3á

ú-
3-
Look through this transparency to either page on this spread ú"
The transparency on this side indicates exceptions to the "rule." A baby on one mother's right may be
ú'
flexed, and a baby on another mother's left may be extended. Hands are felt only a few times a day ú
while you lay down. Heart shows loudest sounds. Read both pages for accvracy and expect variations. ú
é
"fught obliquiry"
OP
A posterior babv e'
makes the right can tuck her chin úé
Kiik cr when pelvis is
side of the uterus
steeper and so
cvlineler
l ample and the
e;
flexion on the
l
l
I

Sural| bunp
pelvic floor is ú;
right side is f exible lú'
slldcs hv naveL
less common.
iÇ é
iggle ;Wigg LOP 3
Kick lBLrige e
q
§-qri!]1,b!1qp- 3
slidrs by iravel
é
:

lViggle ivjggle 5
é
ó'
c'
3'
\Áiig-cle..just a 3é
on right 3'
3:
§
ts-: c\liltiüer 3
ry
Small blrnp by 1av,:I
3
3-

3_

3
Remember, ü
most posterior 3
babies rotate during
baby can have an
extended chin, delayinq 3
labor. Some easily and 'When baby is still in
some with a lot of work, a transverse lie after 30 engagement and sometimes. 3
even interventions. Some weeks several 3O-second the start of labor.
é'
babies won't need to rotate at forward-leaning inversions Note: a tipped head, calied
all to be born. Those that turn within 48 hours may baby asynclitic, can happen with anv 3'
halfway at the middle and stop- get head down (page 32). This fetal position. "The Lunge" may be ô'
may need the "the lunge." makes room for baby's head. successful to make room for descent.
c'
24 6_=
{€
'=4.11q,
*@
reSffiÇs
,
e
?
'e Fetal Compass Rose with firm, solid areas, kicks and wiggles
"a Placing the transparency on this side shows eight common head-down positions, plus a baby in a
rrarsverse lie (bottom). For hands and feet note the quadrant, not the exact spot. See if you can Ênd
rhe right Belly Map for your baby by matching the bulges, kicks and wiggles to the four quadrants.

e
â
â
, OA

,
,
e

tl
LOA

({te §em{
Comyass *,.ose
, zoa<
t
§y çai{t'u{\,

,
a
,
t
a
1' RO-{ LOP

4 l1- CP
Sabr's tbre-
Flexion,
or chin
4a
realj mar tucking
4 ?ut Pressure makes LOP
4' on morher's pubic
'bone
the easiest

4 at. or after, 38
ri'eek gesrarion lvhen try- Transverse Lie
Postertor to rotate.

e ing ro engage in the brim.
? In rhe posrerior fetal
? posirions, rhe burrocks.
? or buige, may be hard to
? locate as it is often deep
inside by mother's spine.
?
e 25
*
Before 26-28 weeks, lying side- The Anteriors are called
"optimal" fetal positions
wâys or at a diagonal is common.
Some babies then turn breech for a perhaps because most come
short time before finally settling head from the mother's left,
down by 30-32 weeks for birth. helping chin tucking. Chin
tucking aims a smaller part of
the head into the pelvis first.
 ao
a'
t
Wendy's Belly a'
É
Mapping É
É
§7endy and Nick are expecting their first baby. They
have a good relationship with their obstetrician and
ç
have discussed their goals for a natural birtb with É
the support of a doula. j'
a'
É"
í'
É
í
É
E
€
É
É
Wendys belly is ripening
Ê
at 38 weeks. Here's where 3',
she feels the strongest j;
kicks. j;
2. \Wendy draws her map. jo
A solid bulge is in her top
left, and kicks are on her
3;
right. The head is dou.n. 3
She draws a heart on her E
left, where she remembers E
her doctor hearing the g
heartbeat.
É
). Her Belly Map as a guide.
the pads of my fingers Ê
verifi, the contours of g
\üendys baby. Starting at
C
the bumocks, a sweeping
C
line indicates the back.
I check the width of the C
head and find it hard to c)
draw a three-dimensional Q*
baby in rwo dimensions on
Qz
paper.
ct
26 3;
1'
a

W'endy could have used a doll to visualize her

baby in Step 2, but she asked me to help draw
her baby on her belly.

,
?
i,
a
7
a

I
a
il
I
I
!
I

Vendy doesnt know if this little one is a girl or

â a boy. But we easily see her baby is left occiput
t transverse (LOT), the best startit gposition for
a a straightforward birth. The LOT baby fits easily
into the pelvic brim to start, and best descends
a
and rotates into an occiput anterior (OA) position
t by the end of labor.
t
t 27
,
 e
F
é

et's Breech Betl Ma F

F
You can use Belly Mapping for your breech baby, too. \Vhen you're lying down and relaxed, use your 3)
finger pads to feel your baby. Bridget shows us how it works. G'
The bulge on top is the first exploration' How can you
tr
é
tell it's the buttocks and not the head? Feel for a thigh.
The head will not have legs extending from it. A thigh ê
will not have a little shoulder lump. The head at the ê
top will sometimes nod freely without moving the ê
trunk. The butt at the top moves only with the trunk.
é
Note that the head and the buttocks may stay in their
set locations or move along short curves. For example, the head may
c,
sometimes be right at the center top and other times be nearer a rib. ?
é
e
Feel your belly to discover
which side the babyt back e 2

favors, if itt not completely G

forward or hiding in the back.
CJ
On your map, mark if it's in
front, on the right, on the left, é
or if you cant find it. G
G
G
G
Now check for the buttocks. They may be deep inside,
sitting on top of the pubic bone or even higher'
G
3z
3"
C"
Can you feel cylinders
near your pubic bone?
3
Can you feel little feet? If 3
not, it may be because of
how the baby is turned.
e
é
For instance, baby's back
may be in your front and his or her legs and feet are out of reach
e
toward your back. Or it may be because the baby is a frank breech CÊ
(see page 29) and the legs are straight up. Legs will be on the same 3=
side as the little bumps (hands) at the top of your womb. C;
C;
Check our page 29 for more details about Belly Mapping a breech baby. Then see if you can match G
your Belly Map with the descriptions of the various breech positions on Pages 30-31.
*,
28 C;
t;
Bell Ma a Breech Bab
Most babies will settle head down by 30 weeks . By 32 weeks,
15 percent of babies are breech. Only 3 or 4 percent of babies
remain breech near their due dates (40 weeks).
Wirhphysiologicalmetbods of birth, most breech babies
can be born safely and with no more difficulry for the mother
ihan a head-down birth. However, mâny physicians or mid-
wives still recommend a cesarenn section, or surgical birth
(see page 39). For this reason, many pregnant women are
eeger to hear their babies are head down.
Belly Mapping works the same way for breech babies as
for head-down babies. Begin by feeling your belly so you cân
chart buiges and kicks, just as Bridget does on page29.
Next, use a doll or belly drawing to help you visualize your
babyt position. If you assumed your baby was head down,
this step will help make sense of the movements that may have
confi.xed you. Bridget shows her baby's position using a doll
and adds a winte r hat to show the location of her anterior
placenta. t^tly, turn to the Breech Compass Rose on page
30 and Ênd a drawing that best matches your Belly Map.

