Asynclitic

asynclitic (ă-sin-klit-ik) adj. a tilt of the fetal skull towards one or other shoulder causing the top of the skull to be either nearer to the sacrum or nearer to the pubis.1

In other words, a tilt of the baby's head, during labor, to the right or left of the midline. Like a dog, trying to figure you out. This is my view of the world. As in, "let's get a new angle on this".

Since I've started this blog with the definition of asynclitism, let's expound on it. Kim James, a doula, has made an excellent summary of epidural risks with links to research, or for a direct peek at research, read this.  My kudos to those practitioners and researchers who actually admit  that epidurals can increase the risk of poor positioning in labor.  Lord knows few at my hospital would admit that, but then, our epidural rate is about 80+%. Why? Well that's a rant for another day.




Malpresentation is my pet peeve. A baby with a bad "attitude". Babies are supposed to, and designed to, come out with the crown of the head first, the part of the skull where the hair swirls. In the "old-old days" (you'll see me talk about this now and then... I'm not that old, but old enough to have a perspective on things) women did not have as much leisure time as we do now. We were out milking (squatting on a low stool), or hoeing (forward-leaning), picking vegetables or scrubbing our floors (on our hands and knees). These postures promoted good fetal positions for birth.

The best fetal position, is one where the baby's back is at the outside of the mother's body. This is called an OA position, for occiput anterior. The occiput is the back of the baby's head, and we want it close to the front of the mother's body, like in this picture at left.

The worst of the head-down fetal postions, is when the baby's back is at the mother's back, or OP; occiput posterior, like in the picture to the right.

OA Good!
OP Bad!

It doesn't matter whether the back is on the left or right side of the mother's body, as long as it is near the front.

Now, regardless of which way your baby is facing, s/he may try to come down with the head tilted, or asynclitic. While new points of view are always welcome in this world, they are not welcome before this world, so greet the world with your head on straight, my wee ones! Anterior and asynclitic, this baby will still very likely deliver. Posterior and asynclitic, and the mother has a much greater chance of having a cesarean section. Boo!

Now, I am not going to re-invent the wheel. Spinning Babies has done a great job of presenting New Zealand midwife Jean Sutton's Optimal Fetal Positioning (or check this out) to the public. Go to that site, or use Optimal Fetal Positioning as a search term and find another worthy site, and they will give you the whole scoop on getting your baby into a good position for birth.

The problem is, you ask, "How do I know what position my baby is in?" Well, here is my plug for midwifery: Most OBs and family docs do not fuss over the baby's position before, or during labor. They only fuss about it after they manage to get the baby stuck (by not fussing about it beforehand), when it looks like only a forceps delivery or a cesarean section will get the baby out. But your midwife will tell you at each visit in late pregnancy what position your baby is in, and if it's not optimal, she will give you some exercises to fix it.

Babies are made to be the right size for their mothers. But they don't fit if we let them get into awkward positions. Stay tuned for a blurb on why.



1. paraphrased from "asynclitism." A Dictionary of Nursing. 2008. Retrieved November 28, 2011 from Encyclopedia.com: http://www.encyclopedia.com/doc/1O62-asynclitism.html