confused about pushing on hands and knees

[neveryoumindthere]

if laying on your back during labour/pushing is the worst position because of going against gravity, i cant picture why pushing on hands and knees is any better

besides getting baby in a better position especially for back labour, isnt it still going against gravity during the pushing stage?

maybe i'm not picturing it right??

can someone explain this to me?
thanks

[Ruthla]

Well, on your hands and knees, you can pivot your hips as needed for optimal positioning/comfort, which you can't do when you're flat on your back. Also, you're free to scoot your tush down closer to your feet, which would be working with gravity.

I'm not sure about the shape of the pelvis, but it might have something to do with that as well- hands and knees is more equivilent to "lying on your stomach" (which you can't do 9m pg anyway) than "lying on your back" and that might affect the way the baby comes out as well.

My 3rd baby was born with me kneeling on the floor, holding the foot of the bed for support- hands and knees didn't "feel right" for me at that moment anyway.

[lilysmom]

I understand what you mean. But, like the last poster said you can bend your legs down into a sort of squat, and you are much more free to pivot your hips as needed.

I had my first sitting up sort of in the bed and believe me hands and knees was was better, in my experience any way. I pushed for 3 hours w/ my first and only about 20 minutes w/ my second. Although, other factors could play into that as well.

With my second, I did'nt necessaarily plan to be on my hands and knees, but once I got in that position, I did'nt want to move. I think that the fact that your stomach kind of hangs down helped me with the pressure. Although,
I do not know if I will be in that position w/ my next , I kind of felt out of touch, since I could not really see the baby come out at all.

[Doodlebugsmom]

I did a hands and knees position for both of my births. It was the only way I felt comfortable. True, I guess I didn't have the gravity helping that I would've had in a standing or squatting position. I feel like I couldn't have done it any other way though. I pushed for about 20 minutes with each birth, so I never really felt the need to let gravity help anyway.

[veggiekicks]

Although this doesn't have anything to do with gravity (as far as getting baby out), when you're pushing on your back, the baby's weight is pressing on the vena cava (your main vein that delivers blood from your lower body to your heart). This can cause a drop in mama's blood pressure, thus a drop in the blood going to baby.

Another reason, as other posters said is that being in hands and knees allows for more flexibility of the pelvis, specifically the sacrum/coccyx (tailbone) which can move slightly out, making more room as baby comes down.

[party_of_seven]

Being on your hands and knees can also slow things down a little...which is sometimes a good thing. Sometimes that pushing stage goes so fast, and you need more time to let the tissues stretch. The position also lets your tailbone move out of the way so that the baby can decend. From the hands and knees position you can also get more upright in a squat sort of position....so the mom can have much more control over the decent of the baby.

Hands and knees is 100 times better than being on your back for so many reasons.

[wasabi]

While I do agree that hands and knees is better than on your back having done both I do agree that no gravity comes into play. Somehow I hadn't really gotten that in my head and so when I was actually pushing in H&K it dawned on me that gravity still wasn't helping me. It was slower pushing than on my back though. If I have another baby I'll probably do squatting (possibly on a birth stool) rather than H&K because it didn't really work as well as I expected though with my back labor it felt much better than side lying which we tried for about half a contraction.

[mwherbs]

any position can be worth a try

there are many parts of the body that gravity acts on so if you are upright and gravity is acting on a baby's body in such a way that he/she does not have the strength or freedom to move easily out of or into a position a bit of movement on mom's part can assist I have seen several babies just swing to back anterior with mom in H+K . Also if you look at a contracting uterus it stands out from the body in a similar way that a uterus can hang during hands and knees
I have also felt during the births of 2 of my own children one in which I went from lying to hands and knees to kneeling where i was sitting on my haunches with baby #4 I gave birth in a squat when in a squat and the baby was fully crowned and not moving back, I thought for a second maybe I should move into hands and knees and when I started to move into that position I felt that baby lift off the perineum and decided no I did not want to do all that work to get him down there again so rocked back into the squat. But what I felt was his shoulder and body move more into the open space of my belly/uterus that is not bounded by bony structure maybe even just that slight move was all the help he needed to be born in the next contraction.
I guess what I am saying is if it is working for you then do it and if it isn't serving you then don't. each position has its uses and may be one of the key ones to help a baby be born, I think that it is important to go into labor with a mind set/resolve that you will do and can do anything it takes to birth your baby safely- in water out of water, standing, sitting, squatting , laying, hanging on a swing, on the toilet, leaning into someone or alone, kneeling, dancing, hands and knees ....

[AugustLia23]

Personally, once pushing his head out, hands and knees position was too overwhelming for me. The birthing stool also wasn't great for me. As much as I thought I would birth more upright, I delivered DS on my back in a mostly reclining position, it was the MOST comfortable position and the most effective way for me to get his head out, feeling all the sensations I was feeling.

[PatchyMama]

I delivered willow on hands and knees... well i was on my knees leaning on my birth ball... but i wasnt really vertical at all. My midwife had suggested it because we were conscerned dd was a big baby and she said she had great luck with big babies coming out easier that way. DD was only 8lbs 6 ounces... but i definately found that position most comfortable and i only pushed for maybe 10-15 minutes total

[Undercover Hippie]

I delivered my DD on hands and knees, actually I was on my knees with my arms and head resting on the edge of the bed so it was still a very horizontal position. A lot of what was said here resonates me. I think the two reasons I liked it were because: 1) my DD was big (9 lbs. 1 oz.) and I could really open up in that position; and 2) because my pushing stage was very fast. I tried to push first in a standing/supported squat position and I couldn't even do it through one contraction--it was excruciating. I guess I didn't need gravity to bring her down, I needed gravity working against her a bit to slow her down. So definitely, each position has its uses and IME if you are in an environment where you can comfortably move into whatever position you want, then you will be able to listen to your body and get into the right position for you.

[MrsMoe]

I would think hands and knees would really save back pain!

[Undercover Hippie]

Originally Posted by MrsMoe

I would think hands and knees would really save back pain!

I was having some back labor with DD, that's probably one of the reasons H&K felt right! Not sure if it relieved the pain but it was an easy position for my doula to apply counter pressue in! :LOL

[cottonwood]

Well, gravity isn't helping in hands-and-knees, this is true, but at least you're not working *against* gravity -- in a reclining position, the baby's head actually has to make its way *upward*.

Also, being in a hands-and-knees position allows for a swift and fluid change to kneeling (and back and forth if need be) a position which allows the pelvis to float and in which gravity does help.