Occiput Posterior: What It Means for Your Birth (and How to Make Things Easier!)

Simply put, it means your baby is head down (which is great!), but facing your belly instead of your back. Think of it as your little one looking up at the ceiling instead of down at the floor. The opposite of OP, OA (occiput anterior), is when baby is looking at your backside. This is the most common, and typically considered the most optimal position for a vaginal birth.

Is OP positioning common?

Yes! OP (aka sunny side up) is the most common fetal malposition. According to a research study, “Of 306,237 term births, 19% had occiput posterior position during labor, 37% of which persisted in occiput posterior position at delivery.” (source) Don’t get discouraged if your provider says your baby is OP. There are things, which we will discuss more below, you can do to encourage baby to rotate. 

True story – both of my babies were OP and I was still able to have 2 vaginal deliveries!

How might OP affect labor?

While it’s usually not too big of a deal and a vaginal birth is still possible it can make labor a bit longer or more uncomfortable – why?

• Trickier fit: It can be a little harder for baby to navigate the pelvis in this position 
• Back labor: You might experience more back pain during contractions
• Slower progress: Labor might progress a bit slower as baby works to turn and get in a more optimal position for birth

I want to say it again, you can still have a vaginal birth, mama. Labor progression might be a bit slower than expected but a baby in an OP position does not exclude you from attempting a vaginal delivery. 

The need for assisted vaginal delivery might be increased when a baby isn’t in the most optimal position for delivery. “Among occiput posterior deliveries, 27% were spontaneous vaginal deliveries, 8% vacuum, 5% forceps, 1% mixed vacuum-forceps, and 59% were cesarean delivery; this distribution differed from that of occiput anterior deliveries” (source.) 

What can you do to encourage rotation?

Fear not, there are things you can do to encourage your little one to rotate and make things easier. Movement and position changes are key! There are things you can do leading up to labor and during labor to encourage rotation. Here are some things you can try:

Leading up to labor

• Curb walking: helps encourage baby into the pelvis, not recommended prior to 39 weeks as it might jumpstart labor
• Miles Circuit: encourages baby into an OA position, safe to start anytime after 37 weeks 
• Butterfly pose, cat/cow, lunges, squats: safe to do throughout entire pregnancy unless indicated otherwise or pregnancy is high-risk
• Forward leaning inversion

During labor

• Hands and knees: can help open up your pelvis and give baby more room to rotate
• Use a birthing ball: simply bouncing or doing figure 8’s on a ball might get baby to turn 
• Squats: can open up the pelvis and give baby more room 
• Leaning forward: can encourage rotation and also take some pressure off your back
• Side lying: different position changes will encourage baby to move around and change positions themselves 

Doula

A doula is such a valuable resource to have during labor. Not only are they your cheerleader and advocate but they can also recommend and assist you in different positions to assist with labor progression. If 

See, there are plenty of things you can do to help encourage baby into a more optimal position. This is by no means a doom and gloom scenario so don’t let it bring you down!

Remember these key takeaways

• Most babies turn on their own: even if your baby is OP going into labor, there is a good chance he or she will rotate prior to delivery
• OP babies don’t always pose a “problem”: there are plenty of mamas that have uncomplicated, straightforward vaginal births with OP babies (I can attest to this from experience)
• You aren’t alone: remember, you aren’t navigating this on your own! You have a team of nurses, a provider, possibly a doula, and hopefully a partner that will support and guide you

After reading this article I hope you find the words “occiput posterior” a lot less daunting! It’s nothing more than one of the many positions your baby might be in and doesn’t have to dictate how you birth your baby. If you have any concerns about your baby’s position or how it might affect your labor, don’t hesitate to talk to your healthcare provider. They’re your best resource for personalized advice and support. You’ve got this, mama!

Additional MLN resources:

• MLN’s FREE Mini Birth Course
• How to Push During Labor: Open Glottis Pushing, Guided Pushing, Positions, and More!
• What is Back Labor? Must-Know Tips for Every Mama