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Spinning Babies® Research & References

Research & References

Table of Contents

Research Spotlight

Clinical trial shows Spinning Babies® Reduced Cesarean Rates by up to 48%

This clinical trial highlights the effectiveness of Spinning Babies® techniques in reducing cesarean rates, particularly for nulliparous, term, singleton, vaginal (NTSV) births. The results show that after nurses received Spinning Babies® training, the cesarean rate decreased from 27% to 14% in the hospital where the training was implemented. This significant decrease demonstrates the power of body balancing and physiological labor support in reducing unnecessary interventions.

In addition to the cesarean reduction, nurses trained in Spinning Babies® showed a statistically significant improvement in their ability to support laboring mothers naturally, without relying on interventions. This boost in confidence was reflected in their hands-on work with laboring mothers and their ability to assist in facilitating fetal descent.

The study also included a review of each nurse’s NTSV cesarean rate over one year before the training, revealing clear improvements in cesarean rates following the education. This emphasizes the lasting impact of Spinning Babies® methods in transforming labor outcomes. Statistically significant results were found after nurses participated in the 8-hour Spinning Babies® workshop, further proving the effectiveness of the techniques.

Nurses reported increased confidence in assisting with labor, especially in reducing the need for interventions and helping babies move through the pelvis. The study underscores the value of empowering healthcare providers with effective, physiological labor support practices that result in better birth outcomes for both mothers and babies.

Funk, B. (2024). The Effects of Spinning Babies® on the Nulliparous, Term, Singleton, Vertex Cesarean Rates. Journal of Obstetric, Gynecologic & Neonatal Nursing, 53(4), S83.

Bridget Funk, RN, shares the results of using Spinning Babies® approach in her hospital, Sarasota Memorial at the 2024 AWHONN National Convention. Workshop given by Spinning Babies® Approved Trainer, Kelly Dungan.

Bridget Funk's Presentation Poster on outcomes using Spinning Babies in Sarasota.

Research on Spinning Babies®

This study highlights the effectiveness of Spinning Babies® techniques in reducing cesarean rates, particularly for nulliparous, term, singleton, vaginal (NTSV) births. The results show that after nurses received Spinning Babies® training, the cesarean rate decreased from 27% to 14% in the hospital where the training was implemented. This significant decrease demonstrates the power of body balancing and physiological labor support in reducing unnecessary interventions.

In addition to the cesarean reduction, nurses trained in Spinning Babies® showed a statistically significant improvement in their ability to support laboring mothers naturally, without relying on interventions. This boost in confidence was reflected in their hands-on work with laboring mothers and their ability to assist in facilitating fetal descent.

The study also included a review of each nurse’s NTSV cesarean rate over one year before the training, revealing clear improvements in cesarean rates following the education. This emphasizes the lasting impact of Spinning Babies® methods in transforming labor outcomes. Statistically significant results were found after nurses participated in the 8-hour Spinning Babies® workshop, further proving the effectiveness of the techniques.

Nurses reported increased confidence in assisting with labor, especially in reducing the need for interventions and helping babies move through the pelvis. The study underscores the value of empowering healthcare providers with effective, physiological labor support practices that result in better birth outcomes for both mothers and babies. 

This publication details how Spinning Babies® supports professional development and the reduction of cesarean rates in a Florida hospital with extremely high cesarean rates.

This study looked at use of Spinning Babies® as a physiological support for birthing women of “racial and ethnic minorities”. Women with more challenging births had less satisfaction compared to women who didn’t rate their births as complicated; but other than such complicated birth, birth satisfaction didn’t seem to vary by race when supported with the Spinning Babies® approach. The use of our approach could be one intriguing way to equalize and promote physiological birth care among communities in the United States.

Read the study here

12 Midwives give qualitative reports on their experience with Spinning Babies®.

This study discusses the role of evidence-based practice in reducing cesarean rates, relevant to how Spinning Babies® techniques can play a role in that process. Learn more here

Research Partially Including Spinning Babies®

This research includes a partial application of concepts that Spinning Babies® propose in our approach. There will be a mention of Spinning Babies®  but these are not research ON Spinning Babies®.

This publication details how Spinning Babies® supports professional development and the reduction of cesarean rates in a Florida hospital with extremely high cesarean rates. This is actually the same report as Euda, below.

In Park’s pilot project nurses used a variety of comfort measures including techniques shared through Spinning Babies®. Gail Tully’s “Spinning Babies book” is cited, and very likely that book is Changing Birth on Earth, a book written for the Intrapartum nurse and midwife, since that was the main book available at the time this article was published.

