Laboring In An Upright Position
the practice of giving birth on one's back can be traced back to the 16th century when a French physician named Francois Mauriceau introduced the use of the birthing chair. Prior to this time, women gave birth in a variety of positions, including squatting or standing. The birthing chair allowed physicians to have better access to the perineum and vaginal area, making it easier for them to assist with the delivery.
In the 17th century, another French physician named William Smellie developed a technique for delivering babies in the lithotomy position, which involved having the woman lie on her back with her feet in stirrups. This position became increasingly popular and was eventually adopted as the standard position for childbirth in many Western countries.
However, the lithotomy position is not the most ideal position for childbirth, as it can cause difficulties with delivery and increase the risk of certain complications.
Throughout human history, women have given birth in a wide variety of positions, including upright positions such as squatting, standing, or leaning. Many traditional cultures around the world have long recognized the benefits of upright birthing positions, and these positions have been used for generations to promote a more efficient and natural birth process.
However, it is also important to recognize that the medicalization of childbirth over the past few centuries has led to a significant shift in birthing practices, with many women being encouraged or required to give birth while lying down or in other positions that are not ideal for the birth process. This has contributed to a range of complications and interventions that may not have been necessary if women had been allowed to birth in a more natural and upright position.
In recent years, there has been a growing movement to promote more natural and woman-centered approaches to childbirth, including the use of upright birthing positions. This has involved a renewed focus on traditional birthing practices, as well as the development of new techniques and technologies that support natural childbirth. Ultimately, the best birthing position will depend on a range of factors, and women should be encouraged to explore a variety of options and work with their healthcare providers to develop a birth plan that best meets their individual needs and preferences.
There are several potential benefits to laboring in an upright position during childbirth:
Shorter labor: Studies have shown that women who labor in an upright position may have shorter labors than those who give birth while lying down.
Improved fetal positioning: Being in an upright position can help to encourage the baby to move into the optimal position for delivery, which can make the birth process easier and reduce the need for medical interventions.
More efficient contractions: When a woman is in an upright position, gravity can help to encourage the baby to move down the birth canal, which can help to promote more efficient contractions.
Increased comfort: Many women find that being in an upright position during labor is more comfortable than lying down, as it allows them to move around and find a position that feels best for them.
Lower risk of interventions: By promoting a more efficient and natural birth process, laboring in an upright position may help to reduce the need for medical interventions such as induction or augmentation of labor, epidurals, or cesarean delivery.
Questions to ask your OBGYN or Midwife
Many expecting mothers choose their doctor or midwife based on the recommendations of friends or other doctors. Others simply look online and go to the first practice that’s nearby or accepting patients. However, your choice of doctor or midwife will have a significant impact on your birth. Not only will you see them throughout your pregnancy, but they influence the medical interventions you do or do not receive during labor.
When considering whom to choose to care for you and your baby during pregnancy and labor pick a provider who aligns with your birth philosophy.
How many births do you and your practice attend each month?
In an uncomplicated delivery, how much of the labor and birth do you typically attend?
Who will assist with the delivery if you aren’t available when I go into labor?
Who do I call if any complications arise during pregnancy? Is someone available to talk with 24/7?
How many of your clients attempt natural birth without epidural or other pain medication?
In what ways do you support moms who want a natural birth?
How do you feel about birth plans?
Do you recommend taking childbirth classes? Do you have any that you recommend?
How do you feel about doulas attending the birth?
Do the other OB-GYNs or midwives in this practice share a similar philosophy about birth?
What is your standard protocol for IVs, IV fluids, and fetal monitoring during labor?
What is your policy on labor inductions? For what reasons are most labor inductions scheduled?
If I’m still pregnant past my due date, at what point do you suggest an induction?
What positions do you feel comfortable with me pushing in as you assist with the delivery? (Lying flat on back, hands, and knees, using a squat bar, side-lying, etc.)
Can I eat during labor?
Is there a tub that I can labor in?
How dilated does my cervix need to be in order to be admitted to the hospital during labor?
Cesarean
Under what circumstances would you recommend a cesarean?
What percentage of the women in your care have a cesarean?
*Cesarean rate in the US is 33%, and in Florida 36%. low (range: 13%-22%), medium (range: 23%-25%), high (range: 25%-36%)
Watch out for red-flag responses. These include:
Vagueness: “I only do cesareans when they are necessary.”
Scare tactics: “I’d like to induce labor when you reach 39 weeks. There’s no reason not to, and even though you’re healthy, you never know what might happen if we wait.”
Patronizing: “Don’t worry; just relax and let me take care of everything.”
Anger: “And what medical school did you go to?”
Bullying: “Decisions will be made by me and are not negotiable.”
*You don't need to ask all these questions. Simply pick the ones that resonate with you.
Creating a birth plan
Creating a birth plan is an essential step in preparing for the arrival of your baby. A birth plan is a document that outlines your preferences for labor, delivery, and postpartum care. Here are some steps to help you create a birth plan:
Research your options: Start by researching your options for labor, delivery, and postpartum care. This can include things like pain relief options, delivery positions, who you want present during the birth, and postpartum care for you and your baby.
