Is it likely to have a posterior baby again, and does that mean I'll need a C-section?

Описание: You wanted to know, if you have a history of a baby that is in the posterior position during labor and delivery in the past, if it means that future babies will be posterior, and if a posterior baby means that you have to have a C-section. And the answer to both of these questions, thankfully, is “No”. About 15% to 20% of babies are in the occiput posterior, or OP position, during labor, but by the time it’s time for the woman to push, when she’s 10 centimeters, only 5% of babies are in the OP position. And what this all means, basically, is that the baby is head-down in the pelvis, so that’s good, but this is referring to the orientation of their head within the mother’s pelvis, and it does make a difference with how easy it is to push a baby out.

Imagine a baby in the fetal position with their arms and legs tight against their body and their head curled down. And with their head curled down and tucked, they’re going to more easily fit through the pelvis. And so if the baby is in the anterior position, this means that they are looking at the mother’s spine, their head is tucked, and they are able to fit through the pelvis more easily. Essentially, in the anterior position, the baby is trying to fit the smallest diameter of their head through the mother’s pelvis, and this is a good thing. And in most cases, the baby fits well, but if their head is turned to the side, or if their facing up and looking at their mother’s bellybutton, then this really increases the size of the diameter trying to fit through the mother’s pelvis and may make it harder for them to fit. But like I said before, only 5% of babies are in the posterior position when it comes time to push. And most babies figure it out. They spontaneously rotate into the right position.

But sometimes a doctor has to go and help to manually rotate the head into the anterior position so that they can fit. And as long as a mother is able to push a baby out, whether they be in the anterior or posterior position, and the baby is tolerating labor and contractions, then the mother is able to deliver vaginally. But if the mother has been pushing for a really long time, and the baby is just not really descending in the pelvis, no progress is being made, this could be due to their size, they’re just not fitting through the pelvis, or it could be due to the orientation of their head. And if the doctor can’t get them to rotate and fit, then a C-section might be necessary. But just because it happened in the past does not mean it has to happen in the future.

As for a C-section, if a woman had a C-section delivery in the past, whether it was due to the baby’s orientation in the pelvis or not, a C-section may be warranted in future pregnancies, and this is a discussion that a doctor would have with a woman, because it’s really based on her circumstances and on what is going to be safest for her and the baby. Ultimately, if you have questions about your circumstances, talk with your OB provider and they’ll be able to give you tailored information and advice. If you have more questions in the future for me, feel free to ask them on our Intermountain Moms Facebook and Instagram pages, and recommend us to your friends and family too.