North American Registry of Midwives (NARM) Practice Exam

If the fetal back is noted on the maternal left and the sagittal suture is in the oblique diameter, what is the fetus’s position?

1. ROA

2. LOA

3. RPA

4. OP

The correct answer is: LOA

In the context of fetal positioning during labor, when the fetal back is on the maternal left side and the sagittal suture is positioned in the oblique diameter, this indicates a specific fetal orientation. The fetal position is typically described using a three-part abbreviation: the first letter indicates the side of the mother (Right or Left), the second letter denotes the part of the fetus that is presenting (Occiput, Sacrum, etc.), and the third letter shows whether the position is anterior or posterior relative to the mother’s pubic symphysis. Given that the fetal back is on the maternal left side, this suggests that the fetus lies with the left side toward the mother's left side. In this case, the occiput of the fetus (the back of the head) is oriented toward the pubic symphysis, which is considered an anterior position. Therefore, with the back on the left and the occiput anterior, the position of the fetus is correctly identified as Left Occipito Anterior (LOA). Understanding this fetal positioning is crucial for midwives and healthcare providers as it impacts the dynamics of labor and delivery. LOA is typically one of the most favorable positions for vaginal delivery, associated with an efficient