Ariana Parkhideh uses interviews and surveys to understand the perspectives of doulas on the Black maternal health crisis and the strategies they use to support clients. “Both Joy and Renie incorporate Spinning Babies®, a series of positioning, massage [massage isn’t actually a part of our approach though it’s lovely], and other techniques to facilitate easier childbirth by balancing the pelvis and potentially repositioning the fetus, into the services they provide to her birth clients… ”

Thank you, Joy and Renie, we are truly grateful to be included through your doula care to reduce violence against birth people and to be able to have something positive to offer Black Maternity.

 

This is definitely not a study on Spinning Babies® but most nurses in this hospital were familiar with Spinning Babies®. Ueda interviewed nurses and asked what their confidence was with birth positions. “53.5% (n=23) of nurses had additional off-unit training for labor positions such as Spinning Babies®” Just less than half had no training in physiologic birth positions. The birth position posters shown the nurses to inspire position changes did not include Spinning Babies® recommended positions nor did they use our labor progress tracking approach. But it is important to note that half their staff was given at least one day of Spinning Babies® training. It is proposable to suggest that their project conclusions included a higher confidence in birth positioning with the added knowledge base that over half of their nurses had from self-obtained study with Spinning Babies®. They suggest that “The results of this project show that standardization of these labor positions is the next step to improving patient outcomes.” It would be wonderful to have Spinning Babies® birth positions poster inform more hospitals before assuming that birth positions are as basic as upright, on the back, or on the side.

This study on fetal “starting” positions at the onset of labor or during the various phases of labor highly supports Gail Tully’s proposals. This study, however, is researching the effectiveness of the length of labor and outcomes that Jean Sutton talks about in Optimal Fetal Positioning.

Witkiewicz found: The distribution of individual initial positions of the head in the right foetal position was as follows: ROP 45.1%, ROT 35.4%, ROA 6.15%, and a position difficult to determine 13.35%. In the left position, it was as follows: LOA 28.6%, LOT 57.1%, LOP 4.3%, and a position difficult to determine 10%. And while LOA is often cited as Jean Sutton’s single optimal position, she said, and if you read all her material completely you’ll find it, that the left side is optimal, even rather the LOP. Spinning Babies® has based much emphasis on Jean Sutton’s affirmation that easier birth when baby begins on the left (which was first in 1800’s medical literature) and that VERY OFTEN But NOT ALWAYS a labor is more challenging when babies start labor on the right side before or at the time of engagement. Gail disagrees with Barth’s proposal not to take any measures to ease the ROP labor for those with a deeper AP inlet measurement. We propose “body balancing” for “all” and especially for those with a baby remaining on the right side, as well as other indicators, no matter inlet or pelvic shape, rather than a “wait and see” approach. We deeply appreciate the words of the authors to de-pathologize labors with babies on the right side of the uterus and emphasizing that physiology persists with any fetal position. That said, we take note when baby persists on the right side, whether in late pregnancy, labor onset, or any time during labor. We take note, we follow invitations to attend to physiology, but we don’t blame, shame, or defame us human beings or our birth process.
This article does not discuss recommendations of what to do and calls for more research (see studies in Section A. Research on Spinning Babies®).

Congratulations to this research team for a very comprehensive observational report! 

General Research and Books Supportive but not Descriptive of Spinning Babies® Claims, Concepts, or Recommendations

