Foetal positions for labour and birth: All you need to know about the ROA position

Foetal positions for labour and birth: All you need to know about the ROA position

The understanding of the baby's position can also help speed up the labour process. Here's a lowdown on the various foetal positions including ROA

The position that your baby is placed in during the third trimester or during the early days of labour can determine your labour plan and ways to ease discomfort. This understanding of the baby’s position can also help speed up the labour process.

In order to understand the various safe foetal positions for labour, theIndusparent interviewed Dr Ragini Agrawal, gynaecologist and clinical director of W-Hospital by Pratiksha, Gurgaon. She began by explaining the Occiputo-Anterior position, the critical labour position.

“It is ideal for birth. It means that the baby is lined up so as to fit through the pelvis as easily as possible. The baby is head down, facing the mother’s spine, with his back on one side of the front of the tummy,” she explains.

Foetal positions for labour

She further explains that there are two types of feotal positions that play an important role during labour. These are:

  • Left Occiput Anterior: In this position, the baby’s chin is tucked onto his chest, so that the smallest part of his head will be applied to the cervix first. The position is usually ‘Left Occiput Anterior’ or LOA.
  • Right Occiput Anterior: This position means that the baby’s head is flexed and presenting part is the occiput or backside of head is on right side of mother’s uterus. This is the position when easy normal delivery can be possible as diameter of head is smallest in this situation.

Is ROA a dangerous position for the baby?

The position of a baby in mother’s womb plays a significant role as far as normal vaginal delivery is concerned.

Dr Agrawal explains, “If a baby is in head-down position only then normal vaginal delivery is possible. If baby’s butt is down or shoulder is presenting position then it is not possible to deliver her safely and need of abdominal delivery arises. But all head down positions are also not considered normal and appropriate for normal vaginal delivery.”

At the onset of labour, the position of the foetus with respect to the birth canal is critical to the route of delivery. Thus, foetal position within the uterine cavity should be determined at the onset of labour.

Why does the ROA position happen?

Dr Agrawal explains that this position happens in most of the cases where the head-first presentation (vertex) enters the pelvis lying in the transverse (see pic) pelvic diameter.

Image courtesy: Photo © Dorling Kindersley/Getty Images

Image courtesy: Photo © Dorling Kindersley/Getty Images

“In 40 percent of labours, the foetus enters the pelvis in the left occiput transverse (LOT) position and in 20 percent, in the right occiput transverse (ROT) position. In occiput anterior positions—LOA or ROA—the head either enters the pelvis with the occiput rotated 45 degrees interiorly from the transverse position, or subsequently does so,” explains Dr Agrawal.

Can variables of ROA affect labour?

The changes in the positions of the presenting part requiring navigation in the pelvic canal constitute the mechanisms of labour. Dr Agrawal explains that the cardinal movements of labour include the following:

  • Descent: In this position, the baby’s body is pushed out of the body due to active labour
  • Flexion: In this position, the head meets the resistance of the pelvic floor and the baby’s head’s diameter will decrease
  • Internal rotation: In this position, the baby’s shoulder reaches the pelvic floor
  • Extension: In this position, the head negotiates the pelvic curve
  • External rotation: In this position, the shoulders and the baby’s head lies laterally facing mother’s right thigh
  • Expulsion: In this position, the entire baby slowly crowns out of the mother’s womb

During labour, these movements not only are sequential but also show great temporal overlap. For example, as part of engagement, there is both flexion and descent of the head.

While an understanding of these positions is critical for an expecting mother, you must consult with your doctor to get a better idea of how your baby is positioned inside your womb. This will make it easy for your and your doctor to chart out a birthing plan.

If you have any insights, questions or comments regarding the article safe feotal position, please share them in our Comment box below. 

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Written by

Deepshikha Punj

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