Before we start, I have a question for you. When you picture yourself giving birth, what position do you see yourself in…?
If you’re anything like me, I visualised myself propped up on my back, legs spread, screaming my lungs out. I also envisaged myself clawing my poor husband’s arms whilst simultaneously cursing him and screaming “What have you done to me!!!???” Is it any wonder that I made a concerted effort to research calm, positive birthing methods? If you’ve read my story, you’ll know that my birthing experiences were not only incredible and joyful, but pain-free. That’s not how I’d previously pictured birthing to be though. I certainly never knew a calm, positive birth experience was possible.
TV shows and movies are the source I blame for what was my interpretation and understanding of what birthing, or labour, looked like. But just like movie ‘love making’ isn’t always a reflection of what sex is like each and every time in the ‘real world’, you don’t need to accept their dramatized version of birthing and make it your own. They have normalised the drama, normalised the ‘pain’ and given us a picture of how to birth, and as a society we’ve accepted it…
Add to this the horror stories that are unfortunately far too common and also far too freely shared (be sure to read my article on how to avoid them) and again it’s understandable why so many of us sadly believe that birthing is something traumatic to be endured.
But I digress. Position. Position. Position. What if I told you there was a better way? That birthing your baby on your back is NOT the optimum way. Even though we’ve always been shown this as normal, an incredible statistic tells us that doing so can actually reduce your pelvic measurements by a staggering 30%!!!! (compared to other positions such as standing or squatting). Now I believe you’ve found yourself here because, like me, you are doing everything within your power to provide both yourself and your precious bub with the best possible birthing experience. So this is absolutely critical information! I don’t know about you, but I sure wanted my pelvis to be as wide as it could possibly get!!!
You may have heard the term “let gravity do the work”. Well, let me assure you that bub will not fall out and that you will indeed still need to do some ‘work’, but there is definitely merit in letting gravity do what gravity does (i.e. draws things down) and allowing it to assist you in the process, which it cannot do when you’re on your back. In fact, if you’re lying on your back when birthing your baby, you are quite literally pushing uphill, and we all know that’s never fun! When you’re lying down, the birth canal curves upwards so you’re actually going against gravity!
But it’s not only gravity at play here. As mentioned, the actual size, shape and opening of the pelvis is fundamental. In the traditional, on your back, birthing position, the pelvis is essentially compressed. And when your baby is coming down through that birthing canal and your pelvis plays a hugely crucial role in seeing bub out, it makes perfect sense to want your pelvis to be as open as physically possible.
So, what do we encourage you to do? Remain upright, as mobile and as active as you can for as long as you can, provided you’re not being monitored or have any intravenous lines etc. Ina May Gaskin, in her ‘Guide to Childbirth’, suggests that labouring mother should move freely, letting gravity work for her. She says “movement greatly helps cervical dilation during the early part of labour and helps bring the baby into the most advantageous position for passage through the pelvis.”
Australian Calm Birth by Peter Jackson advises that “women in traditional societies all over the world almost always choose upright positions in labour. This worldwide consensus suggests that women don’t choose to lie down and give birth unless forces within the culture pressure them into doing so. The list of benefits of the upright position in labour include:
- Better use of gravity
- Maximum circulation between mother and baby (no compression caused by the baby’s weight on the mother’s major blood vessels which can cause mother & baby to not receive the optimum levels of blood & oxygen)
- Better alignment of the baby to pass through the pelvis
- Stronger rushes (waves or surges, i.e. Calm Birth speak for ‘contractions’)
- Increased pelvic diameters when squatting or kneeling”
It is also commonly thought that tearing or the need for an episiotomy is more likely when in the traditional position.
I love these points from a Bellybelly article titled ‘Small Pelvis? Big Baby?’ which help answer my pre-birth education question of “how exactly does something that big fit out of there???!!!”
#1: Neither Your Pelvis Or Your Baby’s Head Is A Fixed Object
The pelvis is not one solid bone. It is made up of several bones held together by ligaments. During pregnancy your body releases the hormone relaxin. Its release causes your ligaments and joints to loosen to facilitate baby’s movement through the birth canal. This hormone is why you might experience joint weakness and discomfort towards the end of pregnancy. Baby’s skull is made up of separate bones that allow their head to mould and fit through the birth canal. These separate, not yet fused, bones is why babies have ‘soft spots’ known as fontanels.
