Introduction
Asynclitism is a condition in which the baby's head is positioned at an angle, typically towards one of the shoulders. This can occur during labor and delivery and can result in longer labor or the need for medical assistance. The cause of asynclitism can be due to factors such as the shape of the uterus, a shorter umbilical cord, or if the mother is carrying multiple babies. However, it is important to note that it is not uncommon for babies to naturally shift into a better birthing position, and it is not related to anything the mother has done.
What Are the Types of Asynclitism?
Two types of asynclitism can occur during labor and delivery:
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In the case of posterior asynclitism, the baby's body is tilted towards the mother's back, with the baby's forehead or crown facing toward the mother's pubic bone.
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In the case of anterior asynclitism, the baby's body is tilted towards the mother's belly, with the baby's head facing toward the mother's spine.
Treatment for asynclitism differs depending on whether it is anterior or posterior. Anterior asynclitism requires lifting the baby out of the belly and into the mid-line of the mother's body. Techniques such as rebozo belly techniques, binding, and reclining in the tub can be effective. These babies are often born to mothers carrying multiple babies with rectus diastasis. On the other hand, posterior asynclitism requires dropping the baby out of the back and into the belly space. Techniques such as forward-leaning, belly-hanging exercises, and frequent disengaging from the pelvis can be effective. These babies are often born to first-time mothers.
How to Diagnose Asynclitism?
A healthcare professional can make the diagnosis of asynclitism during labor through a vaginal examination and an ultrasound. The diagnosis needs to be accurate and timely in order to ensure that there are no birthing complications and that the delivery team is prepared in case a medically assisted birth is necessary. The ideal position for a baby to pass through the birth canal is known as occiput anterior, in which the baby is facing the mother's back, and the head is down. Regularly checking the baby's birthing position in the weeks and days leading up to labor can help to identify any potential complications and ensure that the delivery team is prepared. A study conducted in 2021 found that asynclitism occurred in 15 percent of 92 pregnant women and is more common in first-time mothers.
What Are the Possible Complications of Asynclitism?
During labor, it is normal for a baby to be in an asynclitic position as they move around. However, if the asynclitism persists, it can slow down the delivery process. This is because the baby's head is not in the optimal position to pass through the birth canal. This can lead to longer labor and slower dilation and pushing stages. The mother may also experience one-sided hip pain and less consistent contractions. If gentle repositioning does not correct the asynclitism, cesarean delivery may be recommended to ensure the safety of the mother and baby. In rare cases, if the asynclitism persists for an extended period, the baby may develop complications such as torticollis, a condition where the baby's head points towards one shoulder and the chin towards the other. This is usually caused by muscle spasms or shortening of one of the neck muscles. However, torticollis can be treated and usually improves shortly after birth.
What Are the Treatment Options for Asynclitism?
If the doctor has medically cleared a patient, there are light exercises that a patient can do at home to help position their baby optimally for birth. These may include lunges, pelvic floor releases, squats, easy yoga positions, swimming, and walking. These activities can help to prepare a patient for labor and guide the baby into the right birthing position. Additionally, meditation and other calming activities can help mentally prepare for birth. Discussing a birthing plan with the partner and doctor well before the due date if your baby is in an asynclitic position is important. Other options, such as positioning massages, acupuncture, or visiting a chiropractor, can also be considered to assist with optimal baby positioning before birth. However, it is essential to check with the doctor before trying any of these or other home remedies for baby positioning in the womb.
During labor, the healthcare provider may recommend exercises and positions to help reposition the baby out of an asynclitic position. Some people choose to have an experienced midwife and doula present during the delivery to assist with this. Using a birthing ball during labor can also help promote the ideal position for the baby. It is important to have someone to assist the patient on and off the ball to avoid falling. Additionally, staying hydrated by drinking plenty of water or juice can help keep the contractions strong and energy high. If there is not much progress after several hours of pushing, the doctor may recommend an assisted delivery. However, cesarean delivery may be recommended if complications arise during labor and these methods are ineffective. Typically, a patient can try for a vaginal delivery and switch to a cesarean delivery if it is deemed the safest option for both the patient and the baby.
Conclusion:
In conclusion, asynclitism is a condition that can occur during labor and delivery in which the baby's head is positioned at an angle, typically towards one of the shoulders. The cause of asynclitism is not entirely clear, but it is believed to be related to the shape and size of the mother's pelvis, the position of the baby in the uterus, and the length of the umbilical cord. It is treated differently depending on whether it is anterior or posterior. Regularly checking the baby's birthing position in the weeks and days leading up to labor can help to identify any potential complications and ensure that the delivery team is prepared. It is important to note that cesarean delivery may be recommended in some cases to ensure the safety of the mother and baby.
