Positions for giving birth
Even very large and important scientific studies have shown how childbirth is strongly influenced by positions taken by the woman. Being able to change position and choose the most suitable one at the moment has solved obstetric problems, as it has helped the resolution of clinical problems that would have become serious and would have involved the use of a caesarean section. It has also changed mothers' perception of pain, its containment and the event of childbirth in general, making it more bearable and more satisfying.
Read also: Childbirth pains. How to try less
Positions for active labor
Active labor can be defined as that moment in which the dilation of the cervix exceeds 4 centimeters. It must be admitted that this definition is purely medical and does not reflect the perception of the woman who is instead involved in a continuous crescendo of painful sensations. In choosing the position to adopt for active labor, a lot of freedom is usually left to the woman. We are talking about physiological parts in which monitoring of the fetal heartbeat and contractions does not need to be performed continuously. Depending on the painful sensation, the position can be varied several times.
Here are some examples:
- It can be useful walk and then choose one standing position during labor
- Or in some moments it is need to rest because you are very tired and hence the location On the side is the optimal one.
As labor progresses, women experiment with various positions from one to carponi (on all fours) leaning on supports or squatting. What I would like to convey as a message is that any position even if not mentioned by me can be fine if it helps the woman to feel better.
Positions to feel less pain
Pain in childbirth is certainly the main component on which positions can affect. I emphasize again that in this article I try to summarize the various positions but each woman will have her favorite experience and position. When labor begins, pain is often felt in the area of the lower abdomen, in the pubic bone to penetrate and is due to dilation of the cervix. In this phase, the positions that can relieve are certainly those that take away pressure and tension in that area and therefore walk, place one of the two legs on a support, the position on the side. They may be some of the best positions for pain relief.
With the progress of labor, however, the pain moves to the back, in the sacrum area, because the baby in its descent towards the birth canal compresses the nerve endings of that area. At this point, the positions that can help are those that release the weight from the lumbar area and therefore certainly the position on all fours (on all fours) even with the help of balls or pillows to lean on.
More natural position for childbirth
In reality, there is no more natural position than others for childbirth. Surely there is the less natural one, even more so if it is imposed. And I am referring to the classic position that we call litotomica, that belly up with the legs on the stirrups so to speak. Let it be clear that if it is necessary to ensure good care or if the mother prefers it too this becomes the best position, but it is certainly the least natural one. To understand what is natural we have to refer a little to the animal world, no animal gives birth on a cot with their legs apart, only us. Some animals remain on all fours, others lie on their side, still others squat and give birth assisting themselves. So I would say that there is a wide range of natural positions for childbirth.
Every woman listening to her body already in pregnancy can be able to understand which position is the most natural for her.
Position to give birth earlier
Can using different positions help give birth faster? Absolutely yes, as labor progresses and supported by the midwife you can choose the position that helps the progression more or that reduces pressure.
Is there a position to give birth quickly?
No, or better there is no one that is the same for all.
- The position that absolutely gives birth first is the one in which the woman feels better to indulge the premise, which is the irrepressible desire to push that comes at the end of labor, during the expulsive period.
- The standing position it exploits the force of gravity and therefore can help the child who is a little struggling to channel into the pelvis to find the right path.
- The same position, but with one leg raised it can help a child who is not perfectly positioned with the head to get into an easier position.
- The position on the hip it can be useful if the labor is very long and both mother and baby are tired to rest a little.
- The crouched position it can help in the final expulsion because the push of the abdominal muscles and the force of gravity help. And so on ... there are many positions that can help speed up the birth but each must be studied on the individual situation and the mother must be accompanied in choosing the right one for her.
Best position for the baby
As for the mother, also for the child there is no equally better position for everyone. Babies are an active part of labor and their cooperation is essential for everything to go well. Clearly while the mother has a lot of range of motion, the baby has much less, being "forced" into a small and hardly modifiable space. You have to imagine having to go with your whole body through a cave with hard and protruding rocks covered with something softer, plants for example. And your only possible movement is to push yourself with your legs. Also, these walls occasionally tighten around you. This is not a good situation, but the child knows why all this happens and therefore he is not traumatized by it.
Sure, sometimes he can get tired and then putting himself on his side helps him because it increases the blood supply to the placenta and therefore to himself. Or sometimes he has a hard time figuring out how to stand and therefore standing upright helps him get off. As well as in the expulsive period, the squatting position helps the child to stretch the tissues and get out earlier.
Most used position
In the face of all we can say about free positions and the advantages they have from the point of view of both the midwife and the mother, today the country still uses the lithotomy position (legs on the stirrups) in greater way. And unfortunately I feel like saying. The reasons are varied, obstetric care is more convenient because you have the birth event right at your fingertips. If we are beginners it is certainly the one that puts us less anxiety and allows us more control. If we are linked to an old care in which it is the operator and not the mother who knows what is right then this is the chosen position. Little by little, things are changing and the lithotomy position tends to be left only to situations in which it is necessary to intervene promptly because something is wrong.
Thus returning the competence of knowing what is best to those who experience that birth in the first person and therefore to the mother and child.
Squatting position during childbirth
There has been a lot of talk lately about this squatting position for childbirth. In some cases it can be very very useful but in others strongly discouraged. It is certainly very useful first of all if the mother finds it comfortable and if she has a support to attach to. Normally it happens that during the pause between contractions, the mother gets up and walks and, when the contraction and thrust arrives, she squats supported either by a fabric swing or by whoever is with her in the delivery room.
Lowering for the push helps to exploit all the force of gravity and the muscles of the abdomen and legs and therefore produces a very important advancement of the baby. It is though absolutely to be avoided in cases where the child is very suffering and especially if the mother's genital tissues are delicate, and this will be assessed by the midwife at the time. The reason is that such a powerful push can cause major lacerations in very delicate tissues and this leads to greater postpartum discomfort due to stitches and in the worst case even rectal incontinence problems. However, everything is evaluated at the time of delivery, the midwife will help you and guide you if she thinks it is useful to try different positions will advise you.
Stranger location
I would like to conclude by bringing you an anecdote about the strangest position that I happened to witness during childbirth. In reality I was still a student, in the last year so I was already assisting alone in the delivery room with the support of a colleague. I remember that the mother changed infinite positions and then chose to place herself in a corner of the delivery room at the time of birth. Her partner was behind her pinned to the wall and she was turned towards him. During the thrusts she squatted, indeed she almost sat down, on a soft mat that we had prepared for assistance and covered with a clean cloth. Well, at the time of delivery I was practically lying on the ground with a mirror that allowed me to see how the situation was progressing. The baby was born practically alone, leaning gently on the mattress we had prepared. It was therefore a kind of extreme squatting position in which there was very little space for me. But it was very emotional because being the mother turned towards the father, it allowed the newborn baby to see him first.
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