Case Study: Influencing Baby’s Position in Pregnancy

A lot of my pregnant clients come in because they are in pain, but what they do not always realize is that this pain can be a guide to helping get baby into a better position for birth.

Pain is an indicator that something is not right in the body, but this doesn’t always mean there is a structure that is not working well. Often times, pain can be caused by baby’s position in the body and baby’s position in the body is often dependent on where it has space to go. If there are tight areas of fascial restrictions, then baby may not be able to get to where it wants to go, and instead, it will go where it can find space. Ultimately, this can create pain for mom.

Client History

I had a client come in to see me at 35 weeks pregnant with her third baby. She expressed that she thought her baby was breech. She was having some aches and pains with this pregnancy and reported that the pain was primarily on her R side in her pelvis and hip. She shared that her second birth had lots of interventions, though her pushing went okay during that birth.

Assessment and Treatment

During the evaluation, I palpated the baby’s position, and I felt that the baby’s head was down. Sometimes the butt and head can be mistaken for one another, and you never really know what part of the body you are palpating without getting an ultrasound image. However, the movement of the baby’s body can give you a good indication. If you gently wiggle the structure between your fingers and the whole body moves, it’s more likely your hands are on baby’s bottom. If the structure you are moving gently is the head, it generally just wobbles while baby’s body remains more still. In my assessment, the structure that was down toward her pelvis wobbled just in that area, so my guess was that baby was not breach and that baby’s head was down. After the session, my client had an ultrasound that confirmed these findings.

From my palpation, I found that baby’s head position was slightly off centered toward the right hand side of the pelvis. The client did present with some right-sided tension in her abdomen which I addressed using the fascial release techniques I will be teaching in a new course, Pregnancy Pain and Beyond (coming in May 2025). Her lower abdominal fascia was tight on the right side, as was her broad ligament.

In addition to the restrictions, the client’s pelvis was still in an open birthing pattern. I helped mobilize the pelvis to bring it into balance. I also found increased tension on the right side adductor muscles. As I worked to help these muscles release, I found a strong connection to her sacrum and tailbone on that right side. While working on both together, the adductor muscles melted more easily.

With an internal assessment, the client had bilateral tension in her pelvic floor muscles. After releasing this tension, she had much better core activation and was able to push effectively in all positions.

I had her do an inversion and then re-evaluated the baby’s position, which was more midline in the pelvis meaning a more optimal position for birth.

Wrapping Up Her Session

The biggest issue I discovered with this client after doing all the manual therapy techniques with her was she was not using her core muscles with any movements. Her abdominal muscles were not contracting at all with any transitional movements. I helped her to see the difference using abdominal muscle contractions with her movements and she felt a greater ease in doing so.

She felt better in her body after the session and reported that the right side felt looser and less painful. She also felt more empowered and less fearful going into this birth now knowing that the baby was in a good position for birth and her body was less restricted.

Conclusion

There is so much we can do to help our clients by addressing restrictions in the body with our pregnant clients. We can not only alleviate the pain, but we can also help baby get into a more ideal position for birth which sets the stage for a much smoother start for both mom and baby.

About the Author: Lynn Schulte is a Pelvic Health Therapist and the founder of the Institute for Birth Healing, a pelvic health continuing education organization that specializes in prenatal and postpartum care. For more information, go to https://instituteforbirthhealing.com