  1. Andrews, Christine. “Considering Non-Optimal Fetal Positioning and Pelvic Girdle Positioning and Pelvic Girdle Dysfunction in Pregnancy: Increasing the Available Space.” Journal of Clinical Chiropractic Pediatrics 11.2 (2010): 783-88. Print.
  2. Blanc-Petitjean, P., Le Ray, C., Lepleux, F., De La Calle, A., Dreyfus, M., & Chantry, A. A. (2018). Factors affecting rotation of occiput posterior position during the first stage of labor. Journal of gynecology obstetrics and human reproduction, 47(3), 119-125.
  3. Bellussi, F., Livi, A., Cataneo, I., Salsi, G., Lenzi, J., & Pilu, G. (2020). Sonographic diagnosis of fetal head deflexion and the risk of cesarean delivery. American Journal of Obstetrics & Gynecology MFM, 2(4), 100217.
  4. Borrell, Ulf, Fernstrom, Ingmar. “Internal Anterior Rotation of the Foetal Head; a Contribution to Its Explanation.” Acta Obstetricia Et Gynecologica Scandinavica 38 (1959): 109. Print.
  5. Borell, Ulf, and Ingmar Fernström. “The Movements at the Sacro-Iliac Joints and their Importance to Changes in the Pelvic Dimensions During Parturition.” Acta obstetricia et gynecologica Scandinavica 36.1 (1957): 42-57.
  6. Broberg, J. C., & Caughey, A. B. (2021). A randomized controlled trial of prophylactic early manual rotation of the occiput posterior fetus at the beginning of the second stage vs expectant management. American journal of obstetrics & gynecology MFM, 3(2), 100327.
  7. Bueno Lopez, V., Fuentelsaz Gallego, C., Casellas Caro, M., Falgueras Serrano, A. M., Crespo–Berros, S., Silvano-Cocinero, A. M., … &- Terré-   -Rull, C. (2018). Efficiency of the modified Sims maternal position in the rotation of persistent occiput posterior position during labor: A randomized clinical trial. Birth.
  8. Calais-Germain, Blandine. The Female Pelvis: Anatomy & Exercises 2003
  9. Choi, Sk, et al. Sonographic assessment of fetal occiput position during labor for the prediction of labor dystocia and perinatal outcomes. J Matern Fetal Neonatal Med. (2016). http://www.ncbi.nlm.nih.gov/m/pubmed/26948718/
  10. Dall’Asta, A., Rizzo, G., Masturzo, B., Eggebo, T., Flacco, M. E., Frusca, T., & Ghi, T. (2021). 480 Intrapartum sonographic features of cephalopelvic disproportion in non-occiput posterior fetuses: prospective multicenter study. American Journal of Obstetrics & Gynecology, 224(2), S305-S306.
  11. Elmore, C., McBroom, K., & Ellis, J. (2020). Digital and Manual Rotation of the Persistent Occiput Posterior Fetus. Journal of midwifery & women’s health, 65(3), 387-394.
  12. Fothergill WE. Walcher’s Position In Obstetrics. British Medical Journal 1898;1(1931):53.
  13. Ghi, T., Angeli, L., & Frusca, T. (2021). Fetal Head Rotation in Labor: Intrapartum Assessment at 2D and 3D Ultrasound. In Intrapartum Ultrasonography for Labor Management(pp. 275-283). Springer, Cham.
  14. Gimovsky, A. C. (2021). The Role of Intrapartum Sonography in Persistent Occiput Posterior Position and Prolonged Labor. In Intrapartum Ultrasonography for Labor Management(pp. 183-191). Springer, Cham.
  15. Guerby, P., Allouche, M., Simon-Toulza, C., Vayssiere, C., Parant, O., & Vidal, F. (2018). Management of persistent occiput posterior position: a substantial role of instrumental rotation in the setting of failed manual rotation. The Journal of Maternal-Fetal & Neonatal Medicine, 31(1), 80-86.
  16. Hofmeyr, G. J., & Singata-Madliki, M. (2020). The second stage of labor. Best Practice & Research Clinical Obstetrics & Gynaecology, 67, 53-64.
  17. Lieberman, E., Davidson, K., Lee-Parritz, A., & Shearer, E. (2005). Changes in fetal position during labor and their association with epidural analgesia. Obstetrics & Gynecology, 105(5), 974-982. (Gail strongly disagrees with conclusion that fetal position change is random.)
  18. Malai, S., Pichaiyongwongdee, S., & Sakulsriprasert, P. (2015). Immediate Effect of Hold-Relax Stretching of Iliopsoas Muscle on Transversus Abdominis Muscle Activation in Chronic Non-Specific Low Back Pain with Lumbar Hyperlordosis.
  19. Mercier, R. J., & Kwan, M. (2018). Impact of peanut ball device on the duration of active labor: a randomized control trial. American journal of perinatology, 35(10), 1006-1011.
  20. Nakao, S. et al. (2019) Chronic Effects of a Static Stretching Program on Hamstring Strength. The Journal of Strength & Conditioning Research
  21. Oleksy, Ł., Mika, A., Kielnar, R., Grzegorczyk, J., Marchewka, A., & Stolarczyk, A. (2019). The influence of pelvis reposition exercises on pelvic floor muscles asymmetry: A randomized prospective study. Medicine, 98(2).
  22. Othenin-Girard, V., Boulvain, M., & Guittier, M. J. (2018). Occiput posterior presentation at delivery: Materno-foetal outcomes and predictive factors of rotation. Gynecologie, obstetrique, fertilite & senologie, 46(2), 93-98.
  23. Sandhofer, M., Schauer, P., Pilsl, U., & Anderhuber, F. (2019). Fascia glutealis as mediator of musculocutaneous dynamics in the buttocks region. Journal für Ästhetische Chirurgie, 12(1), 6-13.
  24. Siccardi, M., Valle, C., Di Matteo, F., & Angius, V. (2019). A postural approach to the pelvic diameters of obstetrics: the dynamic external pelvimetry test. Cureus, 11(11).
  25. Tang, G., Chan, Y. V., & Lau, W. L. (2016). P17. 08: Can intrapartum ultrasound assessment of fetal spine and head position predict persistent occiput posterior position at delivery?. Ultrasound in Obstetrics & Gynecology, 48(S1), 223-223.
  26. Thomas, E., Bianco, A., Paoli, A., & Palma, A. (2018). The relation between stretching typology and stretching duration: The effects on range of motion. International journal of sports medicine.
  27. Wasson, C., & Chon, T. (2018). A Case of Sciatica During Labor Due to an Occiput Posterior Fetus. Cureus, 10(1).
  28. You, T., Yang, B., Zhang, X. T., Ren, S. Y., Bai, L., Jiao, F. J., … & Zhang, W. T. (2020). A possible prediction of dystocia at the time of cesarean delivery: Gluteal muscle contracture, a single center experience from China. Medicine, 99(7).

