DESCRIPTION OF TOPIC:
Occiput posterior position (OP) of the fetal head affects 5–13% of births and is associated with increased maternal and neonatal adverse outcomes. This condition results from the failure of spontaneous rotation of the fetal occiput to an anterior position, typically expected during the first. Various maternal postures, such as lateral recumbent and hands-and-knees, have been evaluated in clinical trials to promote anterior rotation, but results have been largely inconclusive, often due to limitations in the study’s methodology. Recently, the forward-leaning inversion, side-lying release, and the Rebozo technique have gained popularity in clinical settings. These techniques optimize fetal positioning by releasing uterine ligaments and relaxing pelvic floor muscles through specific maternal movements and positions. Despite growing clinical use, robust evidence from controlled studies is lacking. To address this gap, we designed the ReMaP-POPP (Rebozo and Maternal Procedures to reduce Persistent Occiput Posterior Position) trial—a randomized, controlled, open-label, single-center study. Women in active labor (3–8 cm), with a term singleton fetus in OP position confirmed by ultrasound, will be randomized to: an intervention group receiving a structured sequence of postures and Rebozo technique; or a control group receiving standard care postures. The primary outcome is the presence of OP position at 3.5 hours after randomization, assessed sonographically by a blinded assessor.

RELEVANCE TO MIDWIFERY:
This research supports midwifery-led and personalized care by evaluating a safe, low-cost, and accessible intervention to promote optimal fetal positioning. Its non-invasive nature allows for easy implementation across all settings, thereby contributing to the reduction of health inequalities. By encouraging normal birth and reducing the need for interventions, this approach improves maternal and neonatal outcomes in both the short and long term. It empowers midwives with evidence-based, practical tools that enhance autonomy and support equity-driven maternity care on a global scale. Physiological - labor progress (including three-minute presentation competition)