren't recognized!) of posterior presentation
- Waiting to see if baby rotates without moving the mother or sometimes, without doing a sidelying release or other technique to address the fetal position in regards to station of the pelvis
The main thing to know is that its not the mother or the baby's fault. We all have to live in our culture, in a body in gravity and things happen. But we can do simple things to get wonderful results - most of the time!!