Towards the time of delivery, your baby should ideally be:
- descending into the pelvic cavity
- facing backwards
On your “yellow card”, you may see these terms:
- x/5 eg 3/5
- LOA or ROA
“Ceph” refers to “cephalic”, from the Greek “kephale” meaning head, top or source. If you see this term, this means the baby is head-down, where it should be. If the baby is head-up, this is breech (there are different kinds of breech position) and your doctor or midwife will discuss options with you.
x/5 is the number of “fifths”.
When your doctor or midwife presses around your pubic bone, they can feel the baby’s head position relative to the top of the bone. If the whole baby’s head is above this landmark, then it will be the width of approximately the doctor’s or midwife’s five fingers, so this is recorded as “5/5”.
When the baby starts to descend, one-fifth has descended past the bone and four fifths can be felt: “4/5”. As the baby gets lower, less of the head can be felt, so the top number goes down: “3/5”, “2/5”, “1/5″…
When the baby is fully descended, none of the baby’s head can be felt: “0/5” or fully engaged.
Depending on your circumstances, the baby’s descent may be more or less relevant to your birth, including any decisions you need to make. Your doctor or midwife will keep you informed and let you know if there is any concern. During prebirth acupuncture, we do like to receive this kind of information so that we can tailor our responses accordingly.
LOA or ROA
If you see LOA or ROA, this means “Left Occiput Anterior” or “Right Occiput Anterior”. The “Occiput” is the base of the skull at the back of the head. “Anterior” means towards the front.
So “Occiput Anterior” means that the back of your baby’s head is facing towards your front. So your baby is basically looking back towards your spine. Theoretically, this presentation allows for the simplest route for your baby to be born, especially LOA.
If you are told that your baby is “Posterior” then this means that baby’s occiput is facing towards your spine, rather than towards your front.
Compared to some other conditions affecting birth, the amount of research into Occiput Posterior presentation is quite limited. Questions being studied include:
- Can the mother’s position (eg walking on all fours, rocking) influence the baby’s position, either before or during labour?
- Can the baby be turned manually by a medical caregiver before or during labour?
- How many babies will turn on their own before labour, how many will turn (either way) during labour?
- What factors cause babies to turn posterior?
- Does use of epidural anaesthesia influence posterior presentation and, if so, then what is the relationship?
- What other methods might help with pain, especially back pain (eg sterile water injection, body position)?
- How can posterior presentation be detected prior to, or during, labour?
- If detected prior to labour, what is the best way to manage this situation?
There is a body of “anecdotal evidence” that your doctor and/or midwife may draw upon. This means knowledge that has been developed through experience but has not been thoroughly tested in controlled clinical trials. Your caregiver will tell you the benefits versus the risks of various kinds of management (including “expectant management” which means watch and wait), both before and during labour, allowing you to make an informed choice.
If you would like to find out how acupuncture can help in various ways related to pregancy or birthing, please request your 15-minute Free Consultation where you can come to our clinic, provide details of your unique situation and discover what we can offer.
Hart J, Walker A. Management of Occiput Posterior Position. Journal of Midwifery & Women’s Health. 2007;52(5),508-513.