Tuesday, February 24, 2015

Birthing Positions

Initially, I was going to include more about vaginal births in this one, but I found that I had a lot of material regarding birth positions, so I will cover vaginal births in my next post.

We are all familiar with the typical Hollywood birthing scene- ya know, where the mom is on her back and her feet are in stirrups:

A lot of times they are screaming, sweating, and appear to be in a LOT of pain. Well, there may be some of that if you choose to birth this way, but I have found that many women, including myself, don't really feel a ton of pain in this position because it is likely the only position you are allowed to be in with an epidural.  I will add that I'm sure there are some women who probably had a doctor say they could stand up with an epidural, because there's always exceptions, but really, sitting or laying down is safest when you're numb from waist down. 

Sitting semi-upright with your feet/legs in a mid-air squat (assisted by stirrups, your birthing partner, or nurses) is probably the most common position and it is out of convenience- mom gets to rest, doctor gets a very clear picture. Here's me after a few hours with my epidural during the birth of my son:

Pain-free gets a thumbs up.  Getting ready to push a baby out soon!
Many women have successful births in this position, but for those like me, it wasn't so much the birth that was rough (though there were several complications with that), it was definitely the recovery.  Because I had to be in this position, I wasn't really able to help my son with gravity and he was basically stuck for the 3+ hours I pushed for, which then led to a number of interventions.  I felt quite broken after delivery and recovery was worse because of how long it took for me to heal. With my daughter, I was able to move around more- walking, sitting in different positions, hanging out in the water for bit, and bouncing on an exercise ball.

So this leads me to share with you about other birthing positions that are available.  Some women go completely medication-free, others find that they would rather labor without medications first to help facilitate the position and then get some pain relief (as long as they didn't wait too long). I like this infographic both for the positions and the fact that the colors are aesthetically-pleasing:

Let's discuss these positions and how they can help:

Squatting- you can squat with a partner from behind, using furniture in the room, or some hospitals even have "squat bars" that provide stable support. Gravity is your friend here! This position really opens up your pelvis by aligning your birth canal with the pelvis.  Contractions are potentially more productive in this position too.  However, this position can be extremely tiring.  If you're like me, your legs may begin to feel jelly-like during labor so take fatigue into consideration. 

Sitting- chairs, beds, straddling chairs, on yoga balls (birthing balls. whatevs, they're just yoga balls), and the toilet (yes, seriously!) are all places that are good laboring seats.  This position is nice because you can rock your pelvis side to side or forward and back, utilizing gravity still.  This is a good resting position, but also note that when sitting, there can be more pressure on your coccyx (tailbone) and perineum.  I don't want to say that increases the likelihood of tearing or tailbone injury because honestly, those are both risks of vaginal birth no matter the position. Depending on how you are sitting, this can be difficult for your providers to check progress and sometimes can be less than ideal for pushing the baby out (no babies allowed in the toilet).

Kneeling- you can kneel with assistance like a yoga ball, a couple of pillows, on your partner's knees, or against the head of the bed (that's what I did with my daughter).  You can also just be on your hands and knees.  This position is really great for anyone who has back-labor because the pressure is lessened against your low back and contractions have been reported to be a little less painful this way. This is also a good position for somebody to apply counter-pressure against your low back for back-labor.  Kneeling is also another good resting position. This can again be a tricky for your providers if you are kneeling on the ground or sitting on your feet or if you're like me, I couldn't really see what was going on once my daughter was out and it was kind of pain to turn around and still have an umbilical cord attached to me.

Side-Lying- this is another good resting position, especially between contractions, and can also work for mothers who have an epidural if your provider allows it.  However, itt doesn't use gravity like any of the other positions so that is something to consider.  You would need assistance in holding your leg open while pushing though otherwise this would probably feel like the worst pilates move you've ever done.

Standing/Walking- the combination of gravity and being able to move around by swaying while standing or just walking around the room is something that helps facilitate birth for many women.  One way to birth in this position is to hug your partner around the neck (try not to strangle them) and then the provider can catch the baby. Leaning against the wall or supporting yourself on some sturdy furniture are also good options.  This can be a tiring position though if you are pushing for awhile or if your labor has already been long.  

a little more up close and personal than I prefer to share, but this is a good example of what laboring while kneeling looks like and my man applying counter-pressure on my low back (correct, he is not pushing my butt).

Every woman finds something that works best for them.  Like I said earlier, just because you get an epidural doesn't mean you won't have a comfortable birth! The best way to prepare is to just research your options, make a birth plan, and be flexible (flexible with your circumstances, though physical flexibility is always a plus).

Coming up next: Expectations of a Normal Vaginal Birth

*images from health-and-parenting.com and scene from Baby Mama

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