Thursday, February 21, 2008

Childbirth - Coping with Pain: Positions For Labour and Birth

Positions For Labour and Birth

The way you position your body can make a difference to the way you cope during labour. Using upright positions can help speed labour progress. This is especially appropriate when labour has been established. Be careful not to tire yourself out in early labour. Walking is a good activity early on and later between contractions. Remember that no one position is going to get you through, so when something is no longer working or you've been using it for about thirty minutes, change to another. Your labour support person should know that you might need encouragement and physical help to change positions. Women sometimes feel like "deadweights" during labour.

During active labour, the following positions may be useful:

standing or leaning forward while supported by your partner or a piece of furniture
  • This position provides support but it also allows you to take advantage of gravity. Lean your body weight into each contraction. This position may relieve backache. It also allows your partner to do a massage.

kneeling with your upper body resting against a chair or your partner's lap
  • This position takes the weight off your spine and is a good position for pelvic tilts to relieve backaches. Many women also find it is a restful position.

on "all fours"
  • This also takes the weight off your spine and allows you to tilt your pelvis to relieve backaches. It can help encourage the baby to rotate from a posterior position. Waggling your hips may help the baby move.

sitting astride a chair facing the back
  • Straddling the chair widens the pelvis and may make you more comfortable. Use a pillow on the back of the chair to protect your belly and put your arms over the back of the chair. This position takes the pressure off your back and allows your partner to do a massage. If necessary, a fetal monitor can also be used in this position.

sitting on a toilet leaning forward into your partner
  • This position may be restful simply because it allows you to relax your pelvic floor muscles without fear of an 'accident.'
propped up in bed
  • This may work simply because many of us associate being in bed with being restful and relaxed. It also works well when examinations need to be done or if a fetal heart monitor is being used.

lying on your side
  • This is a restful and relaxing position where the effects of gravity are minimized. It takes the pressure off your back (or your hemorrhoids if you have any) and it allows your partner to do a massage. Your nurse or midwife will encourage the use of this position if your blood pressure is elevated. It is also a practical position if you are receiving an epidural.
A birthing ball or birthing stool can be used to support different positions and to help keep a woman upright and speed the birth. A birthing stool can also be used in the later stages.

Late in active labour and during transitioning, changing your position can enhance the baby's passage downward through the birth canal. These positions may be used:

squatting
  • This position widens your pelvis to the maximum and takes advantage of gravity to move the baby through the birth canal. Pushing in this position is easier for some women, but others find it tiring and uncomfortable. It is not recommended if the baby is coming quickly.

semi-sitting with your tail-bone flat against the bed
  • This is a restful position that allows you to lay back between contractions. It makes vaginal examinations or the use of a fetal monitor easy, and can be used if you have had an epidural.

lying on your side
  • This is a restful position that lets you relax between pushes. It takes the pressure off your back (or your hemorrhoids if you have any) and allows an epidural to be used. It is a good position to slow down a rapid birth.

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