The Breech Presentations

l-our breech baby may be in one of these basic presentations. Less typical presentations include
one leg up and one down. Or a baby may aim both knees, as if entering the pelvis on a prayer.

Frank: In the frank, or incomplete, breech, the baby's legs are straight up along his or
her trunk. The baby's hips are born first. In a full-term baby, the hips and the head are
rhe same diameter, so if the hips fit, the head will fit, too. \flith a full-term frank-breech
baby, you may not be able to distinguish the legs from the trunk because they are close
to his or her body. You 1l feel only hands on top, which means the "biggest kicks" will be
hand movements, and not kicks at all.
Comptete: In a complete breech, the baby is positioned with the legs folded and feet to
the center-something like a yogi sitting with knees bent. You feel the legs as cylinders,
and úe feet wiggle near your bladder and pubic bone. Sometimes you may feel a knee
poke out like a bump that slides. You may feel the cylinders of the shins crossed above
your pubic bone. There is lots of movement near your pubic bone, and somewhat less
near your cervix.
Footling: The footling breech comes with one or both feet first. If the chin is tucked,
the head may still come readily during full-term physiological birth. A full-term footling
breech will have vertical cylinders behind the pubic bone, and the bum may be as high
as your navel. You may feel the feet "walking" on your bladder or cervix. Footlings can
have their legs in two styles: one up and one down, or both bent at the knees.

29
 r
r
5
The Breech Compass Rose 6
The ideal starting positions are right sacrum anterior (RSA), right sacrum rransverse (RST), and even É
right sacrum posterior (RSP). \7hen physiological vaginal breech birth is protected (the baby is not 3
touched or startled), a baby in one of these positions may move to allow the hips ro rorare until the 3
babyt back is coming down from the left side, which protects flexion of the head.
ç
Ê
t'
t'
3'
ú'
É
É
(
É
Í
g
É
É
3;
3-
3;
ç-
j;
Í'
tú
g
5
g
é-
C
3
3
C
c=
3=
3=
31
30
G,
2..
 The Basic Breech Positions
As you view these drawings, remember that babies bend and straighten their arms and legs often. you
may feel feet to the side at the level ofyour navel (frank); at your pubic bone (complete); or on your
cervix (footling). The breech head may move in an arc, so you may find it under yãur right ribs and
then under your left limb. fu always, note that the left side of your belly is the right side of the drawing.

SP: Babyt back is hard to locate. Babyt head may bulge in the top center. You'll feel babyt
hands and feet all over your front. You'll feel knees, feet, hands, aná elbows moving, making
you wonder how many are in rherel

RSP: Babyt back is hard to locate, but you'll find it on your right side. Babyt head bulges in your
upper right or toP. You'll feel hands and feet all over your front, but more ro the left. you'll feei the
hips aiming a bit left of center. Your provider will hear babyt heart on your right, usually at or above
your navel.
RST: Babyt ârm back is on your right. The womb is softer on your left. Baby's head bulges in your
/,§
í rHg,q iflT,:Í.'*::ff;[?,H:,::lç;;:t*,]:,H:]:H'il:;:#:[:j'3};";T':,.:::jlÍ|i::il:
labor. The chin mav be extended. Your provider will hear babyt heart on your
,3}:.tmÍ.lring
§/
,GN-iI^'iH'L?i:i,:li:*,Í:T],'jl;J,t1+i:':fi Íffi ::'l-t.r[i'i::#:,ffi :t:
starts with a normal progress parrern. Midpelvis diameters can affect
( :il.*::'often
{, &)
YY ,z-â.
*t
. iâ:ifr,:tllffitm;i:::ff.i á:ã .::ffil:i#l.. (d- )
hears babv's heartbeat in a wide area in the rÃnt-
.,fil; L:TIJ:J'f:::.-t', \_/
LSA: naby's back is on your front left. Arms wiggle on top and a little on the righr.
,^.
Baby's head presses up in your top left and occasionally in the center. Babyt bottoà i,
low. Your provider can easily hear the heartbeat left and cente! ât or above your navel.

LST: Baby's back is on your left side and may swing forward temporarily. Babyt head is
in your upper left. The arms are clearly in your upper right and sometime, go the top
to úe head. The legs and feet may kick or wiggle in your middle or lower right;"..or.
in a footling,
you'll feel them on your cervix. The lower half of your belly is quiet with f.r.k breech. BaÚy's
bum may feel low, making pressure rwinges on your cervix and upper thigh. "
The bum engages
by the due date with first-time moms and often with experienced mo-r. yo.r, p.orid., .Iríy
hears the heartbeat left and center.

LSP: Babyt back is on your left, but not close ro the surface, so you may feel some softness
where you expect the back. Babyt head bulges in the upper left. Hands and feet move
all over your front, but favor your right. Babyt bottom may dip into the pelvic brim
in engagement before the due date. You may feel cervical pressure, whether it's
continuous or in thumps. Yolrr provider hears babyt heart on the far left, usually at
or above your navel.