Consider your preferences: Once you have researched your options, think about what is important to you. Consider your desire for a natural birth or a medicated birth, and who you want to be present during the birth.
Discuss with your healthcare provider: Talk to your healthcare provider about your preferences and make sure they are aware of your birth plan. They can provide guidance and information to help you make informed decisions.
Write it down: Once you have identified your preferences, write them down in a clear and concise manner. This will ensure that your healthcare providers know your preferences and can help to ensure that your birth experience is as close to your preferences as possible.
Be flexible: Keep in mind that birth can be unpredictable, and sometimes things may not go according to plan. Be flexible and open to changes if necessary.
Share your plan: Share your birth plan with your partner, family, and healthcare providers. This will help to ensure that everyone is on the same page and that your preferences are respected.
Here’s an example of a birth plan:
Name: Jane Smith
Due date: June 1, 2023
Partner: John Smith
Doctor/Midwife:
Any other important information such as allergies.
Labor:
I plan to have a natural birth without pain medication, but I am open to the possibility of pain relief if needed.
I would like to be able to move around freely during labor and try different positions to find what is most comfortable for me.
I would like to avoid the use of forceps or vacuum extraction if possible.
I would like to have intermittent fetal monitoring, rather than continuous monitoring.
I would like to avoid unnecessary medical interventions and prefer to let labor progress naturally, as long as it is safe for me and my baby.
Delivery:
I would like to deliver in a birthing tub or a private room with a comfortable bed, rather than a delivery table.
I would like to have my partner present during the delivery.
I would like to push instinctively, rather than be coached through pushing.
I would like to avoid an episiotomy if possible and prefer a perineal massage to help avoid tearing.
I would like to have the option of delayed cord clamping, as long as it is safe for my baby.
Postpartum:
I would like to have skin-to-skin contact with my baby immediately after delivery.
I would like to breastfeed my baby as soon as possible.
I would like to have my baby in the room with me at all times, rather than in the nursery, if possible.
Unless medically necessary, I would like to avoid routine interventions such as bathing my baby.
I would like to be discharged as soon as possible, as long as both me and my baby are healthy and stable.
Please note that this is just an example and every birth plan will be unique to each individual's preferences and needs. It's important to discuss your birth plan with your healthcare provider to ensure that your preferences are feasible and in line with safe and appropriate medical care.
Remember, a birth plan is not a guarantee, but it can help to ensure that your preferences are considered and respected during the birth process.
Preparing for Childbirth
Planning for birth involves taking steps to prepare for the physical, emotional, and practical aspects of giving birth. The process of planning for birth typically involves a combination of education, preparation, and decision-making.
Here are some steps you can take to plan for birth:
Educate yourself: Attend childbirth classes, read books or articles, and talk to healthcare providers, doulas, or other mothers to learn about the process of labor and birth, and the various options for pain relief, delivery methods, and postpartum care.
Create a birth plan: Work with your healthcare provider to create a birth plan that outlines your preferences and priorities for labor and delivery. This plan can include things like your preferences for pain relief, your preferred delivery position, and your wishes for postpartum care.
Choose a healthcare provider and birth setting: Choose a healthcare provider and a birth setting that align with your values and preferences. Consider factors such as the provider's approach to childbirth, the hospital or birthing center's policies and practices, and the availability of amenities such as water birth or natural childbirth options.
Prepare for labor and delivery: Practice relaxation techniques, such as deep breathing or visualization, and consider enrolling in a childbirth education class or hiring a doula for additional support during labor and delivery.
Plan for postpartum care: Consider your needs and preferences for postpartum care, including support for breastfeeding, emotional well-being, and physical recovery.
By taking these steps to plan for birth, you can feel more empowered and prepared for the process of giving birth, and increase the likelihood of a positive and fulfilling birth experience.
Peanut Ball for Labor
A peanut ball can be a helpful tool during labor and birth. It is a peanut-shaped exercise ball that is used to help the birthing person find a comfortable and supportive position during labor. The peanut ball can be used in a variety of positions, including:
Sitting: The birthing person can sit on the ball with their legs wide apart, which can help to open up the pelvic area and encourage the baby to move down.
Side-lying: The birthing person can lie on their side with the peanut ball between their legs. This position can help to open up the pelvis and encourage the baby to move down.
Squatting: The birthing person can hold onto the peanut ball while squatting, which can help to open up the pelvis and encourage the baby to move down.
Using a peanut ball during labor and birth can have several benefits, including:
Providing comfort and support: The peanut ball can provide a supportive surface for the birthing person to lean on, which can help to reduce discomfort and fatigue during labor.
Encouraging labor progress: The peanut ball can help to open up the pelvis and encourage the baby to move down, which can help to speed up labor and reduce the need for medical interventions.
Allowing for mobility: The peanut ball can be used in a variety of positions, which can allow the birthing person to move around and find a comfortable position during labor.
If you are interested in using a peanut ball during labor and birth, talk to your healthcare provider or midwife to see if it is available at your birthing location and how it can be incorporated into your birth plan.