Recommended Reading

  1. Balaskas, Janet. Active Birth. N.p.: Harvard Common, 1992. Print.
  2. Evans, Jane. Breech Birth: What Are My Options? London: Association for Improvements in the Maternity Services, 2005. Print.
  3. Fitzpatrick, M. “Influence of Persistent Occiput Posterior Position on Delivery Outcome.” Obstetrics & Gynecology 98.6 (2001): 1027-031. Web.
  4. Floberg, Jan, Patrick Belfrage, and Hans Ohlsén. “Influence of the Pelvic Outlet Capacity on Fetal Head Presentation at Delivery.” Acta Obstetricia Et Gynecologica Scandinavica 66.2 (1987): 127-30. Web.
  5. Frye, Anne. Holistic Midwifery: A Comprehensive Textbook for Midwives in Homebirth Practice. Vol. 2. Portland, Or.: Labrys, 2013. Print.
  6. Gardberg, Mikael, and Marketta Tuppurainen. “Persistent Occiput Posterior Presentation-a Clinical Problem.” Acta Obstetricia Et Gynecologica Scandinavica 73.1 (1994): 45-47. Web.
  7. Jordan, Brigitte. Birth in four cultures: A crosscultural investigation of childbirth in Yucatan, Holland, Sweden, and the United States. Waveland Press, 1992.
  8. Jowitt, M. (2014). Dynamic Positions in Birth: A fresh look at how women’s bodies work in labour. Pinter & Martin Publishers.
  9. Kalogiannidis, I., N. Masouridou, T. Dagklis, S. Masoura, M. Goutzioulis, Y. Prapas, and N Prapas. “Previous Cesarean Section Increases the Risk for Breech Presentation at Term Pregnancy.” Clinical and Experimental Obstetrics and Gynecology 37.1 (2010): 29-32. Print.
  10. Kariminia, A. “Randomised Controlled Trial of Effect of Hands and Knees Posturing on Incidence of Occiput Posterior Position at Birth.” Bmj 328.7438 (2004): 490. Web.
  11. Khorsan, R., C. Hawk, AJ Lisi, and A. Kizhakkeveetil. “Manipulative Therapy for Pregnancy and Related Conditions: A Systematic Review.” Obstetric and Gynecological Survey 6th ser. June.64 (2009): 416-17. Web.
  12. Klaus, Marshall H., John H. Kennell, Phyllis H. Klaus, and Marshall H. Klaus. The Doula Book: How a Trained Labor Companion Can Help You Have a Shorter, Easier, and Healthier Birth. Cambridge, MA: Perseus Pub., 2002. Print.
  13. Klein, Theresa J., and M. Anthony Lewis. “A Physical model of Sensorimotor Interactions During Locomotion.” Journal of Neural Engineering 9.4 (2012). Web.
  14. Lepage, J., et al. “Biomechanical Pregnant Pelvic System Model and Numerical Simulation of Childbirth: Impact of Delivery on the Uterosacral Ligaments, Preliminary Results.” International Urogynecology Journal September.17 (2014): n. pag. Print.
  15. LeRay, Camille, Pauline Serres, Thomas Schmitz, Dominique Cabrol, and Francois Goffinet. “Manual Rotation in Occiput Posterior or Transverse Positions; Risk Factors and Consequences on the Cesarean Delivery Rate.” Obstetrical & Gynecological Survey 63.2 (2008): 83-84. Web.
  16. LeRay, Camille, Marion Carayol, Sébastien Jaquemin, Alexandre Mignon, Dominique Cabrol, and François Goffinet. “Is Epidural Analgesia a Risk Factor for Occiput Posterior or Transverse Positions during Labour?” European Journal of Obstetrics & Gynecology and Reproductive Biology 123.1 (2005): 22-26. Web.