3'1
 ú-'
3

(
Activities for flipping a breech or transverse lie
Begin balance activities early in pregnancy to increase the likelihood of your baby being head down.
n.[in specific breech flipping r.ii,riii.r at 30 or 32 weeks for non-head down babies. Make body
b"ürr.irg a daily priorityl CÀntinue regular balance activities to keep baby head down and ease birth.
é
e'
Ask a helper to support your shoulders €
the first few times you invert' Bridget c;
finds a high, firm surface to kneel on.
ú;
Coming down carefully (inset), she
props herself on her forearms and elbows. c;
She lets her head hangs freely, neck loose, 3)
without resting it on the floor. The inverted 3'
rvomb stretches several uterine ligaments. j'
Âfterwards, Bridget pushes up on her hands, I

straightens her arms ,and pushes back up,

srvinging up, to kneeling. She remains sitting 3-
on her heels a moment before repositioning. 3
Womb and pelvis begin to align by the bal-
é
ance of ligaments. Do "Forward Leaning" for a minute and then do one of the next two inversions.
(\X/ith, ú"d down baby, hold the pose only 30 seconds daily.) More details at SpinningBabies.com ú"
ú';
The Breech Titt ú;
if you have a risk of stroke, high blood
The traditional Breech Tilt helps the breech baby
pressure, non-labor bleeding, or
3'
settle his weight upon his head to cause the chin
to tuck (below). Chin tucking is necessary to flip
heartburn. Consult your provider before 3;
head down. This longer inversion also brings ba-
beginning. Subsíúuúe úhese with a yoga e'
by's bottom out of the pelvis (disengages the hips). 1ú'
Use a firm surface, like an ironing board. Bridget I
tucks her feet into the crack in her couch for stability. A pillow supports her shoulders and Pr.i'-.':s
E
her head from being extended. Her chin is better tucked. Repeat 3 times a day for 15-20 minui'.
1
É
É
E
t
é
3
é
é
c
c
c
Open-Knee Chest -
Open Knee Cfiest
for
The Open-Knee Chest has also been proven to help more 'l{,{fryg isreecí' ra6y
,fliy head down
breechlings fip. Legs are only hip width apart oÍ open enough
to let your belly fit easily. Your knees are far from your belly
--not straight under your hips. Its a tricky way to invert!

M*y mothers say to do handstands in a swimming pooll

iriyofascial Releases
Muscle and fascia hold balance the best when released of chronic twists or resistance. Two myofascial
techniques, introduced here, help release tension in the membrane covering the pelvic bones and pel-
vic floor muscles. A helper applies the lightest possible pressure, the weight of a coin. (Can you feel
a coin pressing on your palm?) You and your helper will soften your knees to allow you to move in
reponse to the unwinding of the fascia. Unwind 15 minutes or longer with one or both releases daily.
The diaphragmatic release (abdominal release) is classic. Lie down, head, shoulders and knees
propped up with pillows. Your helper sits beside
you. Dr. Carol Phillips, DC shows us here, how
her top hand rests so lightly that she holds up the
weight of her arm. Her touch is light as a coin.
Her bottom hand is palm up, relaxed and passive.
Breathe deep and slow. Let your belly rise and fall.

The Standing
Release begins
at the wall with
Bridget's feet hip
width apart and pelvis outward. Her knees âre not
locked. Bridget soon feels the desire to move her
body freely as if releasing wrinkles about the hip,
leg or shoulder. I follow her (photo, left) without
moving her. Video guidance is at SpinningBabies.
com/Techniques.

Professional support for flipping the breech

A Chiropractor uses the \WebsterManuever to align the pelvi
and release tension in the round ligaments (see thumbs at
round ligaments on \7endy's illustrated abdomen, from page
27). Studies show "the \(/ebster" has a higher success rate in
allowing a breech baby to turn on their own than "waiting-
to-see" if they flip. Moxibustion, acupuncture, and hypnosis
aiso have statistically valid success. A manual external cephali
version by a doctor flips baby more or less half of the time.

33
 tr
e
e
Belly Mapping Twins tr
tr_
There are mâny more bumps and wiggles when Belly Mapping rwins rather than a singleton, and 3:
accuÍacy may be more difficult when figuring out the body parts of two closely snuggled babies. 3:
So, Belly Mapping twins might just require ultrasonic sensitivity in your hands-or an ultrasound
machine. Happily, there is still much benefit between par-
s',
É
ent and babies. An evening Belly Mapping session increases
awareness of your babies' play and nap times. e
As with Mapping
a singleton, an added benefit of Belly e
twins is knowing how your babies' positions may affect labor
e
and birth. It could possibly make a difference in your op-
tions with providers. Many providers wont participate in a e
vaginal min birth if Baby A (the first twin in the pelvis) is G
breech, and some wont if either twin is breech (see page 39 3i
for more about breech birth).
?, I
rÊtI
Debbie's Twin Belly Mapping
31
Debbie planned a homebirth with her twin girls. Debbie's midwife wanted to be sure someoÍre ex-
perienced with breech homebirth wâs present if Baby B were breech. She invited me to come during
3)
3
the last month. Debbie wanted few or no ulffasounds, so we all tried to figure out if Baby B (the sec-
ond rwin to come into the pelvis) was breech or head down. To help picture what I felt, I drew two e
picrures, alternating the bulges. Baby À like the majority of first twins, had been head down since G
32 weeks. As it turned out, Baby B taas breech. Debbie birthed her daughters at home near her due
date. On page 35, see Debbie and her husband holding the twins an hour úer birth, plus a photo of
G
the girls later that day. é
é
What to Feel When Belly Mapping Twins e
First, find the biggest bulges. Check them all until you find one lead- é
ing to a firm back. \Work your fingers over that bulge and along the firm 3;
back. Then return to the same bulge and feel the other end-do you
feel a cylinder there? A cylinder leading out from alarge bulge is likely a
G
úigh, and the bulge is likely the hip or buttocks.
3-
Even with these few hints, position a doll over your belly to match ?
bulge, back, and cylinder, as described in Step 2 (see page 19). Place G
the dollt head on the opposite side of your belly as the buttocks. Adjust e
details as the babies reveal more of üemselves.
Notice if strong kicks arc away from the cylinder you suspect is a leg'
?
There may be a gap of "space" between the cylinder and where you feel C"
the kicks. Or there may be a small bump between the cylinder and any C;
small parts away from it, a much smaller bump, and a bulge more mobile than the buttocks. Now (é
itt up to you to determine if this is a knee or an elbow. The difference will be whether the bulge is a
head or a "tail."
e
-Vorking your fingers the opposite way along the back, you may feel a lump or bump at the end. G
G
34 G
(é
 This is likely a shoulder. Itt not that
common to feel the upper arm com-
ing from it, but it's certainly possible.
You ll often feel space around the
shoulder or little mobile bumps-
a hand. Feel deeply about an inch
away from that shoulder lump; you
may feel a gap and then the large,
round head. If this baby is head
down, the head will probably be
deep, unless the other twin props the
sibling up to the surface.
Is anything presenting at the
brim? Reach deeply to find a head-
or rail. Only if the twins are spooning or facing will you feel both buttocks and backs equally.
As with Step 2, use dolls to visualize and work out the hints of bulges and backs, cylinders and
fiee-moving bumps. Compare your findings with your provider, or bring your sketches to your ultra-
sound appointment, if you have one.

