The Forward-leaning Inversion is a classic here at Spinning Babies®. Create room in the lower uterus. Baby will use that space, with the natural pull of gravity, to snuggle into a more ideal position for birth. The Forward-leaning Inversion technique comes from Dr. Carol Phillips, DC.
Be sure to read the directions and the cautions below.
- Why? The forward-leaning inversion potentially makes room for a good fetal position by untwisting any ligaments to the lower uterus and cervix that may be twisted from sudden stops or a habit of a twisted posture. Kneeling afterward allows temporarily lengthened ligaments to align the uterus with the pelvis. The cervix may become less tipped or tight and then able to let baby’s head to position well, and the cervix to dilate in labor more easily.
- Reduction in back pain, hip pain, or tailbone pain has been reported by pregnant people.
- Improved fetal positioning does occur. It is worthwhile trying a FLI because baby turning head down is often enough to be notable.
Who does this? All pregnant people without a contraindication. Head down babies included! Do not do this if medical contraindications exist for going upside down, such as high blood pressure or other risk of stroke.
Don’t do this if…you have heartburn, glaucoma, hypertension, or are at risk of a stroke. Also in cases where amniotic fluid levels are unusually large and the doctors are worried and measuring weekly. If you have a sinus infection, going upside down may throb (or may soothe). Make sure to watch the videos before AND AFTER trying the inversions, as mistakes are common.
Don’t go fast. Protect yourself from falling.
How long? 30 seconds. That’s three breaths long.
How frequent? Once daily!
How To Do a Forward-Leaning Inversion in Pregnancy
Gently! Don’t drop into place! Move slow and be controlled to prevent falls and protect your placenta.
- Kneel on the edge of a couch (or the top of the stairs). Kneel high to see what it feels like in your body.
- Hold the edge of the couch, bed, or other surface you are kneeling on.
- Carefully lower yourself to your hands on the floor and then lower yourself more to rest on your forearms. Elbows out, hands close. Use a stool or step, if you like, to help you walk your hands down.
- Let your head hang freely. Your chin is tucked. Don’t rest your head on the floor. Your neck may need a little movement. Straighten your shoulders to make room for your head.
- Your knees are close to the edge, your bottom is highest. You can tilt or sway your hips if you like, or gently, slowly undulate your spine.
- You can flatten your lower back (posterior pelvic tilt) to give more room for the top of your pelvis.
- Take 3 breaths. Belly loose, shoulders strong. Chin tucked and neck long.
- Come back up on your hands, then lift yourself up to a high kneeling position again (see picture), using a stool, block or help from your helper. Take two breaths here. Then sit on your heels.
- Swing your feet out from under you together. Feet together, moving like a mermaid to prevent a pull on your symphysis pubis (pubic bone). You will protect your pelvic stability this way.
It is in coming back up to kneeling that makes this technique work!
High kneeling position ends the Forward-leaning Inversion
After leaning forward on your elbows, come all the way back up to a high-kneeling position. Take two breaths and then sit on your heels for one more breath. That way you let your ligaments settle into a more symmetrical location while you catch your breath.
Note: When we first get upside-down our body signals us (in case we didn’t notice) by a throbbing head. After 3-6 times your body will realize you mean to be upside-down and your head won’t pound. Just get up early if this happens and try again, one time each day. Soon, it will go away.
How To Do a Forward-leaning Inversion in Labor
Gently! Don’t drop into place! Move slow and be controlled to prevent falls and protect the placenta.
In the hospital, get on your bed on hands and knees facing the foot of the bed.
Put your elbows on the foot portion of the hospital bed. Have your helper push the button to lower the foot of the bed until your hips are much higher than your shoulders. Continue with instructions until you are through one contraction then raise the foot of the bed and be helped up to a full kneeling position, as in the photo, but in the hospital bed.
Alternatively, use a chair beside the bed, or lower the bed and carefully lower yourself to your hands on the floor and then lower yourself to your forearms. Elbows out, hands close. Use a stool or step, if you like, to help you walk your hands down.
