Anterior Placenta

Drawing of hands behind placenta (Pregnancy)What is the effect of an anterior placenta on fetal positioning?

An anterior placenta is a placenta located on the front of the uterus. Most of baby’s small limb movements may be hidden behind the placenta.

The anterior placement of the placenta may increase the chance of posterior presentation (see drawing). Babies can also be anterior with an anterior placenta.

Abdominal tone, when loosened, may allow the baby to turn from the placenta and face the mother’s back. A gentle Rebozo sifting (Manteada) may help baby be anterior when repeated regularly. Be Gentle, please.

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Palpation around the anterior placenta (a hands-on exam through the skin) can be more difficult when the placenta hides most of the baby. But with time, the person palpating, be it parent or provider, will notice the firm back or bottom, and occasionally a limb will extend beyond the borders of the placenta. To be accurate, an ultrasound can determine the baby’s position easily, though with exposure to ultrasound.

In 1994, Gardberg studied the relationship between the placenta being located on the anterior wall of the uterus and the position of the baby near the due date.

325 sonographies [ultrasound] were performed in singleton pregnancies past 36 weeks with the fetus in a vertex position [head down] in order to examine a possible association between placental localization and occiput posterior presentation (OP).* An anterior placental location was seen significantly more often in the OP group. OP was found in 11.6% of all cases.

Gail’s thoughts: Notice, however, that Occiput Posterior occurred a little more than one in ten. This study was unlikely to have considered that babies in the Right Occiput Transverse (Right Occiput Lateral in Australia or New Zealand) position are likely to rotate to the OP position under usual care in labor (Sutton).

An anterior placenta can contribute to a baby’s posterior position. However, babies can also be anterior with an anterior placenta.

Hi, Gail,

I was told at 18 weeks [gestation] that I had an anterior placenta.

The midwife I saw last week told me bub was probably posterior, and the heartbeat was low on my left hand side. The head was down which made me happy…

I have been feeling most movements on the right hand side, just under my ribs, but also some lower on the left hand side (below my belly button, towards the left). This seemed to me to fit with your description of LOT, which I gather is much more favorable than a true posterior presentation. I wonder what your opinion is?

I have been spending time lying on my tummy supported by pillows, and kneeling with my tummy over the gym ball, since I saw the midwife last week, and I always sleep predominantly on my left side. Do you have any other suggestions for postures or exercises I should be adopting in order to achieve/maintain the best possible foetal position? Hope you can help with some suggestions for me, as I am feeling a little lost…

Thanks, Wendy

 

Yes,  Wendy, the Left Occiput Posterior baby can usually rotate to anterior nicely. This is typically true. However, you can support your chances for an easier birth if you follow the 3 Principles of Spinning Babies!

Gently using the Rebozo woven scarf in the all fours position may be helpful. The key is to be gentle, not vigorous, with an anterior placenta. Be smart, hey!? This may soften the broad ligament to let baby have mobility.

Also the abdominal diaphagmatic release is excellent for “making room for baby” to get into a good position. Follow with Rest Smart to use Gravity. Go on over to the 3 Principles in Pregnancy to learn what to do now.

A home remedy to make more fluid for baby to wiggle around in:

Drink 3 quarts of fluid (not counting milk since milk turns to cheese during digestion) every day. Drinking adequate fluid will increase your amniotic fluid and support movement of the baby. Don’t over do the water. Have a pinch of salt to help your body manage the water, and a squirt of lemon. More than a gallon of water can be counter productive!!!

 

An Email from a VBAC mom

Dear Gail,

…first labour ended in c-section, no real support, baby in Posterior Position… She had a big head and was big… second pregnancy am told I have an anterior placenta….a good chance I will get another Posterior baby. I seem to have big babies. I have a midwife this time but not sure if there is something I can do to help the baby position better. I am only 20 weeks.  Thanks for your help.

Gail’s reply:

Congratulations on your upcoming natural birth.

Having all the body work appropriate to balance your pelvis and release your broad ligament and round ligaments is a good choice for any VBAC mom, and also for any mom with an anterior placenta.

You mention you are 20 weeks, that’s a good time to get going with your situation: VBAC, Anterior placenta. Begin now with daily and weekly activities for balance.

Daily inversions, stretching, pelvic floor lengthening with calf stretches and later with flat footed squats, gentle prenatal yoga, psoas exercises, brisk walking, swimming – all these are good. Begin Rest Smart positions now in your 2nd trimester.

Here are some recommendations for professional help:

  • Myofascial release is good for relaxing the broad ligament.
  • Standing sacral release.
  • And the Webster Maneuver with chiropractic helps with the SI joint (and should be done on both sides rather than the pure Webster approach) and the round ligaments. Have the symphysis aligned.
  • Release the Psoas.

I’m going to leave it to you to research these techniques. Some are on my site, some are not.

Print this and take it to body workers with you after you review it with your midwife.

Happiness,

Gail

 

*Reference: Gardberg and, Mikael; Tuppurainen, Marketta. Anterior placental location predisposes for occiput posterior presentation near term. Acta Obstetricia et Gynecologica Scandinavica  1994, Vol. 73, No. 2, Pages 151-152. Department of Obstetrics and Gynecology, Vaasa Central Hospital, Vaasa, Finland