Belly Mapping Written by Gail Tully
A three-step process for identifying baby’s position in the final months of pregnancy. Parents can use Belly Mapping for their own enjoyment. Medical care givers can enhance their skills by using the visual clues of Belly Mapping. Doulas will be able to suggest strategies for fetal repositioning when a posterior lie is suspected.
Step One: Draw a pie.
Draw a circle with four parts, or pie pieces. Imagine you are drawing a map of your abdomen. The top is your fundus, or the top of your uterus at the end of pregnancy, about the 7th or 8th month.The bottom is where your pubic bone is. Your right side is on the left side of the paper map, and your left side is on the right. Just like looking in a mirror.
Make marks on the paper where you feel kicks and show where the big ones are and the little ones. Show where a big bulge pushes up occasionally. If you know, draw a heart where the doctor, nurse or midwife finds the baby's heart beat. Is one side of your belly a lot firmer than the other side when you lay down? Draw a line or write firm on that side.
With words or with pictures, the mother or doula marks each quadrant where she feels:
The biggest kicks,
Smallest kicks or wiggles,
The firm back, A big bulge, usually up top, or on one side or the other
If you know, circle where the head is, and
If you remember where the heartbeat was last heard, draws a heart there.
Leave out any parts you are unsure of, and just draw what you are sure of.
Step Two: Visualize the baby
Get a cloth doll or teddy bear.
Match the toy feet to the feet on your “map,” and so on.
Choose a doll or bear with bendable arms and legs.
To make Belly Mapping easier, keep in mind three opposites in the baby’s body:
Head and bottom
Tummy and back
Feet and hands.
These opposites show up in opposite sides of the “pie.” The bottom is always opposite of the head, up when the head is down. So, when head down, baby’s feet are at the top, hands might be felt in the bottom half. (Feet kick stronger than hands.) Limbs are opposite the back. Knees bend, but when the legs stretch, the feet bulge out like a ball. Baby can make a triangular shape when straightening the legs. The bulge where the feet poke out seems rounded. Be reassured, the baby does not have two heads!
Getting the parts clear in your mind gets easier with practice!
If a mother has been told her baby is head down, she holds her doll head-down with the doll's head near her own pubic bone.
A mother turns the doll so its feet are in the same “pie piece” that she feels the biggest kicks. A baby’s feet are on the belly side of the baby, so turn the doll’s back towards the other side of the “pie.”
If a bulging butt rises up, as it often does near the top of the womb, match the doll butt to that quadrant. This bulge can be confusing, are both bulges feet, or is one a head? If the baby is head down, it can’t be the head. Is baby breech? (The head will not have legs extending of it.)
Knees bend often changing where kicks are felt. A posterior baby’s knees may be the baby parts closest to the surface and can occasionally be felt close to the mother’s navel.
Opposite from the kicking feet is a firmness--the baby’s back. This is the quadrant where baby’s heartbeat is best heard at the clinic visit.
When completely posterior, neither side of the womb is particularly firm and filled in. Knees, feet and hands might be moving on both sides of the womb. Whenever hands are felt in the front, right above the pubic bone, the baby is facing forward.
Hands often feel like wiggles, or champagne bubbles might feel, if felt at all. In a head down baby, wiggles between the pubic bone and navel (not thumps on the pubic bone) are certainly hands. But in a breech, low wiggles can be a foot “tapping.” Other sensations in this area could be bladder pressure, forehead “grinding” in a face-forward baby, pubic bone shifting or, if deep, cervical ripening.
Now think of how a baby’s arms and feet move. They are always going to be more on the tummy side of the body and often near baby’s mouth.
If a mother can feel hands in front, baby is facing the front!
Step Three: Naming the Position
Sharing a common name for fetal positions helps us study and talk about birthing together. Three questions in this very specific order give us the position name:
1. Which side of the mother is the baby’s back on?
2. Which part of the baby is coming into the pelvis first?
3. Which side, front or back of the mother is that baby part along?
In this specific order, a one word answer tells us:
1. Mother’s side
2. Baby’s part
3. Mother’s side, front or back
The first answer, for instance, can be “Left” or “Right,” (“L” or “R.”)
The second answer tells which of the baby’s body parts is coming first that has importance in the birth process. The most common part will be Occiput. The occiput is the bone shaping the back of the skull. Another landmark is the sacrum, which is the triangular shaped bones making up the base of the spine. “S” is used for a breech (bottom first) even if the feet come before the sacrum. The chin (“M for mentum) is used for face-first, and “Fr,” Frontum (brow), is for forehead-first babies, rare but adventurous variations.
The third and last letter is for the mother's front, back or hip. The words, anterior (towards the front of the body); posterior (towards the back of the body); or transverse (to the side or sideways) are used. If question one and question three have the same answer, we just use number three.
Talking the talk: A Left Occipital Transverse baby has her 1.) Back leaning into mother’s left; 2.) Head down and 3.) She's facing mother’s hip and kicking mother’s upper right abdomen. We say she is LOT. (When the words “transverse” and “lie” are used together, the baby is lying sideways in the womb.) When a baby’s back is up front we say “OA” rather than “AOA,” OK?
Copied with permission from Gail Tully.