Back to Back Baby: What It Means and How to Help Your Baby Turn
🤔 What Does “Back to Back Baby” Mean?
A back to back baby, also known as occiput posterior (OP), is when your baby’s back is resting against your spine. Instead of facing your back, which is the most common and ideal position for birth, where your baby is facing your front.
While this position isn’t dangerous, it can make labour:
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Longer
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More painful (especially in the back)
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Slower to progress
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More likely to require intervention, such as an epidural, assisted birth, or Caesarean
🧠 Why Is Baby’s Position So Important?
In an ideal position, known as occiput anterior (OA), your baby tucks their chin to their chest and presents the smallest part of their head through your pelvis. This helps them navigate through more easily.
In a back-to-back position, babies often lift their chins slightly, which creates a wider diameter of the head. This can lead to more pressure on the back and longer labours.
📈 Why Are More Babies Back-to-Back These Days?
There’s a definite rise in OP babies, and lifestyle is a big part of the picture:
1. Too Much Sitting
We sit more than ever; at desks, in cars, and on sofas. Prolonged sitting shortens key muscles and ligaments, like the psoas, and can encourage baby to settle spine-to-spine with you.
2. Slouching and Reclining
Deep sofas and slouched resting positions tip the pelvis backwards, reducing space at the front and encouraging baby to move into the back.
3. Less Variety in Movement
Modern life doesn’t ask us to squat, lunge, climb or bend much. That means less natural encouragement for baby to move into an optimal position.
🤸♀️ How to Help Baby Turn
The good news? There’s plenty you can do to encourage baby to rotate — and it’s never too late to start.
Here are some biomechanics-based techniques used in late pregnancy and early labour:
✅ Daily Movements
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Sit forward on a birth ball
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Spend time on hands and knees
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Use stairs regularly – walking sideways up the stairs helps too
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Walk daily, even just 10–15 minutes
✅ Stretch and Balance
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Try a side-lying release (see The Birth Chapter for guidance)
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Use a rebozo scarf with a birth partner to loosen tight ligaments (also in The Birth Chapter)
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Gently stretch the hip flexors to lengthen shortened muscles
✅ Rest Smart
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Rest in left side-lying or supported forward-leaning positions
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Avoid reclining against pillows or sinking into the sofa
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Prop yourself forward using cushions or a peanut ball
✅ Use Specific Biomechanics Positions
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Incorporate focused techniques such as Side-Lying Release, Forward-Leaning Inversion, and Exaggerated Lateral to create space, release tension, and encourage baby’s rotation (also in The Birth Chapter)
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These movements work by balancing the pelvis and soft tissues, helping baby navigate into a more optimal position
💡 What If Baby Is Still Back-to-Back in Labour?
Don’t panic. Babies rotate during labour all the time. Labour may just be a bit longer or more intense as they work their way around.
In Labour, Try:
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Asymmetrical positions like lunging or one leg up on a stool
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Staying mobile – leaning, rocking, and walking as much as possible
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Upright, forward and open postures: kneeling, leaning over a bed, or using a birth ball
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Side-lying with support to take pressure off your back while resting
💡 On The Birth Chapter, there’s a downloadable position cheat sheet so you can quickly decide what position to use depending on what stage you’re at… super helpful for partners and birth teams too!
🧘♀️ Biomechanics Is About Creating Space
Remember: the goal isn’t to “turn the baby” it’s to create the space and balance your body needs so your baby can rotate if they need to. Your pelvis is designed to move, and your baby is designed to respond to that space.
When you understand how to move and rest in ways that support pelvic balance, you’re already giving your baby the best possible chance at finding their way through.