Being Proactive about Twin Positioning

Bv 36 rveeks, many obstetricians will want to schedule a cesarean
tbr ru'ins, úough many mothers are hoping to "go naturally." Some
pror-iders practicing within the medical model of maternity care
a,ren'r concerned until 36 or 37 weeks whether twins are head down.
But this may be too late for some
mothers. \Waiting reflects an errone-
ous belief that nothing can be done
to change twins' positions.
In contrast, providers understanding a balanced-body Ttoint of
aieut take a truly proactive approach with twins. Optimal fetal posi-
tioning techniques are most efficient in the second trimester, before
the babies have finished positioning themselves for labor. You may
even begin optimal fetal positioning in the first trimester to balance
your womb and give your babies plenry of room to settle head down.
If you begin later in the third trimester, the babies' size adds a cre-
ative challenge as they try to reposition around each other. But since
every situation is unique, itt never too late to try!
Do as many techniques, and as often, as you and your provider
feel comfortable. Nearly all the things you can do to encourage a singleton to turn head down-such
x body balancing and body.rvork-may also help twins turn head down. (See pages 40-45.) One
exception: Due to increased risk of entanglement or placental separation, many providers do not
recommend the external cepbalic uersion with twins.
Meanwhile, with good eating and rest, you can likely go your full 40 weeks and start labor spon-
taneously. Excellent nutrition helps avoid lrretnature labor and other complications.

35
 3-)
5
3"
How Your Baby's Position 5'
a
Affects Your Labor É
ç
Belly Mapping can be used simply for play and bonding, but the added goal is labor preparation.
Now that youve charted, visualized, and named your baby's position, you're aware of how positions
3
differ. In this section, we'll discuss which positions often lead to shorter and easier labors and u,hich s
positions somerimes lead to longer, more difficult labors. (Tâke another look at the Fetal Compass 3=
Rose on page 22 if you need a refresher on the various positions-or their abbreviationsl) 3t
You may have heard someone-perhaps even a careprovider-say babies choose their positions
freely, and some stay in less-favorable positions because they're "stubborn." The truth is, your babv
3;
chooses the easiest position possible in the in your womb.
space available e'
Many variables affect this ar-ailabl. a
space: MaternalTtositioning (see let ,
í
Maternal Positioning the tone of your abdominal muscles,
and the balance (symmetrli of r-our
í
Postures and movements used by birthing
women to open the pelvis and cooperate with gravity womb, via the uterine ligaments anj í
during pregnancy and labor. Maternal positioning pelvic joints. As you'll learn (see paso. t
is widely accepted and used to encourage a 40-45), you can adjust these variable.
baby's rotation and descent, perhaps
É
with body-rvork, whether on )'our o\\-n
shortening labor.
or with a professional. But some thinq-r
É
can't be adjusted-the location of vour É
placenta may hinder rotation, especially if your abs are tight. During labor contractions, rhythmic 3'
movements with gravity promote fetal rotation, but extremes in the amount of your amniotic fluid j=
may make it too easy or too hard for your baby to shift.
3-
The ldeat Starting Positions 3-
j=
The anterior positions (LOT, LOA, OA) are the ideal,
or optimal, fetal positions for the start of labor. Anterior
3'
babies have the easiest time tucking their chins, which helps t
them descend more easily during labor. The shape of your t
pelvis determines which of these anterior positions your baby É
could take. \-l-\ \ E
ít
These ideal positions make your baby's head seem smaller ili
than if he or she were in what obstetrics calls a"m*Qtosition,"
!t i g
,'" ,\"
such as posterior or asynclitic (with the head tipped to the side). {t7
r, g
Being optimally positioned allows your baby to fit somewhat like a -/ g
tube through your pelvis. If your baby is anterior, his or her flexed
E
head (chin tucked) can mold to fit through your pelvis, compared
to the posterior or defexed (chin-up) baby, whose head is not rr
positioned to mold as extensively. Fitting the pelvis better often Ê,
Ieads to a shorter, easier labor. Q:
C,
Q;
36 cr
 The Posterior Starting Positions
The posterior starting positions (LOB ROT, ROB OP) often lead
to longer labors. That's because posterior babies' chins usually
arerit flexed as well as anterior babies' chins, and theyre trying to
move through the pelvis with the biggest diameter of their heads
leading the way.
Tly this: \7ith your chin up, feel the highest point of your
head, from forehead to the back. Now tuck your chin down to
your chest and feel the highest point. Much smaller! Flexion, or
chin tucking, is a leading variable in the success of rotation. Some
posterior babies have flexed heads, some dont. Your activities-
and patience-may help your posterior babyt head flex or your
pelvis widen to allow your baby to fit.
Remember, even if posterior positions arent "ideal," most
posterior babies come out without drama or interventions. There
are, however, a significant minority that present extra challenges
during labor. Some women choose not to worry about it; others
choose to be proactive. \XZhile I dont suggest panic, I do suggest
taking action as early as possible in pregnancy.
If your baby is in a posterior position that implies a hard
labor, remember that other factors play a paÍt, such as your pelvic
shape and size, your babys size, whether the chin is tucked, and
your health and activities during birth.
Your baby isn't stubboru he or she is trying to cooperate
to be in the easiest starting position possible. Your love is very
imporrant to your baby, and your birth partnert support is very important to you. So is your pro-
rider's conÊdence in birth. Please try to be as patient with this labor and baby as this baby is patient
witÀ you. Keep a sense of humor, and do the work for your baby. (See pages 4045 for tips on what
)-ou cân do before and during labor.)

What about ROA?

ROA is not listed as an ideal position,
nor a posterior position. The liver shares the right side
with the ROA baby, increasing the chance of chin
extension and, consequently, the chance of rotating
to posterior. Therefore, while ROA isn't a
posterior position, it may be less
than ideal,

The Differences in Posterior Positions

Because each posterior position can have a different labor pattern, itt important to know your babyt
specific position. \X4rile OP gets the most attention, midwife and author Jean Sutton teaches us to
be aware of all four positions. For each position, having a tucked chin increases the likelihood of a
aa§nal birtb. See page 38 for a summary of each posterior position.

