In my previous article entitled the Miracle of Life Part I, I discussed the various hormones of pregnancy, now we will look at the various body positions during labour and delivery. Many women are surprised to learn that there are different positions that may be employed during childbirth. Some of these positions greatly reduce pain and even foetal distress during delivery.

 

The Lithotomy Position

This is the most popular birthing position practiced in hospitals around the world. Here the mother lies on her back with her legs in stirrups and her buttocks close to the lower edge of the table.  While this is the ideal position for the attendant to deal with any complications which may arise, due to the angle of the birth canal, it forces the baby to be born heading upwards, against gravity, which may increase the likelihood of a difficult birth.

 

There are a number of other problems generated by this position.

 

• Focusing most of the woman's body weight squarely on her tailbone, forces it forward, thereby narrowing the birth canal which increases both the length of labour and makes delivery more difficult (Balaskas and Balaskas 1983:8).

• Placing the vena cava under the uterus compresses it and interferes with circulation, decreasing blood pressure, and lowering oxygen supply to the foetus (Humphrey et al. 1973, 1974).

• It weakens contractions, making them less frequent and more irregular.  It also makes it harder to push due to increased forces needed to work against gravity (Hugo 1977), thereby making the use of forceps extraction more likely.

• Placing the legs wide apart in stirrups can result in venous thrombosis or nerve compression from the pressure of the leg supports. It also causes excessive stretching of the perineal tissue and tension on the pelvic floor, increasing the need for episiotomies and the likelihood of tears (McKay and Mahan 1984).

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Upright Positions

Women do not have to give birth on their backs. There are other positions, both upright and side lying, which may offer more comfort during birthing. Squatting, standing, kneeling and being on all-fours, often in a sequence, are the most common upright positions. In fact, studies comparing women's preferences for lying on the back vs. upright positions for delivery reported, without exception, more positive responses when using an upright position.