One of the biggest concerns my pregnant patients have is the position of their baby in-utero. In fact, this is one of the main reasons we get so many referrals from midwifery clinics. This is a valid concern as every pregnant woman knows that proper positioning of their baby in-utero is directly related to better birth outcomes.
In my discussions with my pregnant patients, I rely on the many tips learned from extensive training in anatomy, physiology, and my training in perinatal chiropractic. In order to bring you the best in postural tips to optimize the proper position in utero, let’s take a listen in to Dr. Jeannie Ohm, a pioneer in perinatal chiropractic care and one of my mentors.
“Malpositioning in labor may occur partly because of the modern, sedentary lifestyles that thwart optimal positioning during pregnancy. Especially while seated, we often compromise our spinal alignment and optimal positioning. Easy chairs, couches and car seats force us into a slouch position. Even when sitting in straight-backed chairs, we can find ourselves slouching, compromising our pelvic balance. Slouching misaligns the pelvis in such a way that it makes it more comfortable for the baby to turn posterior or breech.
If, instead, you sit with your pelvis tilted forward, your lower spine curves forward. Your pelvis will be open and the baby can choose the most ideal position for birth.
Be conscious of your posture as often as possible, especially when you are sitting. Sit with your hips rocked forward and your knees always lower than your hips. Cease slouching, leg-crossing, or sitting on your legs. Sitting toward the front edge of your chair will help overcome negative sitting habits. Well inflated birth balls and the Swedish kneeling chair (pictured below) make it easy to keep your knees lower than your pelvis. 
When taking long car rides or when sitting at work, take breaks often and move your body. Spend time throughout the day moving your hips in a figure-eight type motion (view our instructional video). You can use the back of a chair to lean on to do this movement. This keeps the joints in your pelvis flexible and better able to maintain a balanced state. These positions also lean the uterus forward and encourage the baby to settle into the anterior position, an ideal position for birth.
Another beneficial movement is pelvic rocks. To start, get on all fours and arch your spine. This strengthens and tones your lower back muscles. Then allow your spine to arch forward. This motion opens up the pelvis, relaxes the uterus and gives ample room for the baby to move. Also, you can exercise by crawling on the floor to optimize positioning.
If you have an occupation that is restrictive to movement or has you maintaining a one-sided posture for long periods of time, it is important that you aim to change postures regularly so you can support pelvic balance. For example, chiropractors and massage therapists may spend their entire day on one side of their table. In this case, maintain pelvic balance by adopting alternate stances.
If you are frequently holding an older child during pregnancy, and you elevate your hip for added support, know that this repetitive torque to your pelvis can cause structural imbalances that may adversely affect your baby’s positioning in utero. This was the case for me when I was pregnant with my sixth baby. Having held my fifth child on my left side consistently, my baby was led into a posterior occipital presentation for labor.
It might seem inconvenient to balance out your daily positions, but your awareness and effort to do so throughout pregnancy can make a significant difference in your birth experience.”
Source: Jeannie Ohm, an excerpt from Pathways to Family Wellness magazine, Issue #53, Mar 1, 2017.
Blog by: Dr. Cheryl van der Mark, B.Sc., D.C., F.I.C.P.A.