Posterior symptoms in Pregnancy
There are physical symptoms that the baby may not be in an ideal position, as early as 34 weeks of pregnancy. Discomfort may begin even earlier if the mother's ligaments are really tight.
Many people suppose that a pregnant woman will have back pain if her baby is posterior.
Back pain is not a reliable sign that the baby is posterior.
There are other signs, besides back pain, that indicate that the uterus may not be in position for an ideally positioned baby. Especially, in pregnancy, other signs are more reliable.
A tight spot in the broad ligament will feel, to the mother, as if there is a tight, and often tender, spot in her uterus. It might be near the top or to one side. When the baby's bottom, or head, pushes against this tight spot, it can cause tenderness, a heat, or actually hurt a little. The broad ligament naturally softens at the end of pregnancy. But, for a woman with a breech or posterior baby, her baby may have grown larger and held in that position by one or both tight round ligaments. Special technques would be done to release the tight ligament, such as Walchers.
When the midwife or doctor feels the lower abdomen to find the baby's head their fingers will press on the round ligaments. Pain during this part of the abdominal exam reveals tension in the round ligaments. Tension on one or both sides may be associated with both breech and posterior fetal position. (As is a rotated sacrum, but that may not cause the mother any pain.)
Hip pain can indicate tension in the broad ligament or a twist in the pelvic floor muscles.
Pubic bone pain is more commonly associated with a posterior fetal head position than is back pain.
There can be a grinding feeling when the 37-42 week fetus tries to reposition his or her head between the round ligaments.
A baby that switches his or her back from side-to-side just might be a posterior baby. The head may not be changing position even though the back switches from side-to-side. I observe this often and observe that midwives and mothers will often think that the baby is changing positions randomly and just hasn’t “chosen” their final birthing position. Quite a different scenario may be true. It may be the baby is trying, ever so diligently, to turn their head to face the right hip, but the head is caught in the posterior position.
Tension in the round ligaments may be what blocks the head from rotating. A pressure on the pubic bone can be dull and achy or sharp. Sharp pains are usually occasional and, if they occur, can be from the forehead pressing on the clitoral ligament which wraps over the pubis.
Lifting the lower abdomen with a pregnancy belt (or tied scarf) can support the slope of the uterus and help the baby slip behind the pubic bone, instead of on top of it. We don't really want to encourage the posterior baby to drop early before giving her a chance to rotate first. So, attend to the balance of the uterus and the supporting ligaments first. And this use of the belt shouldn't be so tight as to prevent the baby from dropping down into the pelvis. It is snug, however.
Another type of pubic bone pain is from the natural separation of the pubis symphysis joint by the hormones of pregnancy. Some women will get particularly loose. Then the bone rubs together when she rolls over at night or walks. A pregnancy belt can help that. Wear the belt snuggly around the hips and not across the baby. This pubic bone pain is not associated with fetal position and is not a sign of soft tissue tension or looseness. It is about the cartilage between the pubes.
Of course, the main sign that a baby is posterior is the movement of hands just above the pubic bone and somewhat below the navel. Rarely, a breech baby will run his or her feet over the bladder in that area, but typically, small movement in the front, below the navel and above the pubic bone, is due to hand movement of the OP baby.