Friday, June 8, 2012

What's Your Favorite Position?

After my last post, I was asked to elaborate on why you should not give birth on your back, and to provide more information on better birthing positions. That is what this post will be about!

So as I mentioned in that last blog, birthing on your back is just not a good idea. I will say, some women are comfortable giving birth on their backs, and they feel in labor that it is the best position to be in. To that, I say more power to you! The point I want to make here is that there are much easier, more comfortable, and more ergonomic positions to be in; but by all means when you are in labor please do what is most comfortable for you. It is different for everyone, and hospitals requiring one position for all women is absurd.

So, let's look at why giving birth on your back can be so problematic.

1. For some reason, we picture our birth canal as being a straight line. While there are some positions that make the birth canal straighter, it isn't necessarily a straight line. When you are on your back with your feet in the air, it is far from being straight. It actually begins to resemble a "J". Because of this, you will end up having to push against gravity. When your baby nears the end of the birth canal, you will have to start pushing him uphill, just like the crook of the "J" if it were laying on its side. This picture shows a woman on her back giving birth, but is rotated to show the "J" effect.

2. When you lay on your back, you are putting pressure on your tail bone, which can close your pelvis slightly, as can putting your legs in the air, which folds your pelvis forward. Try it; lay flat on your back and put your feet in the air. It may make more sense if you actually feel it. If you aren't pregnant, imagine how uncomfortable it would be with that round baby belly, to boot. These things combined can close your pelvis up to 30%, making you and your baby have to work much harder to make it around your pelvic bones. This can also raise the risk of shoulder dystocia with your baby; a pretty serious complication in which the child's shoulder gets stuck behind the pubic bone. I won't go too much into that on this post (I will write a separate blog on labor complications if I see enough interest in one) but PLEASE look into it and know your options. Do NOT let your doctor pull on or twist the baby's head, EVER. Simply shifting your position will often free the shoulder and allow your baby to continue his decent. Discuss your options with your doctor, and ask how he or she typically deals with shoulder dystocia when if and when it becomes an issue. (It isn't extremely common, but it is always good to know your options.)

3. If you have been pregnant or you are pregnant now, you know that you are not supposed to lie on your back after the first trimester. The weight of the baby puts pressure on your nerves and arteries, and can slow your and your baby's heart rates. So why is it that it is all of the sudden okay in labor? Studies have shown that laying on your back in labor can reduce the baby's heart rate, and slow contractions due to a lack of oxygen flow to your uterus and your baby. This can lead to emergency interventions that in many cases could have been avoided. This is especially the case when you think of just how many factors begin to work against you; your pelvis is closed so you are pushing harder, but you have your feet in the air and you are having to push uphill. The pushing phase in this position can take a long time, meaning higher odds for slowing that baby's heart rate from being on your back for an extended period of time. Then all of the sudden, the doctors are telling you that you NEED to get the baby out because it's heart rate is dropping, which is every mothers nightmare while she is in labor.  (Scary example, I know. But it happens all too often.)

So, laying on your back can make labor last longer and be more uncomfortable, and it can lower the oxygen supply to your uterus and your baby which weakens contractions and can slow heart rates. Why is that our standard birthing position in hospitals??

Here are some birthing positions that are much better for mom and baby during labor:

1. Squatting: Many pregnant women know the squat pretty well; it is a great exercise in pregnancy and is recommended by most doctors and midwives alike. During labor, it not only opens your pelvis up an extra 15-20%, but it also can shorten the length of your birth canal, speeding up your birthing time. (Hooray!)

2. Hands and Knees: I couldn't handle this position in labor, only because I was just too exhausted to hold myself up. Many women swear by it, though. It also opens your pelvis wide to help the baby move down, and puts gravity on your side as it faces that "J" curve downward. This is another position that most pregnant women will know from their pregnancy exercises; cat/cow, anyone?

3. Standing/Squatting on a Birthing Stool: This is how I had my son! I know everyone is different in labor, but this was the ticket for me. I tried several different positions, I even tried laying on my back (which lasted all of 1.5 minutes, I hated it!) but the second my midwife suggested the birthing stool, all systems were go. It was so much more comfortable than the other positions I had tried, and I could tell that gravity was helping me out. I was able to sit and relax my body between pushes. I also felt like I had full control of my abdomen and uterine muscles while I was pushing; something that was severely lacking while I was on my back.

4. Birthing Tub/Pool: Again, this is one of those that didn't work for me, but oh how I wish it had! Everyone has seen the photos or heard the stories about how beautiful water births can be. The only reason I didn't like it was because I really needed to feel grounded, but even us big pregnant ladies float in a pool. The reason I didn't like it is the reason most women love it, though. Because our bodies are buoyant and float, the water takes a good amount of the weight off of our muscles and joints. Women who do enjoy the pool say that the water is a great pain reliever; I have even heard that it works better than an epidural for some women who have experienced both. You also have the freedom of movement; you can just sway in the warm water, sit on your hands and knees, squat, or recline. And trust me, it is better to move around than to sit still for too long.

I know most of us as women have been taught to be modest, and in some cases we even feel shameful of our bodies, which is extremely unfortunate. Reading these suggestions may make some women uncomfortable and worry about looking funny or strange while they are in labor. Believe me- when you are in your birthing time, you aren't going to give a rats ass what you look like, but to everyone around you, you will look like a goddess.

I hope this helps to any of you preggo ladies looking for advice, or to those who aren't pregnant yet and are just trying to get their fill of information beforehand (good for you!! Empower yourself with baby-birthin' know-how!).

If you have any questions or requests for a blog topic, or you just want more information, please don't hesitate to ask. I don't know everything, but I have learned a lot on my quest for information. If I don't know, I can find out for you! Thank you to my readers! Your support means the world to me.

Stay informed!

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