The Miles Circuit is a specific sequence of three positions and movements designed to encourage the baby into an optimal position for labor and delivery. This non-invasive method is commonly introduced in late pregnancy or during labor to address fetal positioning challenges that may contribute to a difficult or prolonged birth experience. The ultimate goal of the circuit is to provide space and balance within the pelvis, allowing the fetus to settle into the most favorable orientation for passage through the birth canal. Developed by doula Megan Miles, this set of movements offers a practical, physical approach to support the natural progression of birth.
Optimizing Fetal Position
The primary purpose of the Miles Circuit is to encourage the fetus to rotate into the Left Occiput Anterior (LOA) position, which is widely considered the ideal presentation for a vaginal birth. In this optimal alignment, the baby is head-down, facing the mother’s spine, with the back of the baby’s head positioned slightly toward the mother’s left hip. This orientation allows the smallest diameter of the fetal head to engage with the pelvic inlet, facilitating a smoother descent and rotation.
Many labor issues are associated with fetal malposition, most commonly the Occiput Posterior (OP) position, where the baby faces the mother’s abdomen, often referred to as “sunny side up.” This posterior presentation can result in intense “back labor” and may cause labor to stall because the larger part of the fetal head attempts to navigate the pelvis. The circuit uses gravity and specific pelvic stretches to temporarily lift the baby out of the pelvis, giving them room to turn. The sequential movements then encourage the head to descend in a more favorable alignment by releasing tension in uterine ligaments and soft tissues surrounding the pelvis.
Performing the Miles Circuit Sequence
The circuit is composed of three distinct positions, each held for a sustained period to maximize the effect on the uterine muscles and pelvic alignment. The first step involves the Open-Knee Chest position, which uses a gravity-assisted inversion to gently shift the baby up and off the cervix. To perform this, the individual starts on hands and knees, then drops the chest to the floor or bed while keeping the hips raised high, similar to an exaggerated Child’s Pose in yoga. The knees should be positioned wider than the hips to create space, and this resting inversion is held for 30 minutes.
The second step is the Exaggerated Side-Lying Release, which focuses on balancing the soft tissues and ligaments of the uterus and pelvis. The individual rolls onto their side, typically the left side first, and props themselves with pillows for support. The bottom leg remains straight, and the top leg is brought up high, supported by pillows, with the knee angled toward the chest. This exaggerated position creates an asymmetry that helps lengthen and relax the soft tissues on one side of the pelvis, and this pose is held for 30 minutes.
The final step requires upright, asymmetrical movement to encourage the newly positioned baby to descend and engage fully into the pelvis. This movement can be achieved through activities like curb walking (where one foot is on the sidewalk and the other is in the street) or by walking up stairs sideways. Alternatively, individuals can perform side lunges while holding onto a stable support. The asymmetrical nature of these movements actively opens the pelvic outlet on one side, allowing the fetal head to negotiate the final turns into the birth canal. This active phase should be continued for 30 minutes to complete the full circuit.
Recommended Timing and Frequency
The Miles Circuit is often recommended to begin around 37 weeks of pregnancy to help encourage optimal positioning before the onset of labor. Individuals new to the circuit may start with shorter periods, such as 10 minutes in each of the three positions, and gradually increase the duration until they can comfortably complete the full 90-minute sequence. Consistency is often prioritized over immediate perfection, meaning performing the circuit a few times a week can still be beneficial for pelvic balance.
During labor, the circuit is frequently employed if contractions slow down, labor progress stalls, or the mother experiences significant back pain, which can indicate a posterior-positioned baby. The full circuit is designed to be performed through contractions, encouraging the fetus to rotate and descend more efficiently. It is advised to empty the bladder and ensure adequate hydration before starting the sequence, especially since the first two positions are sustained for a long duration. Anyone considering the Miles Circuit should first consult with a healthcare provider, such as a midwife or physician, to ensure it is appropriate for their specific circumstances.