Did you know research shows that only 10% of babies are born in direct OP? How to use OMP Pelvic Mobility Protocols during Labor to enable labor to progress.

Did you know that research shows that only 10% of babies are born in direct occiput posterior (OP) position and that most of babies who start labor in OP position will eventually turn?

However the research also shows that maternal positioning does not have an effect on babies’ positioning and research doesn’t state how much longer a mother’s labor can be prolonged with babies in OP at some point during labor.

This blog post is to prove the research wrong - there is something you can do about it whether you are a pregnant mother, a birth supporter or a birth professional. Here is one of many blog posts to come demonstrating how we can actually make a difference and enable a mother’s labor to progress especially during difficult and/or challenging labors.

This photo of one of our Four Trimesters doulas and a laboring mother makes my heart sing This is pure doula love after 24 hours of labor birthing a baby in asynclitic direct OP baby on a birthing stool without any medical interventions.

Very very proud of my team of birth doulas for doing a phenomenal job at this birth.

Did you know that research shows that only 10% of babies are born in direct OP? This first time mother’s OP asynclitic labor could have very easily ended up either in an assisted delivery or a cesarean however this photo captured the essence of the moment - the parents belief in their ability to birth this baby naturally, the trust that have in us doulas at Four Trimesters Birth Sanctuary to keep them safe and keep their labor progressing and a wonderful Obgyn who gave the parents and us time to work with her to birth her baby in direct OP on a birth stool without assistance! Second stage was about 5-6 hours of alternating between Optimal Maternal Positioning OMP Pelvic Mobility Protocols and heaps of doula love, perseverance and laughter in-between! And she did it!

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Here are some of birth notes during the second stage that might be helpful for you as to how to use OMP Pelvic Mobility Protocols as most of birth professionals get stuck at utilizing only OMP Pelvic Alignment Protocols. With OMP, the intent of why which protocol was used, the intent and purpose are all very important in enabling a mother’s labor to progress.

I was at this birth mostly only during the second stage of labor so this is only part of the birth story.

Ginny’s Birth Notes

• 10am-ish: Even though the mother does show signs that she was past 5cm, she did not look ready for the pumping technique so I suggested 1.1 PSLR for 3 contractions on each side before going into the shower, and more abdominal lift & tuck after. I left the team of doulas to it.

• 1.09pm: Suggested more 1.1 PSLR based on what was reported to me online through our internal doula communication channel.

• 2.55pm: I went to the birthing room to check in on the team. Baby’s head with waterbag intact was definitely visible - about the size of 10-20 cents coin - so I asked one of the doulas to inform the Obgyn. Since baby’s head was visible, we got the parents ready to get into the tub at about 3.01pm.

• 3.02pm: Laboring mother started off with a squatting position with her birth partner supporting her from her back.

• 3.26pm: We moved her birth partner to sit on the seat of the tub in order to be more propped up when supporting the laboring mother in a squatting position.

• 3.34pm: We tried asymmetrical squats to create more space and aimed for 3-5 contractions on each side, with a squatting position in between to see if the asymmetrical positions worked. One of the doulas also suggested a forward leaning squat to see if more pressure on the laboring mother’s belly would help.

• Obgyn arrived, did a vaginal examination with laboring mother in the tub and confirmed that she was fully dilated, station +2, membranes intact and went into the next room to wait. This is the ONLY vaginal examination that the mom had throughout her entire labor. Obgyn commented that she needed to push harder so we worked with her getting more grunty and forceful when pushing.

• 3.41pm: Laboring mother liked to squat holding onto one of the Doula arms for support and refused all suggestions of using the birth rope. Think OMP Kabyle Squat!

• 4.06pm: We alternated between squats supported by her birth partner, squats supported by the team of Doulas, and a semi-reclining position where the laboring mother would put her hands behind her thighs to go into extreme flexion to create more space in her outlet pelvis - all done in the birthing pool. All this time - baby’s head was visibly “just there” however in-between contractions, the head would slide back.

• 5.23pm: More of baby’s head was visible and now membranes were bulging outside of her vagina like a ‘crystal ball’.

• 5.35pm: SROM | Spontaneous rupture of membranes!

• 5.45pm: One of the Doulas had been suggesting to the laboring mother prior to stand up to see if gravity will work and help however the laboring mother has been reluctant to get out of the water. Finally she compiled standing and leaning against her birth partner for support, still holding on to the doulas hands.

• 6.15pm: We got both parents out of the water to try the birth stool and squatting again.

• 6.23pm: Asymmetrical positions seemed to work for the laboring mother so we alternated asymmetrical squats between both legs together with a full squat in-between. It was extremely encouraging and we could clearly see a lot more of baby’s head. Her labia was swollen at this point however as we could see how baby was slowly edging its way out, we were also confident that she would finally birth very shortly. We were planning to move her back to the into the tub when baby’s head started crowning.

• 7.15pm: Baby born in direct OP with its caput on its left side of her head which meant that she didn’t just turn OP, but her head was also asymmetrical which explained why her second stage was so long.

Only about 10% of babies are born in direct OP, more than 50% would rotate to LOA/OA eventually.

This was a birth that would very easily end up in assisted delivery had we been in a hospital setting. However as first time parents were truly determined to have a homebirth at the Birth Sanctuary and trust in her amazing body to do the work which was consistent with her actions and behaviours during pregnancy, together with the tons of doula love which was enveloped with bubbles of love, hope and faith, and generosity of time given by the Obgyn, this mother ended up with an intervention free delivery of a direct OP baby!