The forward-leaning inversion is a classic here at Spinning Babies. The goal is to increase room in the lower uterine segment by releasing a tight or even spasming ligament. Every healthy pregnant woman (not at risk of a stroke) might benefit from 30 seconds of this particularly steep inversion. But the real benefits are apparent for some babies lying sideways (transverse lie), breech, oblique (diagonal lie) or posterior. With more room in the lower uterus, the baby will often reposition themselves.
Daily inversions in pregnancy may promote optimal fetal positioning. Done correctly, the ligaments will respond! Be careful, read the details.
Why do a daily inversion?
Balance. We want room for baby to settle head-down in the uterus. The goal of repeating the forward-leaning inversion every day is to release the utero-sacral ligament and give baby the extra room.
The lower part of the uterus can get a twist in it from poor posture habits or a sudden stop (accident, fall, or sports). This effect is not uncommon among women who twist to do their work (massage therapists, nurses, chiropractors, etc.) or who hold a child on one hip frequently. A twist in uterine ligaments can put the lower uterine segment into a slight twist which reduces the room for the baby to have a good head-down position. The baby needs more room to get in an ideal, or optimal fetal position (Optimal Foetal Position in the UK or down under) .
How To Do a Forward-leaning Inversion
Give the utero-sacral ligament and other ligaments a stretch.
1. Kneel on the edge of a couch (or the top of the stairs)
2. Carefully lower yourself to your hands on the floor and then lower yourself to your forearms. Elbows out, hands close.
3. Let your head hang freely. Your chin is tucked.
4. Your knees are close to the edge, your bottom is highest.
5. You can flatten your lower back (posterior pelvic tilt).
6. Take 3 breaths.
7. Come back up on your hands then lift yourself up to a kneeling position again.
Repeat daily. Just 30 seconds is long enough! That’s about 3 breaths.
Letting the uterus hang for 30 seconds from the uterine ligaments stretches these ligaments. Swinging back up relaxes the uterine ligaments and makes room in the lower uterine segment. With repetition, the womb becomes more balanced. (The uterus naturally tilts right, so here, balance means without an additional tilt or twist.)
When baby’s position is not ideal, help the uterus into a more symmetrical position and the baby will follow.
· Ask for help the first few times you try this.
· You can do this daily at any time in pregnancy – or before!
· Your head may pound a bit for the first 4-8 times you try it. Your body is signaling your unusual position!
· Use a stable surface where you can carefully lean forward to rest your forearms below your knees.
· Be sure to get up and down with out tumbling -or twisting!
· Allow your head to be free to hang freely, chin tucked.
· If baby is breech, do the forward-leaning inversion for 30 seconds and then do the breech tilt for 5-20 minutes. Or, follow with the Open knee-chest position. Do not do Breech Tilt or OKC with a head down baby. When baby is breech, you may do the forward-leaning inversion for 30 seconds each, several times a day along with other techniques to flip a breech.
Alternative: Use an inversion table if you have access to one.
Emily and Ludvig learn to do an inversion. The movie is 1.5 minutes long. See it here, or read more instructions while viewing it on the Spinning Babies Lady Blog. Emily's baby was in a transverse lie (lying sideways in the womb) days before labor. If labor were to begin with the baby lying sideways there would be no choice but a cesarean. She learned to do the Forward-leaning inversion and did it twice for this movie and then again in the morning.
Please don't crawl down! I would now ask her to rise back up to the couch rather than crawl down to protect her SI joints in her pelvis. Off to the Ultrasound that day and the baby had gotten head down by then!
See the ligaments (pink in the inset). The weight of the baby gently pulls on the ligaments and gives a stretch to the cervical ligaments. See the short pink ligaments near the tailbone and sacrum. They are harder to find than the large broad ligament surrounding the baby. When the mother swings back up to kneeling again the ligaments will relax a bit more and are less tense than before. Repeating this daily helps them relax back to a balanced tone (not too tight or too loose).
Relaxing the uterine ligaments helps the uterus be more balanced, meaning not pulled front or back or to either side. This Balance helps the baby to get in a better position for birth- or helps the mother have more room or softness to birth a baby in a challenging position.
Leah is using the forward-leaning inversion in late pregnancy. Leah has her chin tucked and her womb actually hangs, for just a moment, by her utero-sacral ligament.
How not to do an inversion!
When not to do the Forward-leaning inversion:
- If you have very high (or very, very low) blood pressure, or are otherwise at risk for a stroke,
- There is so much amniotic fluid around your baby that your doctor monitors you weekly,
- Right after eating (do it when you don't have heartburn),
- In pregnancy, the abdominal tone is unusually loose and your baby flips breech easily,
- The inversion causes pain (remember, your head may pound a bit for the first few times.)
- In labor, if labor progress is normal,
- In labor, if there had been abundant fluid, AND the baby is high, -2 station, and the water has released with baby’s head high, in which case open the pelvic brim with Walcher’s or a variation of Walcher’s,
- You don't feel that this is right for you.
When to do the Forward-leaning Inversion in pregnancy
When to do the Forward-leaning Inversion in labor
* Slow progress
* Back or hip pain that seems more than from contractions and is not matched by the pain in the uterus or other hip.
* In other words, something isn’t matching up, the labor pattern is not symmetrical.