  17. Lieberman, Ellice, Karen Davidson, Aviva Lee-Parritz, and Elizabeth Shearer. “Changes in Fetal Position During Labor and Their Association With Epidural Analgesia.” Obstetrics & Gynecology 105.5, Part 1 (2005): 974-82. Web.
  18. Lim, Kyoung-Il, Hyung-Chun Nam, and Kyoung-Sim Jung. “Effects on Hamstring Muscle Extensibility, Muscle Activity, and Balance of Different Stretching Techniques.” Journal of Physical Therapy Science 26.2 (2014): 209. Web.
  19. Lowe, Nancy K. CNM, PhD, FACNM, FAAN. “The Dystocia Epidemic in Nulliparous Women.” June 12, 2005, PowerPoint Presentation, Oregon Health & Science University.
  20. Magid, Bernard, and Charles F. Gillespie. “Face and Brow Presentations.”Obstetrics and Gynecology 9.4 (1957): 450-57. Print.
  21. Oxorn, Harry, and William R. Foote. Oxorn-Foote Human Labor & Birth. 4th ed. Norwalk, CT: Appleton-Century-Crofts, 1980. Print.
  22. Phillips, Carol J. Hands of Love: Seven Steps to the Miracle of Birth. St. Paul, MN: New Dawn Pub., 2001. 97-134. Print.
  23. Phillips, C. J. “An Effective Drug-free Approach to Premature Contractions.” International Chiropractor’s Association Review October (1998): 76-81. Web.
  24. Phillips, C. J. “Back Labor: A Possible Solution for a Painful Situation.” International Chiropractor’s Association Review Jul/Aug (1997): 151-55. Web.
  25. Phillips, C. J., and J. J. Meyer. “Chiropractic Care, including Craniosacral Therapy, during Pregnancy: A Static-group Comparison of Obstetric Interventions during Labor and Delivery.” Journal of Manipulative & Physiological Therapeutics 8th ser. October.18 (1995): 525-29. Web.
  26. Phillips, C. “Musculoskeletal and Radicular Pain during Pregnancy, Labor and Delivery: The Concurrent Use of Spinal Manipulative Therapy (SMT), Craniosacral Therapy (CST) and Dynamic Body Balancing Techniques (DBB): Five Case Reports.” Journal of Clinical Chiropractic Pediatrics 11.2 (n.d.): 797-98. Print.
  27. Ponkey, S. “Persistent Fetal Occiput Posterior Position: Obstetric Outcomes.” Obstetrics & Gynecology 101.5 (2003): 915-20. Web.
  28. Röst, Cecile C. M., and Christine Buttinger. Relieving Pelvic Pain during and after Pregnancy: How Women Can Heal Chronic Pelvic Instability. Alameda, CA: Hunter House, 2007. Print.
  29. Simkin, Penny. “The Fetal Occiput Posterior Position: State of the Science and a New Perspective.” Birth 37.1 (2010): 61-71. Web.
  30. Simkin, Penny, Ruth Ancheta, and Suzy Myers. The Labor Progress Handbook: Early Interventions to Prevent and Treat Dystocia. Oxford: Blackwell Pub., 2005. Print.
  31. Sizer, A. “Occipitoposterior Position: Associated Factors and Obstetric Outcome in Nulliparas.” Obstetrics & Gynecology 96.5 (2000): 749-52. Web.
  32. Sutton, Jean, and Pauline Scott. Understanding and Teaching Optimal Foetal Positioning. Tauranga, N.Z.: Birth Concepts, 2000. Print.
  33. Tully, Gail. “Belly Mapping; Using Kicks and Wiggles to Predict Posterior Labor.” International Doula Fall 2004: Volume 12-Issue 4. Web.
  34. El Harta, Valerie. “Posterior Labor: A Pain in the Back.” Midwifery Today Winter.36 (1995): 19-21. Web.
  35. Banks, Maggie. Breech Birth: Woman-wise. Hamilton, N.Z.: Birthspirit, 1998. Print.

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