What Is a Sunny Side Up Baby?

Being pregnant can sometimes feel like learning an entirely new language, especially if it’s your first baby. I can confirm this: When my doctor told me during my third trimester that my son was a “sunny side up baby,” I just looked at her blankly.

I soon learned that this meant baby was head-down (good), but facing toward my belly instead of my back—a position that’s not ideal for labor. My doctor explained there was still time for him to turn, and in the end he did. (But I still had a good giggle over the breakfast lingo!)

Most babies are born facing toward the back. Sunny side up is the most common “malposition” in labor, with data showing it occurs in 1.8 to 8.4 percent of deliveries. “When you’re laboring, the ideal position for baby is to have a tucked chin and be facing down at your spine, or off to the side just a bit,” explains Julie Lamppa, APRN, CNM, director of midwifery services at Mayo Clinic in Rochester, Minnesota. “When baby’s sunny side up, they’re looking up versus down.”

If your doctor or midwife says you have a sunny side up baby, don’t panic: Babies often turn by themselves. And even if yours doesn’t, a vaginal delivery may still be possible. There are a few things to keep in mind, though—ahead, what you should know.

Key Takeaways

• Sunny side up, aka occiput posterior, is a term used to describe baby’s position before labor.
• Sunny side up babies raise the risk of uncomfortable back pain during labor.
• These babies can still be delivered vaginally.

What Is a Sunny Side Up Baby?

A sunny side up baby is a baby who’s facing your stomach, rather than your back pre-delivery, says Eran Bornstein, MD, vice chair of ob-gyn and director of the Center for Maternal-Fetal Medicine at Northwell Lenox Hill Hospital in New York City. “It’s considered less optimal for vaginal delivery compared to the occiput anterior—baby facing towards the maternal spine—position,” he adds.

What makes this position less optimal for delivery?

While a sunny side up delivery is certainly possible, it’s not ideal. “When baby’s occiput posterior, the diameter of the head coming through the pelvis changes just slightly,” Lamppa says. “It’s a more challenging fit for some moms and babies.”

How to Know If You Have a Sunny Side Up Baby

There are a few ways to know if you have a sunny side up baby as you get ready to deliver. Your doctor or midwife may determine this during labor by manually examining baby’s positioning, Bornstein says. A bedside ultrasound can also confirm this, says Lamppa. (At your prenatal visits, your doctor will also perform ultrasounds to check baby’s positioning—but at that point, baby still has time to rotate.)

You may have back labor too, “meaning that the discomfort of your contractions is felt more intensely in your low back,” Lamppa adds.

Risks of a Sunny Side Up Baby

One of the biggest risks of having a sunny side up baby is a potential C-section, says G. Thomas Ruiz, MD, lead ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, California. While it’s possible to have a vaginal delivery with a sunny side up baby, baby’s head is more likely to get stuck in the pelvis in this position, he says. Because of this, forceps and vacuum extraction may be needed, Bornstein adds.

Having a sunny side up delivery is also linked with a longer labor and intense back pain during labor, thanks to baby’s head pushing against the back of the pelvis, Bornstein says. Research also links having a sunny side up baby with perineal tears and postpartum hemorrhage.

Keep this in mind: Just because your doctor says baby’s sunny side up doesn’t mean baby will stay in that position. “Many fetuses rotate spontaneously to an occiput anterior position during labor,” Bornstein says.

Next Steps: What Can You Do If Baby Is Sunny Side Up?

Lamppa stresses that many sunny side up babies will simply rotate on their own. Many parents recommend childbirth education programs like Spinning Babies, which provide exercises for helping baby rotate into the optimal position pre-delivery.

To increase comfort during labor, it helps to adjust your positioning. “Hands-and-knees position and extreme side-lying position with the top leg up and over a peanut ball or pile of pillows might be helpful,” Lamppa says. “Movement and changing positions in labor is always a good thing.”

Once you’re in the pushing phase—which is when your cervix is dilated to 10 centimeters—your healthcare provider can gently rotate baby’s head manually with their hand, Lamppa says. “This is likely the most effective intervention we can do for occiput posterior babies,” she says. “This takes some skill and has some risk, so there should be discussion about it. Having said that, it can work really well, assist with labor progress and increase your chance for a vaginal birth.”

What Are the Other Possible Positions?

Other than sunny side up (aka occiput posterior) there are a few other positions baby could be in for delivery, according to Cleveland Clinic:

• Occiput anterior. Also known as cephalic anterior, this is the optimal position for childbirth. In this position, baby is head-down, facing Mom’s spine with their chin tucked toward their chest. Mount Sinai notes that 97 percent of babies present as cephalic, aka head-down (whether anterior or posterior).
• Frank breech. In a frank breech, baby’s bottom first with hips flexed and knees extended toward the face. About 3 percent of babies present as breech.
• Complete breech. Baby is bottom first with both hips and knees flexed.
• Footling breech. Baby has one or both feet entering the birth canal.
• Transverse lie. In a transverse lie, baby is sideways across the uterus on their back. Fewer than 1 percent of babies present in this position.

To Sum It Up

Don’t panic if your healthcare provider tells you that you have a sunny side up baby. There are things you can do at home—and during labor—to get baby to rotate to the optimal position. And, while labor and delivery can be more difficult, it’s entirely possible. “While a sunny side up baby can pose challenges, many can still be safely delivered vaginally with appropriate support and monitoring,” Bornstein says.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.