Allegheny Health Network’s Women’s Institute Puts a New Spin on Labor & Delivery

Tuesday, August 13, 2024

Press Releases Forbes Hospital Women and Infants Center

AHN Forbes Labor & Delivery Team Completes Spinning Babies™ Workshop, Incorporates Learnings into Innovative Program for Patients in Active Labor with Breech or Traverse Fetal Presentations

Interview Soundbites & B-Roll Available for Download: https://f.io/OSR7y706

Monroeville, Pa. - Allegheny Health Network (AHN) Women's Institute and AHN Forbes Hospital today announced the launch of "AHN Purposeful Positioning," a new initiative that uses intentional positioning of patients in labor to help facilitate the movement of the baby through the birth canal, aiming to ease delivery and possibly minimize the need for cesarian section procedures.

The program was largely informed by Spinning Babies™, a birth physiology education and training system founded by certified midwife Gail Tully in 1998.

The AHN Forbes labor & delivery (L&D) team completed a Spinning Babies workshop in April and combined these learnings with a curriculum developed by the network's leading pelvic floor therapy and obstetrics-gynecology teams to create Purposeful Positioning.

Babies move during pregnancy, but before labor starts, they usually come to rest in a way that allows them to be delivered through the birth canal head down and face down. Sometimes, though, the baby can be positioned differently prior to and during labor, making labor and delivery more complicated and time-consuming, and sometimes leading to a c-section.

The Purposeful Positioning program is a standardized set of movements and positions that aim to reposition babies during active labor in a way to better facilitate their transit through the birth canal. Through these repositioning techniques, the baby is encouraged to rotate into an anterior presentation, the ideal position for birth. Occiput anterior position is when baby is headfirst, facing the mother's back, with chin tucked to minimize space occupied for delivery.

These movements are designed to create more balance in the pelvic and abdominal areas, allowing the muscles in those areas to relax and ultimately increase room for the baby to rotate into a better position for delivery. L&D physicians, APPs and nurses coach patients in labor to expand their pelvic area and coax the baby into an anterior position within the pelvis.

"To date, this program has not only realized incredible patient success stories but it has also fostered a renewed sense of confidence among our clinicians who now have another tool in their toolbelt to help mom and baby at such a critical time," said Katie Peticca, MD, OB/GYN at AHN Forbes Hospital. "Previously, if labor had stalled and a baby was determined to be in an occiput posterior position, our only other option, other than waiting, was to manually rotate baby's head to the best of our ability. If this was unsuccessful, we might have to move to a c-section which, while necessary for some patients, is less ideal. Now we have another technique to employ to help our patients in labor."

In the U.S., the c-section rate continues to rise, for a variety of reasons, and in 2023 c-sections accounted for 32.4% of all births. The rate of low-risk cesarean deliveries (first birth, full-term babies) increased from 26.3% in 2022 to 26.6% in 2023, the highest rate since 2013, according to the U.S. CDC.

A study published in The Lancet (DOI: 10.1016/S0140-6736(18)31930-5) suggested that there can be significant short- and long-term health effects for women and children following a cesarean section. Recovery following a c-section is also known to be more intensive when compared to a vaginal birth.

A separate paper, published in 2023, suggested that first-time moms who utilized Spinning Babies positioning techniques were more likely to deliver vaginally (84%) than women who didn't utilize those repositioning interventions (77%).

"When I was in labor, we quickly understood that my son wasn't in the right position for a vaginal delivery, but I was willing to try whatever my nurses and doctors suggested before making the decision to proceed with a c-section," said Rachel Balog of Murrysville, AHN Forbes L&D patient. "My AHN nurse helped to position me laying down with my left leg across my body, on a table placed to the right of my hospital bed. Almost immediately, I felt my son reposition himself - he felt like a corkscrew working his way down the birth canal. I pushed for about five minutes immediately afterward and my beautiful baby Brooks was born. I'm now just a few months postpartum and feel great."

AHN's Purposeful Positioning program is specifically designed for obstetrical patients in active labor. However, AHN Women's Institute, alongside the AHN Pelvic Floor Therapy team, hopes to extend its curriculum for patients as early as 32 weeks by creating a set of movements and exercises which patients can do at home that can help place baby in an ideal fetal position for birth.

"We are so grateful to have had education and training in the Spinning Babies techniques," said Dr. Peticca. "We're thrilled to take this holistic physiology approach to labor and delivery and combine it with our advanced clinical expertise to give women an even greater chance for a vaginal birth with less pushing time and less exhaustion. Since our official introduction of Purposeful Positioning, we've seen great success and expect that to continue."

To make an appointment with East Suburban OB/GYN Associates or learn more about the Purposeful Positioning program, please call 412-856-7500.

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