ROT back on right
Occiput Transverse (OT or OL)
Left Occiput Transverse (LOT) is when the occiput is towards the mother's left and baby faces and kicks towards her right side.
No kicks are felt on the left of her belly, but the baby's buttock may rise up on her left which she may have thought was a kick until comparing that bulge with the smaller parts on the right. Sometimes both feet kicking together, though, can feel as big as baby's hips when they push upwards and outwards.
When labor begins, the OT baby, especially LOT, but to a degree, the ROT baby, too, can be a fine position. More on ROT in a few lines. But during pushing, most women do not have enough room in there mid pelvis or lower pelvic tunnel to allow a transverse baby through the bones. Some do, but most don't and if the baby is facing sideways then, a cesarean may be done, unless something can be done to help dislodge the baby and turn the baby to where it fits the pelvis much better.
Right occiput transverse is called right occiput lateral (ROL) in UK, AUS, NZ.
Midwife Jean Sutton cites the firm liver sharing the room on the right and making an extended back likely in a first time mother.
The top of the head rather than the crown may enter the pelvis, making the head diameter larger than when the chin is tucked (flexed, flexion).
If a pelvis is smaller than average a baby has a greater chance to become wedged in the pelvis stopping descent. This is true for all the posterior positions. Read more about posterior positions if your baby is ROT (ROL).
The Right Occiput Transverse Baby in Labor
To avoid a stall in labor progress, body work on the abdominal ligaments now is good. Inversion on the stairs for 5 min.s a day will help release a twist in the lower uterine segment that is caused by sitting in cars, crossing our legs, holding a toddler or other weight on one hip, twisting to work, whether at our computer or doing care for others who are lying down.
The drawings on the left are of what I call the four posterior positions. You can see the Right Occiput Transverse baby is the one in the third circle from the top.
I consider ROT to be one of the Posterior fetal positions. The course of labor for babies starting in a transverse head down position (not the transverse lie, from which a baby always needs a cesarean for survival) has not been reported upon in the medical literature.
You can encourage rotation before descent in labor. Be upright, leaning forward, and doing the 3 Principles of Spinning Babies. If the baby descends before rotation, try the lunge and other things that keep the pelvis open in the middle. Eating small amounts of good food every two hours will help keep contractions strong. Be sure to sip electrolyte drinks, like Recharge, Alacer Emergen-C, diluted gatorade or the like.
Give yourself time in labor to let the baby rotate before you expect much dilation. Especially if this is your first birth.
During pushing, squatting will help as will standing and hanging on to a person's neck or a sheet thrown over the bathroom door and knotted so you can't pull the sheet over the closed door. Try a vertical position change every 3-6 contractions, moving your legs in between contractions. When you find one that really works stick with it for 6-10 contractions and if the baby isn't born, be sure to keep changing positions. Keep a straight back during pushing, don't curl, as commonly instructed.
In general, it is easier to help the baby in a left-sided position in your 2nd trimester. Most women can achieve this goal in the third trimester with body work and maternal positioning with gravity. But some can not.
Labor helps baby's rotate. If you loosen up any tight ligaments and get your pelvis joints loosened up and labor in vertical positions with good support, periodic small meals and electrolyte drinks, you are likely to find that your baby rotates as he or she needs to get through the pelvis. It may or may not take a long time.
Individual differences in pelvic shape and size, baby's head flexion (chin tucked), amnioitic fluid levels, location of the placenta and relaxation of the pelvic floor and abdominal wall are some factors that determine whether or not this will be an issue or not. Too loose in the abdomen and you may need to wear a pregnancy belt to support the baby's proper descent.
My observations, like Jean Sutton's who proposed the association of ROT with an posterior result, show that if labor is treated with typical habits of resting in bed, semi sitting, lack of food, lack of movement, that labor is often longer, babies can turn posterior easily and instruments, medications or even a cesarean is more likely than when the baby STARTS labor on the left.
Leaning forward during contractions is an amazingly effective, and so simple, way to help a baby rotate to the left to create a progressing labor. With active labor habits, most ROT babies will succeed in coming out OA at the end.
A co-venture video experience with Spinning Babies and Blooma Yoga! Coming Soon!
Spinning Babies; Daily Essentials For Pregnancy Video.
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.
The Daily Essentials For Pregnancy 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 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. Play this video when the others become too basic and you just want to dance and have fun. Wait, dance? Isn't this yoga? With Blooma and Carin Vagle, your spirit won't know the difference. Soar to greater freedom of movement. 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 March 2014; for Spinning Babies Parent Class, Fall 2014.