37
 LO
(-'
Í-
t-
OP: If you have an OP baby, he or she is spine to spine with you, and you can't (-
feel the back through your abdomen. If your pelvis is roomy front to back, your E-
OP baby will come through without rotating. Most OP babies rotate, however,
f-
to LOT and then LOA. The added labor time may or may not be noticeable.
Rotating out of the posterior position can take an).r,vhere from thirty minutes to t-
twenry-four-plus hours. More time is needed if your pelvis is small in relation to fÉ
your baby or if your ligaments are tight. L;
ROP: If you have an ROP baby, the back is on your right, so he or she has rL'
lessrotation to complete than the OP cousins. ROP babies rotate in somervhat
higher numbers, therefore.
l.=
LOP: If you have an LOP baby, he or she may be better at tucking the chin,
E,
which helps your baby rotate with little or no help. Your baby will rotate to LOT
('
and continue labor from that ideal position. É
ROT: If you have an ROT baby (facing your left hip), he or she will rorate C
to either OA or OP while going through the pelvic floor during active labor. ç'
Depending onyour ltelaic outlet, your baby will finish ROA or OP. If vour
babyt chin is up, he or she will likely rotate to posterior. The ROT position ha-s
é'
not been studied in comparison to LOT, which is an ideal starting position. -\Ír É
observations show that ROT labor is not as straightforward as LOT labor, bur í
that it's somewhat easier than ROP labor. First-time mothers generally har-e ro É
be patient.
ç'
LO
Arrests in Rotation
Cesareans t"'
Babies commonly start labor in
Studies show more cesareans for
an occiput transYerse position direct OP babies than anterior babies. An epidural
L.
and rotate to face the back. Due may soften the lower uterus, either increasing the need for j'
to laboring in bed or semi-sitting, surgery or, less likely, allowing rotation and descent. Reduce tL'
use of epidural, or having a small the epidural side efÍect by waiting until the baby is trying io
pelvic outlet, a few babies become
rotate, usually 5 cm or later. Doula care also reduces É
the rate of cesarean birth.
stuck in a transverse arrest, where É
the head is caught sideways in the midpelvis. Another a
form is posterior arrest, which sometimes happens when the posterior baby gets caught trving to ç-t
rotate in the midpelvis. See page 44 for how the lunge may help avoid a cesarean in these situations.
ç.;
Will Your Baby's Head Change Position? J-
I believe itt unusual for the baby of a first-time mother to freely change head position near the end é
of pregnancy. The narrowing lower uterus usuallyholds baby's head in position over the pelvic brim rE,

by 32 to 34 weeks, even though the head is not usually engaged at that time. If you have abundanr tE,
amniotic fluid your baby may change head position, but this is less common.'§7omb tone promores
head stability.
C'
If you notice your baby is switching sides frequently, it may be that he or she is turning at the neck, rE,
leaving the head in the original position. Usually, the head remains in place while the back shifts. gr
c-J,
38 at
 The baby may try to reposi-
tion his or her head to correct for
a malposition caused by tension
in the uterine ligaments. Such
tension could be the result of a car
accident or oúer torquing events.
If bodywork or the hormones of
late pregnancy soften your liga-
ments and lower uterine segment,
1.our baby may suddenly find
room to move and üy to assume
an easier, more ideal position.
§íhen your posterior baby's
back s,witches sides frequently,
úe internal movement may be Your baby will accommodate the shape of your womb.
accompanied by bouts of strong ln a balanced womb, as shown on the left, the baby will have
"turning contractions." This is more room to attempt an ideal position. But when ligaments are
out of balance, the womb may get a twist, as shown on the right.
sometimes called false kbor- Baby will make do with less symmetry, perhaps settling
but theret nothing false about in a posterior or breech position.
it. The goal of the contractions is
simply rotation, not dilation. So look to your baby's position if youre having strong, frequent con-
tractions but your provider determines your cervix isnt changing as much as expected. Your baby
may be tryrng to reposition his or her head to engage in the pelvis.

The Breech Starting Position

§"hile breech fetal positions are not considered "ideal," such a designation does not mean a breech
birrh will necessarily be difficult or impossible. Cardinal rnoaemenrs, the series of changing posi-
tions a baby makes during labor and birth, are easier for the breech baby when you labor in upright
positions.
Once the baby appears on your perineum, the hands-and-knees (or knees-and-elbow) position
allows your baby to move through the cardinal movements with great safety and spontaneity, as
compared to lying on your back. A sp)ontaneous birtb (when birth begins and ends naturally, espe-
cially without any touch, which interferes with the
cardinal movements) is physiologically sound and
safer statistically than breecb erctraction (when a
provider manually attempts to assist with rotation
and descent by turning and pulling the baby).
Practicing the motto "Hands offthe breech!" will
help keep vaginal breech birú safe. Because most
providers lack this understanding, as reflected in
worsening breech statistics, U.S. practice sees most
breech babies born by surgery. kt hard to find a pro-
vider skilled in breech birth, making cesarean breech
birth a forced "option."

