The LOL position in pregnancy refers to the Left Occiput Transverse (LOT) fetal position, specifically used in the UK, New Zealand, and Australia. This orientation is considered an ideal or optimal position for the baby as labor begins.
Understanding Fetal Positions
Fetal position describes how your baby is oriented inside your uterus in relation to your pelvis. The term "occiput" refers to the back of the baby's head, which is typically the first part to emerge during a vaginal birth. In the context of the LOL or LOT position:
- Left (L): Indicates that the baby's occiput (the back of their head) is positioned towards the mother's left side.
- Occiput (O): Refers to the back of the baby's head, which is the presenting part.
- Transverse (T): Means the baby's occiput is facing directly to the mother's side (either left or right), rather than towards her front or back.
Therefore, Left Occiput Transverse (LOT) signifies that the baby's head is down, with the back of their head facing the mother's left side and positioned horizontally across the pelvis.
LOL vs. LOT: Regional Terminology
While LOT (Left Occiput Transverse) is a globally recognized term, the abbreviation LOL is a regional variation specifically used in the UK, New Zealand, and Australia to denote the exact same fetal position. This difference in terminology does not alter the meaning or implications of the position for labor.
Optimal Fetal Positions for Labor
For a smoother labor and birth, certain fetal positions are considered more favorable as they allow the baby's head to engage and navigate through the pelvis with greater ease. The likelihood of an optimal fetal position is often linked to the mother's pelvic shape. The most common pelvic shape, gynecoid, is particularly well-suited for babies in an LOA or LOT (LOL) position at the onset of labor.
Here are some of the ideal fetal positions:
- Left Occiput Anterior (LOA): The baby's head is down, with the back of their head facing the mother's left front side. This is frequently considered the most ideal position for birth.
- Left Occiput Transverse (LOT / LOL): As described, the baby's head is down, with the back of their head facing the mother's left side, horizontally. This position often naturally rotates to an LOA during labor.
- Occiput Anterior (OA): A general term indicating the back of the baby's head is positioned towards the mother's front. This category includes both LOA and ROA (Right Occiput Anterior).
| Fetal Position | Description | Optimal for Labor | Common Regions for LOL |
|---|---|---|---|
| LOL (Left Occiput Lateral) | Baby's head down, back of head towards mother's left side, transverse. | Yes | UK, NZ, AUS |
| LOT (Left Occiput Transverse) | Baby's head down, back of head towards mother's left side, transverse. | Yes | Global |
| LOA (Left Occiput Anterior) | Baby's head down, back of head towards mother's left front side. | Yes | Global |
| OA (Occiput Anterior) | General term for baby's back of head towards mother's front (includes LOA/ROA). | Yes | Global |
Further information on optimal fetal positioning, including the Left Occiput Anterior (LOA) position, can be found from resources like Spinning Babies.
Why is LOL/LOT Considered Optimal?
The LOL or LOT position is favorable because it allows the baby's head to present the smallest diameter to the mother's pelvic inlet, especially in women with a gynecoid (round or oval) pelvic shape. From a transverse position, babies often naturally rotate during labor to an occiput anterior position (such as LOA or OA). This rotation facilitates an easier descent through the birth canal, which can contribute to a smoother labor and minimize potential complications.