* You are advised to by your care provider (Dr., Nurse, Midwife) and you feel that it is safe for you to do so.
In labor. The forward-leaning inversion can now be used even when baby is head down. Regular contractions keep baby’s head down so the inversion can be held through an entire contraction and between them for 2-3 contractions. It’s better to repeat than stay there too long. Make sure the belly isn't leaning against the bed. Let the abdomen hang free. Don’t bother with the FLI when labor is progressing, but try it when labor is stalled.
In the hospital, you can easily do the inversion with the help of the nurse or doula to adjust the birthing bed.
Kneel in the middle of the bed but face the foot of the bed. Place a pillow on the foot of the bed. Lower your elbows to the food of the bed. Your cheek can be resting on the foot of the bed.
Have help to lower yourself to rest your breasts on the pillows and let your chin come down lower. Tuck your chin.
It's easier to get into Knee Elbow-position while the bed is flat and once you are in the bed, lower the foot of the bed. It would be less acrobatic for you than the steeper inversion.
Here's a story of a hospital midwife helping a mother's whose labor stalled, she advocated for the
mother to get into this position, but she calls it something else, she called it knee-chest, yet her link is to this page!
So I can only assume she linked the name for the technique she chose to the technique she used.
Read this cool story of how a midwife, an forward-leaning inversion and someone else's cesarean prevented one mom's cesarean.
When the care provider says no inversions
I was hoping you could help me out... a CNM who saw one of my clients and told her not to do inversions because it could cause the baby to become breech. I would like to educate her, the CNM, on the benefits of Spinning Babies techniques. Have any studies been done that I could reference? Any help that you could offer would be greatly appreciated!"
My reply is that the CNM has palpated this mother's abdomen. Perhaps she has polyhydramnios, far too much amniotic fluid, a history of an unstable lie (the baby goes from head down to breech to head down again easily), or a very loose muscle tone even with normal amniotic fluid.
These are reasonable areas of concern to avoid an inversion, though not necessarily absolute reasons. They'd be reasons to leave the decision making between the care provider and, perhaps, her experienced Myofascial worker/Chiropractor.
A normal pregnant woman with a head down baby who does the forward-leaning inversion for 30-seconds a time is not likely to flip her baby to breech.
A provider might confust the Forward-leaning inversion with the Breech Tilt. The Breech Tilt is not the same inversion as a Forward-leaning inversion. Its done longer and on the mother's back. The Breech Tilt has the purpose of helping the baby's chin to tuck. The Forward-leaning inversion has the purpose of stretching uterine ligaments and then, after the inversion, releasing the ligaments so they relax. Repetition of the Forward-leaning inversion is to release a twist in the lower uterine segment, improving the angle of the fetal head or allowing the breech baby to find room for the head. I've been recommending this for years and following many pregnant women through their pregnancies with the Forward-leaning inversion.
A different inversion done incorrectly- A woman on the east coast was told by a student of mine (a nurse at this woman's clinic) to do the Open-knee chest position for 20-minutes in pregnancy to help her posterior baby rotate. The next day she came into the hospital in labor and was sectioned for a breech fetal position!!! First of all, the Open-knee chest position is not to be used for posterior presentation -unless in labor- the baby's head is jammed in the pelvis and there is no progress with strong contractions, or as a comfort for back labor in the presence of contractions. Contractions keep the head down. Its always good to go back over the instructions before recommending a new technique that you may not be fully familiar with.
Is there any risk to being inverted and have her move in a less than ideal position if she is already in a "good" position?
- This type of inversion is for 30-seconds at a time, not 20-minutes, the typical recommendation for a breech tilt.
- If a woman has a notably large amount of amniotic fluid the risk of flipping the baby moves from none to small.
- Loose ligaments and lots of water, a little more risk.
- A baby in an instable lie might go breech, continue balance activities and when baby is head down then wear a pregnancy belt 24/7 and don't invert any more.
- If the baby's head is high (not engaged) and the water is broke, don't invert.
- A woman who has a very chronic imbalance, even without feeling the pain of it, begins to loosen. Her body is not in balance, but spasming ligaments are beginning to loosen. Her baby might rarely flip breech during this process. This is RARE. Continue to finish balancing the pelvis, uterus and ligaments and baby will return to a head down position. Don't delay! Please email right away if you think this happened to you.
- For a normal pregnant woman there is very little risk of flipping the baby in this short time.
Could it? With hundreds of women now using the Forward-leaning inversion, I suspect it may occur that sometime a baby will flip breech. Would it be from a short inversion? Or would it be from beginning to loosen a very tight pelvis? Could it be from flipping a mother who is very loose with enough water for baby to flip?? Continuing the balancing activities would let the baby get head down again in a couple days. This technique is working well to help transverse babies get head down. Use your intuition, common sense, and see if it is right for you.
...Be in this head down, bottom up with pubic bone away from your spine position WHILE YOUR HEAD is flexed towards your chest.
"I am extremely optimistic that I have made really good progress with getting her head in a good position. I have also noticed that since yesterday, I am feeling more pressure and pinchy feelings on my cervix. I want to try the stairs. I also have made a Chiropractic appointment for Monday and a cranio-sacral appointment for Tuesday."