Hello all,

I'm confused about the recommendations for knee-chest position. The Miles Circuit recommends it starting at 37 weeks all the way to early labor, as part of the circuit that should ensure the baby will be in the best position possible for birth. However the spinningbabies websites says don't do knee-chest before baby is engaged (unless baby is breech of course), which with some moms can happen much later than 37 weeks.

My client did the positions recommended in the Miles Circuit at almost 38 weeks (she had been cramping for a few nights) and after that she feels that the baby moved to posterior! Baby had been LOA for a while. The cramps also disappeared and belly seems softer and lower than before.

What can this be? Is it possible that the knee-chest disengaged the baby from a good position into a worse one?

Very interested in your opinions.

Narchi

The knees should be further behind the hips, not underneath them. She can have someone Rebozo for extra support. And her chest should be on the ground/supported by a pillow.

According to the Miles Circuit she can be rather well supported by pillows for the open knee chest, and can use them just to roll to the exaggerated sims.

If you need a better definition I would look closely at the Spinning Babies site, it's explained well there IMO

When you are using spinning babies it is also important to remember the 1st priniciple which is balance. There is a section that talks about daily activities which addresses balance. There is also a new website from Jean Sutton/Pauline Scott about optimal fetal positioning.. http://optimal-foetal-positioning.co.nz/

This is from Spinning babies website...

Occasionally, the question arises, can maternal positioning and the techniques featured at Spinning Babies cause a baby in a good position to get into a "bad" position. For instance, could doing these techniques when baby is head down make the baby flip head up. Or, could they turn a baby who's in an anterior position to a posterior presentation? Is there any harm in doing these?

I am inclined to say no. With exceptions....
•Does the baby have an "unstable lie" (flipping from head-down to head-ip or to a transverse lie).
•Does the mother have polyhydramnios (so much amniotic fluid that special monitoring by her doctor is required for safety)?
•Does the mother have high blood pressure or is at risk for a stroke in other ways?
•Does the mother have both have a lot of water and membranes have released when the baby is still high, not in the pelvis?

These would be reasons not to get upside down without someone involved who is highly skilled in fetal monitoring, such as an experienced Labor and Delivery nurse.


Also I am pretty sure spinning babies also does not recommend open knee chest position (different from knee chest position) because there are no contractions to keep the baby head down. Open knee chest position is used in labor with contractions to help back baby out for better positioning.