Is maternal posturing during labor efficient in preventing persistent occiput posterior position? A randomized controlled trial
Doi : 10.1016/j.ajog.2012.10.882 

Raoul Desbriere a  This email address is being protected from spambots. You need JavaScript enabled to view it., Julie Blanc b, Renaud Le Dû b c d, Jean-Paul Renner f, Xavier Carcopino b c, Anderson Loundou e, Claude d'Ercole b c


Desbriere R, Blanc J, Le Dû R, et al. Is maternal posturing during labor efficient in preventing persistent occiput posterior position? A randomized controlled trial. Am J Obstet Gynecol 2013;208:60.e1-8.





We sought to evaluate the efficacy of maternal posturing during labor on the prevention of persistent occiput posterior (OP) position.

Study Design

We conducted a randomized trial including 220 patients in labor with a single fetus in documented OP position. Main outcome was the proportion of anterior rotation from OP position.


The rates of anterior rotation were, respectively, 78.2% and 76.4% in the intervention group and the control group without significant difference (P = .748). Rates of instrumental and cesarean section deliveries were not significantly different between intervention and control groups (18.2% vs 19.1%, P = .89, and 19.1% vs 17.3%, P = .73, respectively). In intervention and control groups, persistent OP position rates were significantly higher among women who had cesarean section (71.4% and 89.5%, respectively) and an instrumental delivery (25% and 33.3%, respectively) than among women who achieved spontaneous vaginal birth (5.8% and 2.8%, respectively). In multivariable analysis, body mass index and parity were found to have significant and independent impact on the probability of fetal head rotation.


Our study failed to demonstrate any maternal or neonatal benefit to a policy of maternal posturing for the management of OP position during labor.

Key words : fetal malposition, persistent occiput posterior position, posture



Please, someone, research Balance before Gravity and see if this improves outcomes! Though these are pretty low cesarean rates for today's University practices, they are still higher than the World Health Organization recommendation.

The first principle of Spinning Babies is to make the point that body balance is often necessary. The workshop instructs how to match technqiues for the station of descent. In other words, certain techniques are specific for the inlet, certain ones for the midpelvis, and others for the outlet. While changing position is useful and good, it is not specific to opening the diameters of the pelvis. Yet, the research sticks to repeating this point.

It is deceptive to say researching fetal positioning within the parameters of what isn't working  shows that "nothing" works.

Maternal posture is helpful for comfort, pain relief, and moving between postures may have added benefits and should be studied.

See The Three Principles, Balance, Gravity and Movement.


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Hi Gail, 

I want to say thank you! A first time mother's posterior birth went well [with] a short labor. Membranes ruptured about 8am. Her labor started about 6pm: 3cm dilated; LOP station -1; cervix soft and effaced. 

We did rebozo sifting, sidelying release, abdominal lift and tuck, standing sacral release, Dip the hip, circling on the birth ball, lunge and she birthed at 9.58pm in sidelying position with hands around the husband's neck.

Baby's head showed more molding on the right side. What you taught in the workshop and website made a difference!

Chiew Gin, Doula, Singapore