North American Registry of Midwives (NARM) Practice Exam

Which of the following indicates the best fetal positioning for labor?

1. Occipito-anterior position

2. Occipito-posterior position

3. Transverse position

4. Breech position

The correct answer is: Occipito-anterior position

The occipito-anterior position is considered the best fetal positioning for labor because it facilitates an optimal alignment of the fetus with the birth canal. In this position, the back of the baby's head (the occiput) is facing the mother's abdomen. This orientation allows the baby's head to engage in the pelvis in a way that promotes smoother progression through the stages of labor. It helps in the flexion of the head and can reduce the risk of complications during delivery, such as prolonged labor or the need for assisted delivery methods. In contrast, the occipito-posterior position, where the back of the baby's head is facing the mother's back, is less favorable as it can lead to a longer and more difficult labor. Additionally, the transverse position, where the baby lies sideways in the uterus, is not conducive to vaginal delivery without significant maneuvering and is often associated with increased risks. The breech position, where the baby is positioned feet or buttocks first, can lead to various complications and often necessitates cesarean delivery. Therefore, understanding fetal positioning is crucial for midwives in providing optimal care during labor and delivery.