- Let your head hang freely. Your chin is tucked. Don’t rest your head on the floor. Your neck may need a little movement.
- Your knees are close to the edge, your bottom is highest. You can tilt or sway your hips if you like.
- You can flatten your lower back (posterior pelvic tilt) to give more room to free your ligaments.
Take deep breaths and hang in there for 1 contraction, come up to kneeling with the help of a strong person. Belly loose, shoulders strong. Chin tucked and neck long.
Come back up on your hands, then lift yourself up to a high kneeling position again (see picture), using a stool, block or help from your helper. You can repeat this through one more contraction about 15 minutes later. Repeat each phase of labor (early, active, pushing) if necessary. But have a provider ready to catch baby if you were pushing, just in case this was the technique needed.
Why do Forward-leaning Inversions in Labor?
Sometimes labors have strong contractions and yet no progress in cervical dilation.
Please consider doing Forward-leaning Inversion in these situations. FLI is especifically good if baby is waiting to descend or rotate at -2 Station, or remaining at 0 Station yet with strong contractions.
Coming back up to kneeling may make this technique work best!
Be Safe Doing Inversions
- Ask for help the first few times you try this. Have someone help you move slow.
- If you are already in your third trimester, do a very mild (not steep) inversion a few days/times before a steep inversion.
- Your head may pound a bit for the first few 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. Hold this surface BEFORE moving your hands to the floor! Do not go from a high kneeling position all the way to the floor in one movement! Hold on!
- Be sure to get up and down gently, without dropping, thumping, tumbling -or twisting!
- Allow your head to hang freely, chin tucked, neck long.
Warnings, Contraindications, Guidance – PLEASE READ!
Gentle as you go:
Listen to your body and check out unusual symptoms with your physician before going upside down. Thousands of women are getting mild or dramatic benefits from the inversion, but there are risks. Here’s what we know at this time.
Round ligament pain happens occasionally with an inversion. Round ligament pain is not typical, nor health-threatening. Round ligament spasms can be resolved with the Webster, or self-care or warmth, and a specific sort of self-massage. It’s OK to repeat the inversion carefully (for 30 seconds) even though this is happening. The inversions may resolve the spasm but the Webster is specific to resolving this type of ligament spasm.
A pain that persists more than a few minutes or is severe deserves attention. Report abdominal pain to your provider, including shoulder pain. Let’s rule out a placental problem, as abdominal pain or shoulder pain might indicate. Understand the warning signs in pregnancy.
Don’t drop fast! One mother whose abdominal muscles were very separated dropped fast from a high bed and partially separated the placenta. She and the baby had to remain under observation in the hospital until she gave birth several days later; mother and baby were healthy. Another woman with a history of placental issue of IUGR and high blood pressure in a previous pregnancy experienced separation and had an urgent cesarean. I don’t know of other issues. If you (or your client) experience an issue, please email me!
- If your abdominal muscles have extreme separation you must be extremely careful, wear a pregnancy belt and go slow!
- If your shoulders are weak or too tight to support you in an inversion, you’ll feel stress. Roll your shoulders first. Don’t begin with a steep inversion. Start easy.
When not to do the Forward-leaning Inversion:
- Right after eating (do it when you don’t have a chance for heartburn).
- If you have high blood pressure, or very, very low blood pressure, or are otherwise at risk for a stroke or fall.
- There is so much amniotic fluid around your baby that your doctor monitors you weekly (no data, being conservative here).
- In pregnancy, if there is a suspected or known problem with the placenta, including bleeding. Also avoid inverting if you have uterine pain of an undetermined origin. Get assessed immediately. Do not do an inversion if you have or unsure if you have pain due to placental separation.
- If the baby is having or has had frantic vigorous movements. Have the baby assessed immediately. Don’t wait.
- The inversion causes pain (remember, your head may pound a bit for the first few times, that’s actually OK if mild), but abdominal pain other than round ligament stretching is not right. Severe headache must be evaluated by a physician immediately. (I don’t know of this ever happening, but let’s be aware that sudden headache needs physician evaluation.)
