Spinning Babies: Asking Questions
Do a google search about a breech, posterior, or otherwise mal-positioned baby in the womb, and you’ll find Spinning Babies high in the search results. Spinning Babies is an organization founded by Gail Tully, a midwife, that hosts classes and workshops, both online and across the world. They teach techniques they claim help babies find the optimal position in the womb for a more comfortable pregnancy and easier delivery. On their website, they advertise easier labor, fewer cesareans, less pain during birth, and more with the use of their techniques.
They are growing in popularity every year, certifying “parent educators” and spreading across the globe. It’s easy to understand why. Mal-positioned babies often lead to painful labors, complications, invasive interventions such as forceps delivery, and, often, cesarean section. This is costly in every way—physically, emotionally, and financially. Parents, desperate to avoid this, often seek help from professionals claiming to have detailed knowledge of fetal positioning and effective techniques to help their babies move into a position ideal for easy, vaginal birth.
The problem, however, is that there is no evidence that Spinning Babies can do any of what they say they do. Anecdotes abound, but they offer zero scientific evidence to substantiate their claims. So far, the evidence we *do* have on postural management of fetal position in pregnancy suggests that it is not an effective intervention. It is worrisome that an increasingly popular program claiming to help vulnerable parents is not bearing the same burden of evidence that we, rightfully, demand from medical providers who treat and advise expecting families. While Spinning Babies claims to not treat or give medical advice, they are nonetheless offering solutions to parents in need, and doing so without scientific research to validate their methods.
Why does any of this matter? If people find benefit or comfort in Spinning Babies techniques, is there any good reason to press for answers? Yes! There are several important reasons why we must ask questions and think critically about Spinning Babies, even if people enjoy their techniques or anecdotally find them effective. All interventions, even “natural” ones like those taught by Spinning Babies, come with important considerations and risks.
Firstly, when we’re working with expectant families, being honest and ethical about our services is of utmost importance. Parents have a right to make informed decisions about their pregnancy, and making misleading claims creates hurdles for families looking for real answers. In the birth community, we have long fought for evidence-based practice, accountability, transparency, and respect from our care providers in the medical field. Those of us in the non-medical fields ought to be held to the same standards. We shouldn’t get a pass just because we’re the “good guys.” Having evidence to support our methods is the lowest possible bar, and all those claiming to have solutions for expectant families ought to pass it.
Secondly, not only do they not have evidence to support what they say they can do, some of their claims have actually been debunked. Take their Standing Release, for instance. Here is the explanation they give on their website of this technique:
The Standing Release is done with a very light touch to release the fascia around the pelvis and the pelvic and respiratory diaphragms. When effective, this may improve fetal positioning, pelvic alignment, and even reduce heartburn and snoring.
Except, the evidence we have about fascia does not support that we can manipulate it through touch. In fact, the opposite seems to be true. It appears to be incredibly hard to move. Despite the popularity of “fascial release” as a therapy, it is likely not a real thing. That’s not to say nothing is happening with a fascial release. Human touch, after all, is powerful, but we are still ethically bound to be precise with our words and seek the best possible evidence to support our work.
They make other claims that don’t stand up to scrutiny. Let’s examine one of their most-well known techniques, the Forward Leaning Inversion. From the Spinning Babies website:
The forward-leaning inversion potentially makes room for a good fetal position by untwisting any ligaments to the lower uterus and cervix that may be twisted from sudden stops or a habit of a twisted posture.
We have no evidence that ligaments twist in this way. Further, research suggests that twisted postures, or movements like stopping quickly, will not affect your connective tissue in a substantial way. They are incredibly stable structures. We have reason to trust that our bodies are not fragile, but are indeed robust and not easily manipulated. While this means we might have to rethink how we imagine our bodies to work—and that can be a hard-on-the-ego process—this is really good, empowering news! This means that our bodies are resilient, adaptive, and stronger than we know. We need not fear that simple movements in daily life are affecting our tissues in a harmful way.
Understanding the truth about our bodies, especially during pregnancy and birth, can make a positive difference in our confidence (you are strong!), and self-esteem (no need to shame yourself for slouching on the couch!). Believing in a fragile body can do the opposite, creating fear and mistrust. This is the last thing we need in pregnancy, and an important consideration for those exploring Spinning Babies or other musculoskeletal-based fetal positioning techniques.
Fourthly, we have to consider the emotional and mental health of a family desperate to reposition their baby in the womb. Is introducing unproven measures really in their best interest? While a “try everything and see if it works” strategy is fine for some parents, for others it is anything but. Investing time, energy, money, and heart-felt desire into a strategy only to have it prove ineffective can be stressful and trying. It can breed shame, disappointment, and feelings of failure. These emotions are not benign. While we have no evidence that mothers can affect fetal position during pregnancy, we have strong evidence of the detrimental affects of stress during pregnancy. The “try it and see” approach isn’t without risk and professionals teaching unsubstantiated fetal positioning techniques should discuss this with parents.
Last but not least, it’s important to remember that all of this is resting on what may be an incorrect presumption. In order to believe that stretches, posture, or passive interventions like massage can “fix” mal-positioning, as Spinning Babies suggests, we must first presume that skeletal defects, tissue imbalances, or other musculoskeletal deformations in mom’s body are the root cause of the problem. So far, we have no evidence to support that presumption. The human body is incredibly complex, and while that theory may seem intuitive, I would caution against assuming to know too much. While it could prove to be true that constraints or imbalances in mom’s body are one reason babies don’t position themselves well, so far this is only a guess. There are other potential causes, such as too little or too much amniotic fluid, fibroids, placenta location, just to name a few. These are only guesses, of course, as we don’t yet know why some babies don’t position themselves well. But it’s important to consider that mom’s body may have nothing to do with it at all.
I encourage families and birth professionals to consider these points before using Spinning Babies for fetal positioning. But, to be clear, I am not against Spinning Babies. If parents enjoy Spinning Babies and find their techniques helpful, then I encourage them to keep doing them. But, I am against misrepresenting claims. I am against profiting off vulnerable families with unsubstantiated solutions. I am an advocate for transparency, accountability, and evidence-based practices. I am not claiming Spinning Babies is entirely ineffective, as that would require proof that neither they, nor I, have. Their techniques may very well do everything they say they do. That would be great news! But, the burden of proof is on the person making the claim. If the first sentence on their website reads, “Easier birth with fetal positioning” and they tell parents to “Use this site and videos to improve fetal position (breech, transverse, posterior) and birth. Reduce the chance of cesarean,” it is not unreasonable to ask them to support these bold statements with evidence. It is, in fact, unreasonable for them to have not done so in the first place.