birth positions

[tibdoml]

I was reading other threads, and they mentioned that on your back is not good.
This is how DS 1 was born w/o too much trouble - he was upside down. Took about an hour of pushing alternating between back and squatting w/ squat bar on the bed.
I guess I did not think about birthing positions... now I feel really unprepared!!
I intend to labor @ home as long as possible.
What are better birthing positions?

[Graceoc]

I birthed dd out on my hands and knees and could not imagine pushing her out any other way.....There was NO WAY I was laying on my back or even sitting for that matter - I had ALOT of back pressure which my doula and DH countered pressured.....Oh I was also in the birth tub....

I had an epi with ds and pushed on the bed with the bar....but didn't feel anything. He came out after about 40 minutes, so I don't know if it were good or bad....

[cottonwood]

Pushing on your back (or in a reclining position) is bad because 1) it compresses the main blood vessel that supplies blood to the uterus and 2) it prevents the pelvis from opening to its maximum volume.

In an instinctive unhindered birth (where the mother is not unhibited and not being told what to do) the mother will spontaneously get into an upright position, squatting (if she happens to come from a culture in which women spend a lot of time squatting,) or kneeling.

[JeanetteL]

In an instinctive unhindered birth (where the mother is not unhibited and not being told what to do) the mother will spontaneously get into an upright position, squatting (if she happens to come from a culture in which women spend a lot of time squatting,) or kneeling.

Blueviolet,
You know I'm a big fan of yours and read every post I see from you trying to soak up little bits of your wisdom here and there but I just wanted to note that although I didn't have a 'instinctive unhindered' birth (in that I did have a midwife present), I really don't believe that I would have instinctively gotten into an upright position even if I had. They had me try squatting, and I felt all along most comfortable and natural semi-reclining in the water. Hands and knees hurt like hell (BAD back labour), squatting took way to much energy to maintain and I wanted to lie back and float in the water. This is where my pushing felt good and right - and not externally guided. All through my labour, I leaned back instinctively. It struck me as strange even then, because in all my pre-birth visualizations, I spontaneously imagined myself squatting.

I guess there is no way to tell if the same would have been true if I had chosen UC, but my gut tells me I was where i needed to be.

I guess this should be a whole different thread question - but I'd love to discuss this more. I'm working as a doula now, and in hospital births most women I have helped have to be coaxed to try anything other than lying in bed once they are in serious labour-land. Do you think this is because the cultural image of women labouring in bed is so ingrained in our minds?

[cottonwood]

"I'm working as a doula now, and in hospital births most women I have helped have to be coaxed to try anything other than lying in bed once they are in serious labour-land. Do you think this is because the cultural image of women labouring in bed is so ingrained in our minds?"

That may be part of it. But I think it is also just that when people hire others to guide them (and this applies to anything, not just birth,) they tend to lose the ability to tune into their instincts, and also lose a certain motivation, so that they feel almost paralyzed -- no urge or energy to act -- and even more so perhaps in birth, when the person this is happening to is exhausted and in pain, and unaided by the adrenaline that naturally rushes through the body right before birth when the hormonal process is undisturbed. (Which very much describes how it was with my first two births.)

I suspect waterbirth perhaps is a different situation but I don't have time to speculate on that and your experience right now because my kids just woke up and are calling me to bed!

[tinyshoes]

Originally posted by JeanetteL
... I wanted to lie back and float in the water. This is where my pushing felt good and right - and not externally guided. All through my labour, I leaned back instinctively.

Maybe I'm not imaging your position properly, but it sounds kinda upright to me, *espeically* when compared to the old fashioned lithotomy or 'modern' pull-back-on-your-knees-chin-to-your-chest style you see in hosptial births, which are they ways women are told to push out their babies.

The pull-back-on-your-knees-chin-to-your-chest position acutally elevates the pelvis so that mom's pushing uphill and on her back. Fun. Effective.

blueviolet, I think you're right on the money with the statement that mamas will birth upright when they're unfettered and not bothered.

Anyway, I just felt like chiming in and saying that maybe you were 'upright' and unhindered, in your own way, JeanetteL, even if you weren't a demonstrating Textbook Squat or whatever.

[JeanetteL]

Hey Tinyshoes (another one of my favorite posters)

No, I was pretty much semi-reclined. Used the sides of the pool to brace my legs against. I was just in a fishie pool instead of a hospital bed

I do hope to be more "unfettered and not bothered" next time - and I hope that , just by virture of going at it for a second time, I will be. My midwife and I have also got a whole bunch of chatting to do beforehand

Jeanette

[ldsapmom]

Well, back to the original topic -- I birthed my first lying on my back in a hospital bed, I guess that is what I thought you did. My second I was in a side-lying, modified squat. He was posterior, but I di not have back labor, I had front labor. I could not sit in any position, even in the tub I had to be on my side.

I think if you go with what feels good, you will be fine. If you are hurting or really uncomfortable (okay, it is labor, you are going to be uncomfortable!) it is your body;s way of telling you you should move to another position. Don't get hung up on not knowing the right positions, or feeling like you need to learn more -- be aware of your position-options, and keep trying one until it fits.

You will do just fine -- listen to your body and things will work out.

[JeanetteL]

Very good advice indeed Stacie!

[norasmom]

I birthed in a squat position in a hospital bed with squat bar. I did have assistance getting into that position, ie: I didn't pull myself up. It must have helped because only 15 minutes after I started pushing I had my baby girl in my arms! Now whenever I see those silly birth shows on TV I get mad at the doctors for putting the moms on their backs. Why push the baby uphill and out? Someday they'll learn...but I'm not holding my breath!

[lorijds]

As I attend more and more births, I find that many women do indeed, at some point, like to be on their back, in a semi reclining position.