- In labor, if labor progress is normal. Enjoy your labor!
- In labor, if there had been abundant fluid, AND the baby is high, -2 Station or higher, 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 (always trust the mother’s intuition and respect her choice to do or do not).
The cloth is NOT in the groin but rather on the thighs, helping hold the mother’s weight. If done during a labor contraction, a doula or calm, loved one would be in front of her face and under the table to give eye contact. 30 seconds in pregnancy, and in labor through 3 contractions, coming up in between.
Alternative: If you have an inversion board, you can use that instead. Standing sacral release and chiropractic are helpful but without comparable success. Do this even if you are also doing “Downward Dog” in yoga. They are NOT the same! Down dog doesn’t let the uterus hang from, and thereby stretch, the cervical ligaments. It is going back up that is the technique, however, not the inversion itself!
Tell me if you have a concern
Of the hundreds of women doing this inversion, very probably thousands, there are understandably going to be some bad outcomes. I must be told about them.
Report complications of pain or immediate bleeding and describe the situation exactly, date, gestational age, health concerns, way of doing the inversion, whether it was a first time or had been done, and time of complication. It seems that going fast and/or having an unstable placental bed add risk! gail [at] SpinningBabies [dot] com.
Inversion in Labor
You can do Forward-leaning Inversion in early labor as your daily inversion. But if labor hurts or lasts longer than expected, then do another Forward-leaning Inversion at that point. Particularly for tight or swollen cervix, asynclitism (add sidelying release), deep transverse arrest (add Sidelying Release), or in spite of a good position, baby won’t come down (add psoas release). See more tips for labor progress in Start>Labor.
Forward-leaning Inversion for helping a breech baby turn head down
- If baby is breech, do the Forward-leaning Inversion for 30 to 45 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 Open-Knee Chest with a head-down baby. When baby is breech, you may do the Forward-leaning Inversion for 30 seconds each, several times a day. I suggest 7x in one 24-hour period for babies remaining breech after 32 or more weeks. But not day after day. Balance your muscles and pelvis in more ways if a day of repeated FLIs do not flip the baby by the next day.
See this and other techniques in Flip A Breech.
Alternative: Use an inversion table if you have access to one.
Tight before and loose after daily use of the forward-leaning inversion. These don’t show a twist, but that can happen, too.
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. Any help that you could offer would be greatly appreciated!
My reply is that the CNM has palpated this mother’s abdomen. Perhaps the mother has polyhydramnios (far too much amniotic fluid), or very loose muscle tone even with normal amniotic fluid. I add that IUGR, Intrauterine Growth Retardation, a condition caused by placental insufficiency may be a reason not to do Forward-Leaning Inversion.
Sometimes a concern means the provider will advise to avoid an inversion. I’m going 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 confuse the Forward-Leaning Inversion with the Breech Tilt or the Open-Knee Chest position. These are not the same inversions as a Forward-Leaning Inversion. They are done longer. The Breech Tilt has the purpose of helping the breech baby’s chin to tuck. The Forward-Leaning Inversion has the purpose of stretching uterine ligaments and then, after the inversion, releasing the ligaments while the mother kneels upright 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, when the baby’s head is lodged incorrectly in the pelvis (-2 station) 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. It’s always good to go back over the instructions before recommending a new technique that you may not be fully familiar with.
Forward-leaning Inversion is working well to help transverse babies get head down when used 5x in one or two days.
Forward-Leaning Inversion Video Demonstration
Learn how to do the Forward-Leaning Inversion by watching Gail Tully teach it to pregnant parents in our Spinning Babies Parent Class and Daily Essentials videos. Parents across the globe are using these techniques for comfort in pregnancy and easier birth… and they’re working! Both are available on DVD or digital download.
Preparation for physiological birth. “Childbirth education for a birth nerd.” A similar outline to Spinning Babies® Workshop. Watch here!
Activities for Pregnancy Comfort & Easier Birth. Get the results you want by restoring balance day by day. Start today! Watch here!
Is Down Dog the Same as Forward-Leaning Inversion?