Series: Brilliant Activities for Birth Educators - Putting the "Tee" in Teaching Fetal Positions

Today, in our monthly series, “Brilliant Activities for Birth Educators,” regular contributor and LCCE Andrea Lythgoe shares a fantastic, interactive idea for helping families to better understand the different positions their baby can be in and the abbreviations used to refer to these positions.  If you have a great Brilliant Activities for Birth Educators idea that you would like to share with Science & Sensibility readers, please contact me and I will be in touch with you. – Sharon Muza, Community Manager, Science & Sensibility

Why I made it

With the increasing popularity of websites discussing good positioning for the baby late in pregnancy and during labor, I found that I started fielding a fairly large number of questions in my classes like “What does it mean if my baby is ROA?” or “My sister said she hopes my baby isn’t OP. What’s that?” I also noticed more care providers talking about positioning when I would attend births as a doula, and quite often I had to interpret those conversations for my clients.

TeachingTeeWithBabyOne day such a question came up in class, and in order to best answer it, I grabbed a stack of nearby sticky notes, wrote letters on them, and stuck them on my body. It worked! I could see people grasping the concept. I did it a time or two more and then began to make it a regular part of my class.

But the sticky notes had their own problems. Sometimes, they wouldn’t stick well to whatever I was wearing that day. Sometimes they stuck too well and there was that incident where I stopped at the grocery store on the way home, not realizing I still had several sticky notes all over my body, until someone pointed it out. I started thinking about other options.

How I made it

I bought an oversized cotton T-shirt that is large enough to wear over my regular clothing. I found iron-on letters at a craft store and just followed the package directions to place the letters like this:

“A” on the front of the shirt, a few inches above the hem.

“P” on the back of the shirt, a few inches above the hem

“T” on either side of the shirt, a few inches above the hem and just in front of the side seam

“R” on the right side, near the T

“L” on the left side, near the T

How I use it

I use this in the fourth night of my seven week series, just before we discuss posterior babies and the variations that position can cause during the labor process. It might also work in a discussion of the basic physiology of birth, or any time the question comes up from your students.

© Andrea Lythgoe

© Andrea Lythgoe

To prepare, I generally put the shirt on over my regular clothes before class or after the break. I also put a label on the back of the baby’s head, using masking tape and a sharpie.

First, I show the baby and point out the “O for Occipital bone” on the baby’s head. I discuss how this spot is used as a marker to identify the baby’s position, and refers to how the baby’s occiput is positioned in relation to the mother’s body.

Then I point out the letters on the shirt, explaining what each one means. I take a minute to clarify the difference between a transverse LIE and the occipital bone pointing to transverse, reminding them if they are ever confused which transverse it is, they should ask for clarification from their doctor or midwife.

I then show them the most common positions for baby to be in when labor begins and review the normal motions baby does to move through the pelvis.

I write three spaces on the board (as if we are playing hangman) and tell the class that when health care providers talk about the baby’s position as the baby moves through the pelvis, they typically use two or three letters.

The middle one is almost always “O” with a head down baby, so I fill in the middle slot with the O.

I then tell them that the last one is where the baby’s occiput (or “O”)  is relative to the pelvis. I hold the baby in an OA position and ask them which letter from my shirt would explain where the O is pointed. They easily get it and I write the A in the last space.

Then I shift the baby slightly to my left and add the modifier L to the front.

Draw another set of three blank spaces, and move the baby to LOT, and repeat the process much faster. By this point, there is usually someone in the room who is eager to fill in the blanks.

Ask for a volunteer to come up – anyone can do this. I hand the baby to the volunteer and ask them to show me the OA position on themselves. Then I ask them to show me another position, maybe ROA. If the volunteer has caught on and has the right personality for it, I’ll give them other positions to do rapid fire until they laugh.

© Andrea Lythgoe

© Andrea Lythgoe

I always end with the volunteer showing the OP position. I then transition into talking about OP babies and how some babies will spend part of labor rotating around to a position that facilitates moving down through the pelvis easier, and the discussion continues. At some point in that discussion, I turn around and hold the O on the baby’s head next to the P on the shirt, so it reads OP and reinforces visually what that means.

How Parents Receive It

Most of the time, the families start grasping the concept as I write the letters on the board in the first example, and by the time I have a parent volunteer up at the front they are all on board chiming in with answers. My favorite is when we do the rapid fire positions, and everyone is verbally helping the partner like something out of “The Price is Right.” It doesn’t always get there, but I love it when it does.

I find that as we move on to our next topics, that the parents will use the letter abbreviations to ask questions and clarify their understanding. I’m confident that they will be able to remember and understand the terms through their third trimester and into labor and have more clarity when their provider mentions the baby’s position.

Do you think that you might use this “BABE” idea in your classroom?  How would you use it?  Would you make any modifications?  How do you teach this topic in your classes? Share your thoughts in our comments section. – SM

Note/Disclaimer: The use of the acronym “BABE” (Brilliant Activities for Birth Educators) is not affiliated with, aligned with or associated with any particular childbirth program or organization.
7 Comments
1 Like

WOW....brilliant idea. Permiss

February 13, 2015 07:00 AM by Mindy A. Cockeram, LCCE
WOW....brilliant idea. Permission to steal? I'm attending a fetal positioning workshop in two weeks and I think I'll bring the T-Shirt along and show everybody. GREAT STUFF!!

Andrea - what an awesome way t

February 13, 2015 07:00 AM by Teri Shilling, MS, LCCE, CD, IBCLC
Andrea - what an awesome way to make something that can go in one ear and out the other, very tangible and memorable!

Mindy, please feel free to use

February 14, 2015 07:00 AM by Sharon Muza, BS, LCCE, FACCE, CD(DONA), BDT(DONA), CLE
Mindy, please feel free to use or modify! That is the purpose of the BABE series! Certainly, give credit to the creative Andrea Lythgoe and share with others! Thanks for asking.

@Mindy Cockeram Hi Mindy enjoy

February 15, 2015 07:00 AM by Susan Marie Bemis, MS, RPT, LCCE, FACCE,GCS,DPT
@Mindy Cockeram Hi Mindy enjoyed your post - am very much interested in this baby class that you are going to what will it be about exactly, where will it be held and what is the price?? I am very interested in this as I teach Lamaze classes, am in a quan

This is such a wonderful idea

February 28, 2015 07:00 AM by Jennifer Perry, LCCE
This is such a wonderful idea to help parents more easily learn and understand positioning. Thank you for sharing! It reminds me of when I read about belly mapping on Spinning Babies (a very neat try-at-home activity that I had even tried out when I was pregnant).

What a great idea. I could hav

March 8, 2015 07:00 AM by Becky Knight
What a great idea. I could have used this in nursing school! :) I think actually being able to see the different positions on a real body is very helpful.

permission to make tshirts for peers

April 9, 2017 06:23 AM by Tina

What a brilliant idea. I would like to make a few tshirts and sell them at cost to my peers. I am very happy to give credit of course!

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