Positions for Labor-Part 2

POSITIONS FOR LABOR – PART 2

Variations of the Squat

The Supported Squat

birthing• Your partner sits or squats behind you, toboggan-like style with back against the wall or bed, or using a chair for support
• Or your partner can be in front, doing a squat, and hold your hands for balance.
Standing Supported Squat
• As you relax down into the squat, take the weight off your feet and melt into the arms and against the body of your partner.
• In this position your body will tell your mind to relax
• You then surrender your mind and body to your labor
Dangle Support Squat
• Your partner supports from behind, or two people supporting you (one on each side) helping in supporting you in the squat position.

Kneeling

image004This position is a natural extension of the squat position when the labor is too intense.

• Kneel on the floor with a pillow
• Lean against a chair
• Or get on all fours
o especially good for back labor
o to try and turn a posterior positioned baby
o or if your labor is accelerating and seems unmanageable.

Kneel-Squat Position

• Kneel with one knee while squatting with the other leg.
• Alternate between legs, or you can do a rocking and swaying motion.
Knee-Chest Position
• Your knees are on the floor, while your head and arms are on a pillow
o Slows overly intense contractions
o Counteracts an urge to push when your cervix is not fully ripened.

Sitting

CHAIR STRADDLE• Sit straddled over a low stool, toilet seat, chair or birthing bed angled like a seat
• The best of these is the sit-squat over a low stool, for the same reasons as the plain old squat position

 

Side-Lying

SIDE-LYING• Does NOT use GRAVITY in the same manner as the SQUAT.
• Best on the left side, to prevent the uterus from compressing major blood vessels that run along the right side of the backbone
• It provides a way to labor without pressure of the uterus on the back, and allows for some sleep in a long labor.
• Use pillows for your head, and pillows under the knee of the right leg, and support pillows behind your back.
o It allows you to quickly roll into the kneel or up into a squat
o Once the contraction is done you can roll back into your nest of pillows.

 

*Images from The Birth Book, Sears & Sears (1994) and internet birthing images/stock photos*

REFERENCES:

Balaskas, Janet. Active Birth: the new approach to giving birth naturally, rev. (1992) Harvard Common Press.

Dick-Read, Grantly. Childbirth Without Fear: principles and practice of natural childbirth, 2nd ed. (2013) Pinter & Marition.

Sears, William and Martha Sears. The Birth Book: everything you need to know to have a safe and satisfying birth. (1994) Little, Brown and Company.

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Optimal Fetal Positioning

OPTIMAL FETAL POSITIONING

anterior posterior

The Anterior Position is the optimal position for birth. The head of the fetus is more round. When entering the birth canal, the crown of the head presents first, molding to the birth canal and opening more readily.

With a Posterior Position, the head is more oval. Unlike the presentation of just the crown of the fetus, the baby’s head is not as moldable. The head will have more difficulty moving into and through the birth canal.

If the baby is in the Posterior Position, see if your support person can assist you to move the baby into LEFT Occiput position by using the Rebozo, forward leaning inversion (discussed in another handout), or have a Chiropractor do a pelvic adjustment (Jamie Zenner, specializes in this area).

The ROT (Right Occiput Transverse) position is a common position the fetus would be lying prior to the onset of labor. During birth, the fetus is most likely to rotate to Posterior Position rather than Anterior Position. The chin is usually flexed upwards, presenting first (See D, below).

Cranial Flexion

With LOP (Left Occiput Posterior) position the fetus’ back is lying opposite the mother’s liver. This position may allow the fetus to flex or curl his/her back, to tuck the chin. This would allow for an easier birth.

fetal position in relationship to the pelvis

The illustration above shows the various acronyms for the lie of a fetus, where the face of the fetus is turned towards. This will assist you in understanding what your doctor is telling you about the position of the fetus in your womb.Nearly half of the babies start out as breech babies, but turn on their own at around 34 weeks. 3 to 4 % still remain breech in presentation.

Doctors can do a maneuver to turn the baby called External Inversion. 60% of the babies will turn, but some revert back to breech presentation. Doing this maneuver may cause a premature birth.

There things that a pregnant woman can do for a breech baby without the external inversion:

  1.  Use an ironing board lain against the couch and lie with head towards the ground
    i. Be sure to use cushioning for the body, and a pillow for the head
    ii. Do this 3X a day for 20 minutes
  2. Another way is to lean forward, on your knees, butt up/head down resting on arms
    i. Do for 10 minutes, 3X a day.
    ii. Think of it ( and mentally “couch” your baby) as the position you would like to have your baby in birth
  3. Do not do either of these exercises if baby is head down, and posterior (without consulting your labor support person).

    Do not do either of these exercises if baby is head down, and posterior (without consulting your labor support person).

    If after reaching 37 weeks and these techniques have failed, try:

    1. Chiropractic Webster Maneuver with pubic symphysis aligning (see: Resource Page or class hand-out for local chiropractors)
    2. Craniosacral Therapy and Myofascial Release