Get Off Your Back!
You don’t have to take having a baby lying down. Other positions can help reduce pain and shorten labor.
When Pamela Berens was a medical student in Minnesota, she learned that lying on your back with your feet in stirrups was not the only way to have a baby. “We saw a lot of Hmong women [from Southeast Asia], and many of them gave birth squatting in a corner of the hospital room,” recalls Berens, who’s now an OB-GYN at the University of Texas Medical School at Houston.
The standard hospital labor-and-delivery position is also not the ideal one. For one thing, when you’re lying on your back, your uterus compresses major blood vessels, potentially depriving the baby of oxygen and making you dizzy or queasy. “Most women feel better when they are not lying on their back during labor,” says certified nurse-midwife Katy Dawley, Ph.D., director of the Institute of Midwifery at Philadelphia University in Pennsylvania. “Lying on your side, standing, sitting, walking, rocking—anything that keeps you active can help decrease pain and speed up labor.”
When you’re ready to push, squatting can be especially effective. One study found that first-time mothers who squatted while pushing had labors that were an average of 23 minutes shorter than women who labored semi-reclining. They also required significantly less oxytocin (Pitocin) to stimulate contractions and had fewer “mechanically assisted” deliveries (i.e., forceps or vacuum) and fewer and less severe perineal tears and episiotomies.
Unless you’re having a drug-free delivery, one thing that can help increase your position options is choosing what’s called a “walking epidural,” a newer combination spinal/epidural anesthetic that allows you to be aware of your contractions yet able to move more easily than with a standard epidural. “You’ll be numb and won’t be running around, but you’ll still have good muscle function and will be more mobile,” Berens explains. “You can probably use a birthing ball [to sit or lean on].” Berens’s hospital even allows women who’ve had epidurals (traditional or walking) to give birth while lying on their side. “I suspect many others would be open to different delivery positions,” she says.
If you’ve had a walking epidural (or are forgoing drugs altogether), other options include delivering while sitting on a birthing stool, kneeling, crouching on your hands and knees or, as women do the world over, squatting. Don’t want to squat in the corner of your hospital room? No problem! Use the squatting bar on your hospital bed for support. The correct form: knees wide, feet flat.
Don’t try squatting unsupported unless you’re sure you can keep your balance. In fact, you should get in shape by practicing squatting during your pregnancy: You don’t want to find out at the crucial moment that your muscles aren’t up to the task.
Seven soothing labor positions
“Discuss the different positions you think you’d like to try with your doctor or midwife beforehand,” says nurse-midwife Katy Dawley. “In the throes of labor, you’re not going to be able to advocate for yourself.” What’s more, fetal heart monitoring can help determine which positions you can sustain without impairing circulation to the baby during labor, so it’s best to have a repertoire available. Here are some options:
1. Get on all fours This position eases back pain and helps the baby rotate into the optimal position for delivery—face down.
2. Lean Drape your chest over a table, bed, countertop, pillow or birthing ball.
3. Lie on your left side This may increase blood flow to your baby and can help reduce backache. Support your belly and legs with pillows.
4. Lunge Place one foot on a sturdy chair or footstool and lean into that foot during contractions.
5. Rock Sit on a large exercise ball, the edge of a bed or chair and gently rock back and forth.
6. Sit and lean Sitting in a chair, prop up one foot and lean into it during contractions.
7. Sway Put your arms around your partner’s neck and pretend you’re slow dancing.
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