Manual Rotation:
Manual rotation is a simple procedure performed by many obstetricians and midwives. It involves an internal (vaginal) examination during the later stages of labour, when the woman's cervix is fully dilated. While the woman pushes, the examiner gently rotates the baby from the posterior position (facing towards the front of the mother's body) to the anterior position (facing towards the back of the mother's body). The purpose of the procedure is to reduce the chances of a caesarean section, forceps/vacuum delivery, or other complications of the posterior position.
However, there are no good quality studies to prove that manual rotation actually works. The purpose of the POP-OUT Trial is to demonstrate once and for all if manual rotation is of benefit to mothers or their babies.
Manual rotation is believed to be a safe procedure. We found only one case report of a prolapsed umbilical cord. Although this is a rare event, it is an emergency which is usually life-threatening to the baby unless an immediate caesarean section is performed.
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This image shows a baby in the posterior position.
The obstetrician or midwife places two fingers or a hand into the vagina and rotates the baby into the transverse position while the mother pushes.
The obstetrician continues to help the baby rotate into the anterior position and the mother continues to push.
The aim is for the baby to descend into the mother's pelvis as the baby turns.
The size of the baby's head that passes through the pelvis is smaller when the baby is in this position.