8 Positions of Cephalic Fetal Presentation

OK, you’re pregnant. Congratulations!! You’ve read all the books and articles on pregnancy that you could find. You think you know everything there is to know and that’s good, but what about the actual birth? Do you know enough about that? Do you understand the terms being used by the doctor and nurses that are constantly checking and monitoring you and your baby? Some of these terms may be scary if you do not understand them. For this article, let’s focus on “fetal presentation”. This simply means the position of the baby at time of birth. There are basically 3 positions that your baby can be in; breach, shoulder and arm, and cephalic (head first). Breach means the baby is coming feet or butt first which only happens in about 3% of births. The most rare presentation is the shoulder and arm position which means that the baby is lying sideways which only happens in less than 1% of births. The most common position for birth is head first (cephalic). Cephalic presentation is considered normal and occurs in about 97% of births. However, there are eight different ways a baby could be facing while head down. This is the type of presentation we are going to concentrate on in this article.

1. Occiput Posterior (OP) – head facing mother’s tummy (sunny side up)

2. Occiput Anterior (OA) – head facing mother’s back

3. Left Occiput Anterior (LOA) – head facing mother’s right butt cheek (best position)

4. Right Occiput Anterior (ROA) – head facing mother’s left butt cheek

5. Left Occiput Transverse (LOT) – head facing mother’s right side

6. Right Occiput Transverse (ROT) – head facing mother’s left side

7. Left Occiput Posterior (LOP) – head facing front of mother’s right leg

8. Right Occiput Posterior (ROP) – head facing front of mother’s left leg

When labor begins, babies in the OP position will normally turn to be in the OA position. As labor progresses and babies begin to descend further into the birth canal, they continue to turn. LOT and ROT babies will normally turn into back facing positions. Facing toward the back half of the mother is the ideal position for birth. In the LOA and ROA position, the mother has a faster delivery and less pain.

If the baby does not turn from the OP position to the OA position, then he or she will travel through the birth canal facing the front half of the mother (LOT, ROT, LOP, ROP). This will cause a much longer labor and much more pain which is known as back labor. These positions can also cause such complications as assisted deliveries (use of forceps), bodily injuries and c-sections.

Because of the shape of the mother’s pelvic, sometimes the baby does not have enough room to turn. This is what happened with me. My first baby did not turn and after being in labor for 36 hours, we had no choice but to have a c-section. My next 2 babies were born by scheduled c-sections, so I really don’t know what position they would have been in. With my fourth baby, I decided to try a VBAC. After several hours of labor and the baby still not turning, it was back to the OR for my final c-section.

Talk to your doctor about the progress of your baby’s position. Your doctor may be able to suggest ways of helping the baby turn to a better position!