Fetal Station: What It Means and Why It’s Important
During labor, there are three indicators of labor progress that your doctor of midwife will assess, usually via cervical exam. Dilation is probably the one that most people are familiar with, followed by effacement. I wrote a whole other blog post explaining these two and how they’re both equally important for cervical change, and you can find that post here. Station of the baby is just another piece of important information that gives you a clue into what’s going on inside your body during labor. The station of the baby, combined with cervical dilation and effacement measurement, can help you better understand how your body is progressing in labor, and even what body positioning may best assist your baby in their descent through the birth canal.
What is fetal station?
Fetal station is a term that describes where your baby’s head - or other presenting part (shoulder, feet or buttocks) - is located in your pelvis. During most of your pregnancy, your baby is floating above your pelvic inlet, which is how they can so easily flip-flop between head-up, head-down and sideways. Later on in the third trimester, your baby may begin to drop lower into your pelvis - you may hear this referred to as “lightening” or your provider describing that “baby has dropped”. Although this may begin in the third trimester, for some baby may not drop until labor has already begun. During pregnancy, you may feel like your baby has dropped if you are feeling relief from acid reflux, breathing a bit more easier, and feel more pressure on your bladder.
How is fetal station measured?
Fetal station is generally described in numbers ranging from -3 to +3. The negative numbers are relative to the top part of the pelvis. So you may hear -3, -2, or -1 if your baby is still making their way through the pelvic inlet. 0 station is considered “engaged” - which is when the presenting part is engaged at the part of your pelvis called the ischial spine. The positive numbers (+1, +2, +3) are relative to the pelvic outlet, and typically anything past +3 station is not measured because your baby is near crowning or crowning.
What can I do with this information?
Understanding fetal station can help you understand how your baby is internally rotating and getting themselves in a good position for birth based on the unique anatomy of your pelvis. It also may help you understand how you can better adjust your body to give baby the most space within the pelvis to move as they need to. If you have been laboring for a while and your baby is still at a -3 or -2 station, you may want to try some positioning that will open the pelvic inlet and give baby adequate space to move down a bit farther. Deep, supported squats with the help of your partner or doula, pelvic tilts on a birth ball, or lying down in “flying cowgirl” position, which includes tucking your hips forward while your knees are bent and a peanut ball is placed between your legs.
If your baby is engaged (at 0 station) and you are 10 centimeters and 100% effaced, your provider may consider you “complete” and say you are able to start pushing. If you don’t have an epidural, you may or may not be feeling the urge to push at this point. Another option to pushing now is to choose what is called “laboring down” - sometimes called “passive descent” - where you delay actively pushing to allow your contractions to push your baby lower and lower into the pelvis, so that when you start to push, your baby has a shorter distance to travel down the birth canal. Typically good positions for laboring down are upright so that you can use gravity to your advantage. There are many different upright positions you can even utilize with an epidural, such as throne position (sitting with legs lowered on the bottom half of the bed), squatting using a squat bar, and if you don’t have an epidural of course standing or sitting on a birth ball, toilet or stool may help.
If your baby is at +1, +2 or +3, they are on their way down and out! It’s important to get into whatever pushing position is most comfortable for you, but positions that open the pelvic outlet may be especially helpful at this stage. Things like hinge squatting with your knees rotated inward and ankles facing out, lying down with a peanut ball between your shins, or side-lying while a partner or doula helps hold one leg up and slightly internally rotated. If you are still laboring down at this point and not actively pushing, these positions may still help you.
Fetal station is just as important as dilation and effacement when it comes to knowing how effectively baby is moving down through the pelvis descending towards birth! Labor is intricate with a lot of moving parts, but understanding how these three things are measured and assessed by your care provider can help you better understand how your baby and your body are working together.