#2: Your Position Makes A Big Difference
Being on your back or being in a semi reclined position during birth can narrow pelvic measurements by 30%! When you’re giving birth, 30% can make quite the difference. Squatting, side lying or being on all fours can create optimal space for baby to descend.
Of course, baby’s position is also very important and sometimes bub will just not be in the ideal position for a normal, vaginal birth. On occasion this can be rectified during labour, either bub does so of their own accord or with assistance, and other times a c-section or other forms of intervention may be required. Should this be the case, it is so important to remember that the health and wellbeing of both mum and bub is always of the utmost importance. Accept and embrace your unique birthing journey however it plays out – this journey is one we can prepare for as much as possible, but never predict.
Here on Fit Pregnancy you can view a selection of recommended birthing positions.
The birthing position I chose was on my knees, leaning over with my arms resting on the headboard (pretty much no. 9). So essentially I was facing the wall, not the medical team. Admittedly I wasn’t giving them the loveliest of sights but you know what, they’re the ones who chose what they do for a living, right?!
Interestingly, a quote made on the Fit Pregnancy site really resonated with me as I recall my own experiences and find it to be true: “Your body will let you know just what position is best at every point in your labor”. Choose the position that feels right for you. Once a comfortable position is found, use it until it is no longer helping you relax.
I had different obstetricians for both of my births and neither of them had an issue with the position or had ‘difficulty’ assisting with the birth (as the con states on the Fit Pregnancy site). The obstetrician who delivered my firstborn (who wasn’t my booked obstetrician but bub came 8 days early & my intended doctor was inter-state) did ask me at one point to move onto my back so that he could do an internal examination.
I know that for me personally, for the brief time that I was in the traditional position, I felt like a deer in the headlights. This certainly might not be the case for everyone, some of you may feel more supported this way. But for me, it was as if everything shut down. Contractions stopped. Everything that was progressing so nicely, just stopped. I felt like I was staring at them, and they were staring at me. The doctor, two midwives, my husband…
And as soon as my midwife said to the doctor, “I think you’d better let her turn back around again now” (he was old school/traditional), within a short time, my body kicked back in to gear, contractions started back up again, and we were back in our rhythm.
My intended obstetrician, when I spoke to him later, explained that possibly the doctor wasn’t confident performing the examination when I was in my preferred position. But to me, it makes sense why everything just stopped. The sphincter muscle can’t open if feeling embarrassed, observed etc. You need to create a calm environment where you feel comfortable, confident. Music, dim lighting, a closed door, the right support person or people can all assist… but I’ll save this for a post on creating the right birthing environment.
This is a great short read from the Prenatal Yoga Center that describes The Sphincter Law and Childbirth perfectly, please do take a quick look.
Ideally, you really want to open yourself up as much as possible. Already at home in pre-labour… straddle a chair or sit on the toilet. Don’t lie flat on your back if you can help it, it presses the coccyx in. Open up that pelvis so squat on all fours, leaning forward with your legs open. But do conserve your energy.
If labouring on your back is comfortable and preferable for you, then by all means go for it! But don’t feel pressured that it’s the ‘normal’ way or the ‘only’ way and the way you ‘have’ to do it. Alexia Leachman from www.fearfreechildbirth.com says it “makes labour longer, more painful, more difficult, more risky and less healthy.” I actually couldn’t find any positives for it, but the purpose of this article is purely to inform and educate you of a variety of options.
To finish with, let me leave you with and reiterate to you “some positive thoughts to take with you into labour:
- During late pregnancy, hormones soften and relax the pelvic ligaments, making the bones elastic, rather than rigid, so the bones can stretch and open more easily for the birth of your baby.
- Your pelvis is not fused and does stretch and open, expanding for the amazing process of birth.
- Your baby’s skull bones are divided into five plates that cross over during labour, making their head smaller by moulding to fit the birth canal.
- Your baby has an innate sense of crawling or burrowing, as they move down and out of the uterus and through your pelvis to be born. Gravity helps your pelvis open and aids the descent of your baby.”
Source: BIRTH: Conceiving, Nurturing and Giving Birth to your Baby – Catherine Price & Sandra Robinson
Knowledge is power. Forewarned is forearmed. Take this information, commit it to memory, discuss it with your medical team and let’s shake up the status quo.
You are calm.
You are confident.
You are more than capable.
You’ve got this girl!