39
I
'. I

t-''
t
ft'
Spinning Babies for Easier Birth É'
E
"Spinning babies" is a simple wây to describe optimal fetal positioning. It seems
É
optimal fetal positioning is all about your baby, but really, it's a lot about you.
It seems theret only one goal: getting your baby into an ideal position. But actu- É
ally, the hidden benefit is balancing your own body, which can only moye you toward É
easier birthing. The same changes in your body that allow your baby to reposition may f
just allow your baby to be born without needing to reposition at all. §lhen your body is
flexible and balanced, you give your baby needed space. You and your baby are pamners
at
in birth, and optimal fetal positioning helps you both. a'
j'
What to Do During Pregnancy *'
The sooner you begin optimal fetal positioning, the better your chances to balance your body E
and encourage your baby into a good position. Conversely, the longer you wair, the more you ma\- É
have to overcome, and the less time you ll have to affect change. Still, if sooner is better than later. t
later is better than never! Tly to incorporate the following activities into your daily life.
3
Good Posture: Make your belly a hammock for the baby. This meens 1er r-ou:
É-
belly relax forward or down, instead of pointing up. Think of your bellr.burron é-
as a flashlight. \Mhether you're standing, sitting, or lying down, aim the "beam" é'
either straight úead or down toward the floor. This will keep your spine higher
C
than your abdominal wall, allowing graviqy ro secure your baby in a better
position. Good posrure gives your baby the mosr room ro rorare and enter the
3
pelvis. Another way ro give your baby room is to keep your knees lower than 3'
your hips, a tip made popular by midwife and author Jean Sutton. 3é
Move Freely: Brisk walking relaxes the psoas morscle pair, r,vhich, 3à
when tight, can literally hold your womb and baby up. Stretch ri-irh 3-
hip-opening and pelvis-balancing exercises and yoga. Srvim. Dance ,
3;
Belly dance is said to originally be a celebration of-and prepararior:
for-birth. Sit on an exercise ball and make rhythmic circles. like C'
kids do with Hula-Hoops. \(hen your baby is acrive, help him or C
her get into position with rwenry to fory pelvic tilts (see page -il C
while on your hands and knees and with your belly relaxe d. Squ.: C
daily for muscle srrengthening and good bowel healrhr siari
with your back against the wall for supporr. But dont squar ii
C-
you're having repeated bouts of "turning contractions" (see paee j:t .
e-
Rest Smart: Rest when you need to rest! Make
C-
a nesr of pillows or use a childt inflatable swim 3
ring to rest nearly belly-down, with your lower C
leg behind you and your upper leg over high pil- C
lows. Alternare on each hip with a pillow berween
your knees and ankles. Protect your belly and the
c=
small of your back with pillows. G-',
C'
40
G'
ç
Get Bodywork: If within a couple weeks the measures on page 40 dont bring your baby to one of
the ideal starting positions-with the baby's back on your left side and kicks to your right (see page
36)-youmay benefit from some of the following techniques and activities. Discomfort in pregnancy,
whetlrer "false labor" or a general sense of being uncomfortable, is an indication for bodywork. Many
successful " bnfu spinners" use a combination of these techniques.

âi Chiropractic adjustments
a* Craniosacraltberapry
a* Diaphragmatic release
& Sacralrelease
& Acapuncture
& Moxibustion
& Honeopatl4r
& Maya uterine rní$sdge
& Prenatal yoga
Find Birth Support Now: Rates of satisfaction soar when
a moúer or couple hire a doula for birth support. Having a
nonrelative, nonmedically trained Person who knows birth
and puts your emotional needs first adds üemendously to the
birth experience. A doula has helpful tips for labor progress, but most importantly, her continuous
presenc€ sooúes away some stress ând even some of the pain. Research shows that doula support is
úe most e#ective labor intervention, making some medical interventions unnecessary. V4rile youte
pregnant, check for referrals at sites such as www.dona.org.

What to Do During Labor

I-abor is a continuum of pregnancy. Active birthing is a continuum of childbirth preparation. If
you've done your work, good posture and free movement are now part of your life, and you can
likely expect a straightforward labor. A few babies and mothers may need more help than what can be
achieved in pregnancy, however. The good news is that labor contractions help babies
rotate! §íhether your baby starts
Trust Your
labor in an anterior position or a less-
Body
ideal position, here are some helpful
tips for the work úead. Labor is enhanced by a peaceful and
relaxed state that is quite the opposite from the mental
preparation involved in "trying to do it right." Relax,
Let Labor Begin on lts Own: nurture labor, and follow your instincts.
Find support for letting labor begin Your birth partner can always pull out this booklet if
you need it. Trust your body. Without rigidity,
spontaneously. There are many
labor will tell you what to do.
benefits to avoiding induction with
Pitocinor manual rupture of yow bag
of uaters. Research studies support

41
 tt
t;
tt
spontaneous onset of labor, as described by Lamaze International. Nature may break your water, but tt
if it aint broke, dont fix itl Some caregivers "break the bag" to try to speed labor, begin an interven- tt
tion such as afetal scalp elec*ode, or check for meconium (baby's first stool, which may signify a
problem). But actually, breaking the amniotic sac may make a slow labor slower; it may make a fast
tt
l
labor faster. It's especially best to avoid breaking your water if your baby is posterior. The amni- C
l
otic fuid makes rotation easier, so breaking the water cân cause the head to lodge before rota- C l
tion, which prevents a vaginal birth. If your caregiver suggests induction, communicate to learn C
whether your personal medical needs justify the risks. Often times induction is merely a routine
Practice that may not serve your particular situation best.
t' 1i
C
Be Patient with a Start-and-Stop Labor 1
Pattern: You may start and stop labor so many
c1
times, you'll feel like a car with a broken starter! C1
!
Stay patient. Usually, this early-labor pattern C l
means your womb is trying to reposition your E
babys head so it can engage and/or descend. Most l
of the dme, your baby will engage, and labor will
€
l
continue. E I

tÉ
Work with Gravity: You are designed to labor l
vertically and work with gravity. Unless you have €
l
to labor in bed due to health concerns, stand and €
lean forward to bring your babyt back forward, I
C
kneel with your back straight, or use the bands- I

and-hnees Ttosition.
'W'henever
you have to lie
C l
C
on your back for exams, remember to roll to your
side and lean over a nest of pillows when the exam is done. ê
i
Continue to Rest Smart: Even healthy women musr
g1
1
rest during a long labor. A good sleep is important-don'r C
force yourself to stay awake when labor is slorv or earl.-.
1
ê
Your uterus will work more effectively after sleep. er e n :
C
when sleep is brief. Rest is cumulative, so keep qoins rc':
micro naps when labor is long. Rest when you are rirei lE
or when your body is accustomed to resting. If r-ou are C
laboring at night and can't sleep as you're accustomed. tE
use the Rest Smart positions (see page 40) to doze be-
G
I
fween contractions. Regularly alternate lying on r-our le .
and right sides. Sometimes rest your chest and face o\-e r i.
g I
birth ball or the head of the bed while your knees are on C
I
the mattress. t I
I
Stay Nourished: Your body needs nourishment to do the hard work of labor, especially if your babr C
is in a less-than-ideal position. Keep labor progressing with frequent electrolyte drinks and easilv t 4
j
l

digested snacks.
t1
Move Your Body: Your womb morres your baby down toward your pelvis with a mild spiraling C
t 11
42 C
1
amion. Being vertical lines your womb up with your pelvis. Your movements help the baby wiggle
úrough your pelvis. Remember, "To move the baby, move the mother." Tip your pelvis this way,
turn ir úat way, do a Hula-Hoop moyement while standing or sitting on an exercise ball.
Work with a Supportive Birth Team: A midwife and/or doctor is necessary for the safe monitor-
ing of labor. A nurse can be your advocate regarding hospital policies and is often the first person to
communicate (and interpret) your needs to your provider. As discussed on page 41, a doula can give
you helpfi.rl tips for labor progress and soothe stress and pain. A supportive birú team can bring you
úrough the challenges of labor, no matter what position your baby is in. For your part, you can
help your team help you if you're open about your needs in a friendly, yet direct way.

