Active Birth
Active Birthing position
Women don’t want to lie flat on their backs to labour or to give birth. Women naturally want to be upright, which is a gravity friendly position for baby to move down the birth canal.
Positions for Labour and Birthing
If a woman feels safe and well supported she will naturally use lots of different positions both during labour and for the pushing stage. Interestingly, many women want to be close to the ground – they feel safe. Being on a hospital bed should only be reserved for those few women who need medical intervention. In fact, I would like the hospital bed removed from birthing rooms. It seems to be the ‘feature’ piece of equipment in the room! They could be brought in, if needed. This could certainly help to bring down the medical intervention rate, especially epidurals, which inevitably lead to other interventions.
What Should be Available
- A deep enough bath for a water birth
- Shower with a plastic chair with no arms, so that a woman can straddle the chair
- Toilet – some women find sitting on the toilet very comfortable and safe
- Hot/cold packs
- Comfortable, yoga type mat for the floor
- Bean bags, many women enjoy being on all fours on a mat with belly firmly pushed into a bean bag
- Fit balls, sometimes referred to as swisse balls. Wonderful for sitting and bouncing OR on all fours and resting head on ball
- Birthing stool
- C.D. player. Many women bring their own ipod, although most facilities provide some type of basic player for music.
- Access to a kitchen for drinks and food
Important to check before you book in to a hospital that the above basics are provided.
Why is it important to be in an upright position? - it is a well known fact that the position of a baby in a woman’s pelvis at the end of her pregnancy will have a major influence on the kind of labour she has and the way her baby is born. It makes sense to encourage the baby to lie in the most favourable position, that is, the occipito anterior (OA) prior to labour beginning. In this position the likelihood of medical intervention is reduced. If baby is in an OA position it is lying with his back towards the front, and kicks are felt out to the side. When labour starts with baby in this position it is shorter, more comfortable and an easy passage down the birth canal for the baby.
The opposite position, which we are seeing more of, when baby is lying in the posterior position. This means baby is lying spine to spine with his Mum and many of these women report lower backache, and lots of baby kicks out to the front.
Optimal Foetal Positioning (OFP) is the term coined by Jean Sutton (N.Z. Midwife) and Pauline Scott (Childbirth Educator).
For many women, the expectation of a normal birth goes out the window when it is discovered during labour that the baby is in a ‘posterior’ position. With a baby in this position, medical intervention is almost unavoidable.
Factors which influence the Posterior Position
In their book Optimal Foetal Positioning (OFP), there are a number of factors which influence the baby’s position:-
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Modern Lifestyle - Since the 1960’s lifestyle changes have been dramatic. We are far less physically active. We have every labour saving device we can afford and many of us have comforts in our homes previously unheard of. Our leisure time is spent mainly sitting – at the computer, watching TV, reading etc. One of the most important lifestyle changes has been the advent of television. This has meant a change from straight-backed armchairs and sofas (for reading or needle work), to furniture which is designed to relax in to whilst watching television, DVD’s. When a pregnant woman sits down in a modern design armchair or sofa, her pelvis tips backwards and so does her ‘passenger’. To balance her body in this position, the woman has to cross her legs – which further decreases the amount of space in the front, or anterior part of her pelvis. Her ‘passenger’ has no alternative but to lie towards the back or posterior part of her pelvis. If the woman spends a lot of time resting in modern furniture during the latter part of her pregnancy, it is probable that her baby will remain in the posterior position, and therefore enter the pelvis in this position. The same sequence of events can happen if the woman travels in a car seat, especially if it is a ‘bucket’ type seat, for long periods at a time.
Work has also changed for women. In times gone by pregnant women worked physically hard in the home, scrubbing floors on their hands and knees and doing other menial tasks around the house or farm, which involved leaning forwards. In the past, more importance was placed on correct posture and good deportment. Young women learned to sit upright with their knees together and to walk with their shoulders straight. All of these postures are ideal for correct alignment of the baby in to the maternal pelvis. This may well be one of the main reasons the incident of posterior labours is higher today, than in our grandmother’s day. The lack of emphasis on correct postures and the different kind of working environment experienced in our modern life, has had an effect on the way babies position themselves for labour and birth. - Position of the Placenta - if the placenta is positioned on the anterior (front) wall of a woman’s uterus, it is likely that her baby will favour the posterior position. However, as labour draws near, the lower section of the uterus develops more and it is possible for the ‘posterior’ baby to rotate to the ‘anterior’ position at this stage especially if measures are taken to encourage the baby to do this.
- Abdominal Muscles - a pregnant woman who has tight abdominal muscles produces a sharper angle between her lumbar spine and her pelvic brim. This can encourage her baby towards a ‘posterior’ position, compared to the pregnant woman whose abdominal muscles are more relaxed. This refers to a small percentage of the population who are excessive exercisers.
At our Birth Right™ classes, we will guide you through the many ways you can encourage your baby to be in the most favourable positon for birth. What you can do in the latter stages of pregnancy, and what you can do in labour. What questions you need to be asking your caregivers, during pregnancy and in labour.
By encouraging your baby to be in the best position for birth, you are setting the stage for a shorter, more comfortable and enjoyable birthing experience, and an easy passage for your baby to enter the world.