I think key to remember is that, in the few hospital births that I have seen, the mom pushed in the same position the entire time she was pushing.

In contrast, our moms, unless their second stage consists of only one or two pushes, usually are very mobile during pushing. They assume a new position on average every half hour. Every hour or so, we encourage them to walk to the bathroom, stay there for three contractions, and then come back and try a different position for pushing.

I think the changing of positions is at least as important as the position itself. The movements involved in changing position encourages the baby to move, the pelvis to open, and minimizes the disadvantages of any position. For example, on a squat stool your bum and labia can swell, especially if you are short, and your legs can fall asleep. On hands and knees, your arms can get weak and your knees can hurt. But if you are up moving around, these things usually don't occur.

Oh, and we don't MAKE anyone assume a new position. but we usually encourage them to get up, stretch their legs, and then say something like "Do you want to try the squat stool, or hands and knees?" If mom says, no, I think I'll go back the the bed on my side" that is fine; we try to get her on her other side, just for a change, but we let her choose. Prenatally we talk about the importance of movement during all aspects of labor, not just the first stage, and so moms are prepared for this.

Just wanted to throw that out there!

Lori

[momnloveit]

The position I found myself in for most of my labor was on my knees, on the bed, hunched over a pile of pillows. Occasionally, I would change from this to the "stink-bug" position with my bum in the air. Even when I got in the tub, I felt most comfortable kneeling while resting my arms and head on a ledge with a towel on it. My main regret of my waterbirth was when my MW said, you told me you want to catch, so you should sit back to push. It was awful, and I felt stuck there. THe tub was molded in the shape of a chair-like thing and having the hard tub against my bottom while I pushed was awful! Next time I will definitely do what's comfortable and if that means I don't catch, so be it!

[TinyBabyBean]

With baby 4 I alternated between being on my knees and squatting in the water. I think I was actually on my knees with my rear near the bottom of the tub when she was finally born. This is the first birth I did squatting with and I found this to be the easiest birth. Oh, first waterbirth too. Second totally unassisted birth. I was actually all by myself when she was born although my hubby was there through labor- he just happened to be out of the bathroom.

[sarahwebb]

the exception

Hi there,

Just wanted to chime in as one of the few women who needed to birth on her back with knees pushed up...

I had a midwife attended homebirth with a doula and another friend who had birthed at home attending. I pushed for 4-6 hours...none of us can really remember, but it was a long time. I walked, I squatted, I got on all fours, I sat on the toilet, in the tub...you name it, I did it.

Finally, my midwife said I should try being on my back with dear husband and favorite aunt holding my feet and legs way up towards my chest. Midwife said even though it was counter to all natural birth wisdom, sometimes it was the only thing that would work for some women. Sure enough, my pushes became effective and my son was born soon after.

I agree that this position is not the best for most women, but with everything, there is are exceptions. Just as you shouldn't be afraid to try alternative positions, you shouldn't be afraid to try the one everyone criticizes if it feels right for you.

Best,
Sarah

[lizabird]

I labored upright until 8 cm (sitting, standing, walking around...) and then got into the tub and had the baby there. My first push in the tub was squatting, but then I sort of leaned back to relax, floating on my back or side. I pushed the baby out on my back and holding my knees way up, but in the water, there was no pressure on any nerves, and it all went really fast!

FWIW...

[stafl]

I was only in labor a few hours, only pushed for 15 minutes, and changed positions probably between every one or two rushes.
What worked best for me was to be semi-seated on the bed, hanging from DH's arm as if he were a tree.
As the baby's head crowned, I let go of DH and put both hands down there to help support my labia and feel the head come out.
So as DD2 was born, I was sitting/laying on my back supported by pillows. My legs were just spread wide, I never pulled my knees up.
I think what matters most is that you move around, and do what feels right to you.

[majazama]

I had a lot of problems with the midwife that I had for my daughter's birth. I laboured for hours in a pool, and was quite happy there. I just floated around, sometimes hanging on the side, sometimes leaning back. As soon as she arrived, she asked me to get out of the pool and lay on the couch so that she could check me.

I ended up having the baby there, and I got some tears. I wanted to standup, or squat, or get back in the pool, but she said the baby would come too fast. : I think I know my body better than her.

So what I say is to go by your instincts! And if someone is trying to make you have your baby a way that you don't feel comfortable, move. If I had had my baby "my way" I don't think I would have teared at all. Being semi-reclined was not the best position for me.

[Lisalee2]

With ds, I tried pushing on all fours and wasn't feeling much progress so my midwife asked if I wanted to squat. I did and ds descended much quicker and was born a couple minutes after.

With dd, I was using the birth tub and gave birth in a semi-squat I was leaning my arms over the edge but still had my legs squatted.

I think that as long as you are able to try different positions during the birth, you can't go wrong. Just do whatever makes you comfortable and gets that babe into your arms!

[onlyboys]

For my last (and certainly easiest baby), I was standing next to the bed with one foot on the bed. My midwife (a CNM, I'm not a canididate for a home or birth center birth) said when I was complete, "So, how do you want to do this?" I could not even imagine lying down (ever again in my life) and so I said, "Right here, right like this." They piled up towels and blankets on the floor below me. And, I pushed.

Once my son's head was out, I had a shoudler dystocia. He wasn't budging with my little pushes. The midwife told me, "This is a very important push," and I pushed and screamed (this helped) and he was OUT!

Later, the midwife told me that pushing on my back would have been terrible, and somehow my body knew this. He was considerably bigger than my first two boys (by more than a lb and and inch) and while I felt fine birthing them in bed semi-reclining, I don't think that the result would have been as pleasant for me had I been in bed.


Amanda