Watch any birthing scene in a movie or tv and women are laying on their backs. With 68% of all Americans labouring this way it certainly is common. However, just because something is common doesn’t mean it is evidence based or beneficial to the birthing person. There are many benefits to mother and baby by moving off the bed and into an upright birthing position.
Why are we on our backs?
It started with a King wanting to watch his mistress birth as a perversion, but the trend really took off when royals began using pain medications during birth. Doctors were needed to monitor the drug’s side effects. More and more women were birthing with a doctor to access pain medication and turning away from female midwifes. The Doctor wanted easier access for THEMSELVES, combined with the inability to move or interventions being required with the pain medications. Women moved out of the upright birthing positions they had been instinctively moving into since the dawn of time and onto their backs.
What’s wrong with being on our backs?
Think about how we poo. Would laying on your back be a comfortable or easy position for you? Would it cause you to strain and push harder from being in this position? Now think of baby, being pushed up hill through the birth canal - no wonder it leaves women red faced and strained. Unlike a poo however, babies’ weight can lead to reduced blood flow and oxygen to both the baby and the uterus. Lack of oxygen can put baby into distress and have the uterus work less effectively. The same as if we don’t get oxygen to our muscles when running. Most women are told to avoid being on their backs during pregnancy for this reason. Back laying can also press on the tailbone, reducing its ability to create space within the pelvis for baby to descend.
In addition to the physical aspect, back positions tell birthing women to ignore their instincts and leave them exposed to others. This may leave mum feeling disempowered.
Benefits of Upright Birthing Positions
*Gravity aids baby’s decent
*Increase space in the pelvis by up to 30%
*Decrease in the need for medical assistance such as vacuum, forceps or episiotomy (up to 21%)
*Baby is less likely to become distressed
*Pushing phase is generally shorter
*Reduced need for epidural & caesareans
Allows baby to work with gravity and take pressure off the back. Birthing person can stand alone, against a wall or against their partner. The position allows for full access to the belly and back for massage, heat packs or water use (such as in the shower)
Squatting can help to open the pelvis and shorten the birth canal. A partner can support the birthing person under the arms to take some pressure off the legs if needed as this position can easily become tiring.
Hands and Knees
This position involves being on all fours on the floor. Variations can include arms resting on bed, ball or partner. It takes pressure off the spine and may help babies oxygen levels.
Sitting allows the mother to remain upright but rest arms and legs. It can be done on a birthing stool for access during birthing phase or on a ball to allow for hip movement.
Is great for when a rest is needed, or an epidural is used. It takes the pressure off the spine and can be used with a peanut ball. For birthing, the partner, mother or medical team can support the upper leg.
Ultimately, go into a position that just feels right to you. Your body knows what to do when given the opportunity! Partners can encourage this by placing a bag on the bed and knowing some of the above positions to suggest. The medical team is capable and WILL adapt to any position you choose to birth in.
Get me out: A History of Childbirth from the Garden of Eden to the Sperm Bank by Randi Hutter Epstein