Birthing Positions

There are different birthing positions that you can try to find out which one gives you more comfort and less pain during labour and delivery. If one position is uncomfortable then it's a good idea to change position during your labour so you don't develop a cramp or strain your muscles. Try out a position for a few contractions. If it works, stay with it. If not, switch to a new position in between contractions. Changing positions is good not only for the mother's comfort, but also to change the shape of the birth canal to help the baby make the required movements prior to birth, and to ensure on-going oxygen supply to the foetus. And don't forget to use pillows to give you enough support.

Here are some effective birthing positions with their respective advantages and disadvantages:

Standing:
The more upright you are, the more you let gravity aid you. During the first stage, simply walking around can help your labour progress, but take care not to become too tired. Upright position helps in dilating your cervix and widening your pelvic opening. The contractions are stronger and less painful. It helps in bringing oxygen to the muscles in your uterus and to the baby thereby causing less stress on the baby. However the disadvantage is that during delivery the attendant will face lot of problems visualizing the baby and also will have a poor control on the delivery.

Sitting:
Try sitting with one knee bent and the other relaxed. Don't lean too far back. When you sit, your uterus drops forward, improving the blood supply to the contracting muscles and easing pressure on your diaphragm. Use cushions or your partner for support. Sitting position helps relax perineum (the area between the vagina and the rectum). However if you are trying the sitting position on the toilet seat then it can cause pain because of pressure on toilet seat.

Semi-sitting:
This position should be tried with pillows underneath knees, arms, and back. During contractions, can wrap hands around knees and pull knees up toward shoulders (as in squatting). It is comfortable for mom since there is a good use of gravity. It works well in hospital beds. For doctors there is a good view of perineum and easy access to perineum.

Kneeling:
If you want to remain upright, but no longer feel comfortable walking, try kneeling on a pillow. Put your hands on the bed, and knees comfortably apart. This can help if baby is pressing against your spine. In this position contractions are less painful and more productive. Relieves backache and assists in rotation of the baby.

Lying on your side:
A sideways position is good if you're tired or have had an epidural or if you have high blood pressure. It takes weight off the main blood supply to the baby and reduces tension on your perineum. This position also speeds up labour and the contractions are less painful and more effective. The disadvantage is that access of baby's fetal heart tone is poor if the mother is lying on same side as baby's back.

Squatting:
Squatting is ideal for the second stage of labour, but it may be difficult to sustain without support. Many women find sitting on the toilet comfortable. Try squatting supported by another person, or a low stool. In squatting position the pelvis opens, gravity is enhanced and there is a sense of control for mom. It encourages rapid descent of the baby and also helps in rotation of baby. During squatting, the average pelvic outlet is 28% greater than in the supine position. Stand, or sit back to relax in between contractions. However this position is often tiring for mothers.

On hands and knees:
If upright positions are tiring, or the contractions are too fast or overwhelming, an all-fours position is useful. Arch your back occasionally for increased comfort. It gets gravity to work for you. It can slow down contractions, and is also good for easing back labour, which occurs when the baby is positioned with the back of his head pressing against the rear of your pelvis and hemorrhoids. It's the best position to avoid laceration or need for episiotomy. It's a good delivery position for large baby. The only slight difficulty is delivering the baby since the baby has to be passed through mother's legs.

Lithotomy:

This position is often used in hospitals. In this position the mom has to lie on her back, feet in stirrups. It is advisable not to use this position. There is risk of supine hypotension; increased risk of tearing or episiotomy, pushing the baby uphill minimizes pelvic dimensions. Most convenient position for doctors.

 

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