Priorities When Laboring with a Posterior Baby

Âll the optimal fetal positioning tips on pages 4043 will be helpful when laboring with a posterior
labor, but please keep these in specific priorities in mind:

Let Go of Expectations: Labor with a posterior baby is much different than labor with an anterior
baby. So if your baby comes through your pelvis differently,
you must labor differently. Thade your dreamy expectations for
a pragmatic approach to the work of childbirth. Unrealistic
expectations cause more suffering than labor itself for most
women. Expecting an easy birth, you may find posterior labor
a real challenge. Or if expecting a long labor, you may be
or.erwhelmed by a fast labor, as some posterior births can be.
lrming go of expectations helps you identify the real facts of
r"our baby's position and your progress. Then you can either
trr to change the facts or accept and deal with them.
Hep Baby Rotate: Most posterior babies rotate to face their
moúers' backs before they actually come out. Some posterior
babies dont have to rotate and will be born facing forward.
If your baby isnt rotating during labor, it may be because he
or she doesnt need to, which makes labor last anFwhere from
úree to eight hours to an occasional twenry-four hours. Or it's
because your baby can't rotate, due to a dght pelvic floor or A second baby may come
somewhat smaller pelvis. If need be, you may wânt to change much faster than the first.
vertical positions and Rest Smart positions every thirry min- This family's second labor was
utes (when you're not sleeping) in order to help your baby only three hours-and it was a
posterior birth.
rotâte. After rotation, you'll find labor easier to deal with and
less painful.

Take All the Time You Need in Early Labor: In early labor, a posterior baby needs room at the
pelvic brim to engage oÍ rotate. Once the baby is either anterior or deeply engaged, your womb will
rest. You cân rest, too. After eating and sleeping, labor will resume. Check with your provider or
Írurse to monitor vital signs. Squatting closes the brim a bit while opening the outlet, so wait to squât
with a posterior baby until after engagement.

43
 3?
€
e'
Open the Brim to Help Baby 3'
Engage and Descend: Arch your
pubic bone away from your spine for
3;
three strong contractions by doing 3=
l) Walcber's position on the bed, 2) e-
an open-bnee-cltest position, or 3) an a=
open-knee position in a deep pool.
C;
Aim Your Baby into the Pelvis: é
Use the abdominal ffi.Flattenyour lower back against a wall, if
é
you like, and bend your knees slightly. At the start of each contrac-
tion, link your fingers to lift your belly 2 inches up and tuck it 1-2 é
inches in. Let go and move your legs berween conrractions. Repeat e
the lift for ten contractions. Skip a contracrion if you get a late starr, C;
and resume counting with the next conrracrion. This relieves back
i pain, and directs your baby into your pelvis,
3'
perhaps tucking the chin.
G'
é,
Widen the Pelvis in Active Labor: Help your baby I

through the midpelvis and pelvic foor with the lunge.

lê'
i
Open one side of your pelvis by putting one foot on a ?)
stool, offto the side. Keep your
other foot flat on the floor. Rock 7
G);
side to side toward the stool
during contractions. A variation
G4
of this technique is called the é
bed lunge, for which you need c1
a partner to help move your leg. The bed lunge can be done even with an
él
epidural. This is typically effective 4-6 centimerers, bur can be done anytime.
é,
Widen the Pelvis During the Pushing Stage: You may benefit from )
c-)
opening your pelvic oudet, making more room for the babyt descenr, and,
therefore, shortening the pusbing stdge. Squatting opens the outlet, as does
Ci
a double-ltip press.Lyingon your side is also useful, especially if you hold Gj
your upper leg bent and away from your hip. et
Surprise!-Don't Curl Your Back: Curling your back like the letter Cnhile c4
pushing is okay with an anrerior baby, who is curled, but you need a srraighr
spine with a posterior baby. Tiaditionally in cultures all over the world, moúers
4
q
use positions that keep their backs straight and their knees bent. They mav
hang from a pole, branch, or sturdy shawl over a ceiling beam. If you can't
G}
get out of bed during labor, turn on your side and straighten your back. This G}
helps the baby come down. Many women spontaneously arch their backs in GJ
transition and pushing. There's a common urge ro sit on the toilet when à
descent begins-an instinct to go where your back is straight while you
release. Straightening your back gives your baby more room to tuck the chin
é
and kick and wiggle lower through your pelvis. Gà
é
44 à
4
What If You Have a Long Labor?
Theret a reason for a long labor. Your baby may be trying to engage. An arm may be folded along the
side of his or her head. Your baby may need time to rotate before dilation can proceed. If you find
yourself in a marathon labor when you expected a sprint, keep in mind that attitude is everything.
Surrender dreamy expectations and get practical support, as a marathon Íunner would receive.
Some providers or hospitals put labor on a clock and force unproyen policies, such as limiting food
and fluids. Going against current birth customs takes determination. If you have a posterior baby
and you find yourself in a long labor, you must be able to eat and sleep as needed. AIso, time is saved
when you and your provider start techniques sooner than later to help the baby rotate.

Stay Patient
Sometimes simply knowing long labors do occur-and generally end happily-can help you cope
and go the distance. Social support cannot be understated! Keep your goal in your mind, and enter
into the rhythm of your labor. Don't judge or time your labot. Stay with your breath and let the
labor determine its own course. If you need strategies to cope, ask your nurse or doula for support.

