Labour of love: Birthing positions

In the movies, we usually only ever see women giving birth on their back … and then a baby pops out, completely clean and without looking like a raisin. So we can assume movies aren’t to be relied on, which is why pregnant women should know there are a range of birthing positions to choose from, including lying down or standing up. Your labour position won’t affect your baby’s health or the length of the labour. Unless your doctor says you require a specific position, it’s your choice, so get comfortable.

Standing, and lying, ovations

Evidence suggests that no one birthing position is generally considered to have all the benefits. Some professionals feel upright positions are better, as they encourage good alignment of the baby’s head, improve blood flow, aid contractions and reduce pain. However, it is thought that they may increase the risk of perineal (between the vagina and anus) tears and increase maternal blood loss. It’s give and take.

Upright positions include standing, leaning against something, sitting in a birthing chair, or squatting. Non-upright positions include lying on the back or one side, or kneeling on all fours.

It is important to realise that labour occurs in three stages, and the best position may change depending on the stage of labour.

Stage 1: Finding the sweet spot

The first stage of labour begins with contractions that (dilate) open the cervix and prepare it for the delivery. For this stage, a range of upright or non-upright positions can be used. Women often walk around a bit during this time, so upright positions are very common. Often, women may make small position changes to help relieve pain, such as shifting their weight between their feet and gently rocking.

Having the ability to move around and find positions that reduce your pain can also give you a sense of control and relieve a bit of that stress. While there is limited evidence about the effect of any position on the delivery, available evidence suggests that maintaining an upright position in the first stage of labour may reduce the length of the first stage by about one hour, and may make the woman less likely to need an epidural.

But non-upright positions may also be used in the first stage of labour. Kneeling on all fours for at least half an hour is thought to reduce pain, so it’s up to you to decide where you are most at ease.

In this stage of labour, lying on your back is not recommended because it reduces oxygen supply to the foetus and abdomen, and can impair contractions.

And don’t forget about the water. In some cases, women find that immersing themselves in water (e.g. in a bath) in the first stage of labour reduces pain.

Stage 2: Down the waterslide

The second stage of labour is when you need to push your baby out, as your cervix is adequately dilated and ready to rock. During this stage, upright positions have traditionally been used, but professionals find it easier to check the progress of both mum and bub if you’re lying down. That’s why lying down has become the norm in most hospitals.

It’s still your choice, though, and it doesn’t affect health outcomes for you or your newborn, so read up on what your options are.

Regardless of the position you choose, it’s advised that when you’re baby is hurtling down the waterslide, you should try to round your back and tuck in your chin in to increase the effect of pushing. Legs should be widely spread and the hips flexed, and you can use support from pillows, furniture or even attendants at this stage of labour. So grab onto whoever’s close and push!

It’s raining babies

By now, you’ve reached your third stage of labour, where you have delivered your baby and the placenta is on the way out.

Whatever way you choose to birth your baby, be informed about your choices because you don’t have to ‘just take it lying down’. You can change and shift as you please, and you don’t have to stick to one spot. Remember, it won’t affect you or baby’s health. So go get as many pillows, positions – and, possibly, curse words – as you need to feel empowered.

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