Out of Patience?
But should the hard work of labor gives way to suffering, it's past time to get extra help. \ffhen will
enough be enough? Use the four-hour rule: Four hours of strong, long contractions two to three
minures apart while you open to gravity with absolutely no progress. Not slow progress: z, progress.
Interventions are big tools for big challenges. They are tools for times like these.
Hospital staffcan offer contraction-strengthening Pitocin and/or pain medication if either your
labor pattern or your well-being requires. Pitocin can promote fetal rotation. An epidural is occasion-
ally usefirl, particularly for very tense ligaments or a super-strong pelvic foor due to riding horses,
ruÍrning, ballet, or pâst trauma. But labor can also slow for some women if the epidural softens úe
lower urerus too much for rotation or when a womân with a smaller pelvis is stuck in bed. Pain
medications lead to a number of other interventions, which may include bed restriction, fV-Pitocin
use, E isiotorny, and aacuuTn deliuery or cesarean. No pain medications are proven safe for babies or
úe bonding period. §leigh the risks.
Cesarean birth is a blessing for those few babies who cant find their way through the pelvis.
'§7hen
used ludiciously, surgery is a lifesaver. My hope for you is that in your approach to birth, you
fully engage yourself in your labor. Then even if the doctor finishes the baby's birth for you, you will
have given birth to yourself as a mother, no matter which way your baby came out.

Conclusion
labor is an important physiological process that contributes to a heightened abiliry to selflessly
nunure your baby. Belly Mapping can help you set reasonable expectations about labor and chart a
course to make your time in labor more effective and satisfying. Belly Mapping supports the palpa-
tion skills of nurses, midwives, and physicians. But most of all, Belly Mapping is a fun way to eÍr-
hance the relationship between you and your baby.

45
 3_'
Here's \{hat üthers Are §aying 3-'
about lhe 8eííy Nuppíng Wcrkbçok! J,
Gail Tully combines unique gi[rs of clinica] cxperrise, experiencc. crc;rir -. 3_
sensitivity, intuition, original thinking, and wisdom to solve the mvsreries
3_
the baby'.s position in utero. She shows pregnânt women and their carcsilc:. .
variery of clues that reveal the baby'.s position and how to put them all rogerrt: , t_
create a picture of the baby inside. She also suggests many \vâys for a prcsn;r: .

3_
laboringwoman to c.reate favorable conditions for her baby to find irs \\':-,. ,:-,-
and through her pelvis and be born. Gail'.s work deserves the artention àn. .:- '. 3_
of the scientific community, since fetal position is a rna.jor determinan, ,r: ": --
3_
progress and mode of birth, and there is very little reliable inlbrmarirrn !r.r r:.:. i
to identify and improve feral position. 3
PT, author Birth Partner: Á Complete Gtiit :' L)-:.-;r':-: '
of The -
-pgçrç'Simkin, Dads, Doulas, and All Other Labor Contp,ttlor::.rr1. . ::: ' : e
Ihe Labor Progress Handboob and ?regnann, Cltildbiri... .i,::t :,': -'.t....: ' 3
3
Hooray For women getting to know rheir own bodies and rhr.:
The Belly MappingWorkbook is a wonderlil read for moms â;r. ra t-
doctors, doulas, nurses, and childbirth educarors. Ir gives solid i:..i-.
ç_
that all readers can u.se to better Lrnclerstand and erplain s'har i. :-,.:
that wonderfully mysterious place we call the u'omb. The :ir. - 3_
baby get into the best position for birth are invaluablcl I am .i :..: ,-1,
3_
many situations and gives concrere, easy-to-undersrand dire.r.Lr:ri :-:
... A wonderful acldition to any professional's libran-. and rr i. sL, rji - . 3_
Discover What Thcse Kicks a family can save it as a keepsake ro track the journer- crirhcir i:tr:---:
í
and Wiggles Reveal absut L)ebi;it }r'urrg. DCrl)t )\{r. f t'D Dr t\.\ .IL. .

ard pasr president uiDil\:.,:- .:::: r- Í_

Your Baby*and Possibly Yaur
t
U pcon":i ng *i rth ! The Betly MappingWorkbookrs essential reaciing fôr a1l presnanr \\..,:r-:: :,.:
piltners.Gail Tirllyopensoureyestotheintimaremother-bab'co:r:.-::,..:--. é''
In three simple steps during the last months how posture and positions can help mothers and babies havc cas:er ian.,r. .-:-: Í_'
of pregnancy, your hands can make sense of births. Full ofinsights and exercises to enhance vour connccrion anJ r:É:à:=' , '
those bumps and bulges, you'll "see" the baby and your baby for an optimal, safê, and satislying birth experien.. ,* .::.r-. é-'
inside using a doll or drawing, and you'll trainer I highlv recomm end Be tly Mapping to all birth profission:-s. Í ;
name and learn about your baby's specific
position.
;rH:fã:Í":::;,1:J:,)i,.H::;;:;^j:i:,,.i#,,..:j :.':":, . - 1Í'
Orgasmic Birth: Your Guide to a Safe, S,tri,fiing, ;r4 Pit.;.;.r.;i ., -::-:. :,;::-::.:.. 15 '
Belly Mapping will become a fun nightly
té_
bonding experience, but there's also the ...4 wonderfully intimatc way for a mother ro hclp .onnú-: :',,-.. ..= .
bonus of childbirth preparation. Itt full of the womb as well as have a sense of babys posirion. The in:.,:n::- : - - ,, - 3_

easy-to-follow tips to give your baby a chance volurne will makc a world of differcnce in vour coniàrr I.r::,--:..'-.. , '
3_
at the best position to make labor easier and Robin l.lise Si,'eiss, BA, CLC, ICCE-CPE. CD: L\r\,1, - - -: r - --

andÂbout.comGuiJ.r -:.. r- -: É
shorter. It's a revelation for expectant parents
and careproviders alike. E
unique resource for expectant pârents and rheir caregivers. litc irc: :: ' - -:
...,A.
The perfect gift and source for
re of the book is in understanding how the posirion of rhe Àabt aÊi;:. :--. : ---..
lÉ
par€nts, providers, doulas, and childbirth labor, and how maternal postures or movements can help a bah..':::,'.. -:- :: E
educators, The Belly Mapping Workbooh is optimum position for an easier delivery.
lÉ
sure to delight as much as inform. Iiia *arragh, CPM, LM, board member North ,{merican Rcsj.:r. : '. tr : ., . . .,
tsting Department. ilr -..:r r : E
ittl G:,:.;t : - '.1:.. ,
From Calling to Courtroam: A Sun t
*aiI Tully, CPM homebirth midwife and G_
doula trainer, lives in Minnesora, USA. --;
Belly Mapping is a well-loved feature ar her
SpinningBabies.com website, one of the

ttrlt ::
most popular and informative sources of
pr€qnancy and labor techniques to enhance ISBN- í 3: 978-O-97', ;:H:il l[ililfi|ilfllffillilti tt