Like many of you, I spent an April 15 Saturday morning watching April the Giraffe give birth to a healthy boy calf. I think he was something like 6 feet tall and 150lbs. While watching the live stream I couldn’t help noticing all the people comment: “Why is there no one with her?” “Where’s the Veterinarian?”   Of course others jumped in saying “She’s a wild animal and there are no doctor’s in the wild!”

It struck me how natural birth is, but how controlled humans have made the process, especially in hospitals.

In February 2017, the ACOG (American College of Obstetricians and Gynecologists) released a paper entitled “Approaches to Limit Intervention During Labor and Birth”. In this document, OBGYN’s are reminded that “Labor management may be individualized” and include “such techniques as non-pharmacological pain relief”

The paper also advocated for delayed admission when both the mom-to-be and baby are stable in status. Once admitted, OBGYN’s are reminded to employ: “education and support, oral hydration, positons of comfort…massage, or water immersion”. This new view point is very empowering!

COMFORTABLE BIRTHING POSITIONS

So let’s talk “positions of comfort”. Upright position on hands and knees or deep squat can be beneficial because gravity can assist with pushing, uterine contractions will be stronger, and there is less compression on the mother’s aorta (increasing blood supply to the baby). X –ray evidence even shows that the pelvic outlet is larger in upright position meaning more space to get the baby out. (Gupta et al. 2012).

There’s also lots of buzz about water births nowadays so what’s the deal? ACOG has conceded that water immersion during the first stage of labor can shorten labor and reduce need of pain medication. They do however recommend that birth “occur on land” vs. water, but women are allowed to give birth in water if they are informed of the risks. The American College of Nurse Midwives notes that there is a “large and growing body of research that supports water birth as a reasonable choice for healthy women experiencing normal labor as well as birth.”

Almost 75% of women get epidurals and may be limited in their ability to stand after the injection. They are still not limited to the traditional birthing position on their back. Several women have recently reported giving birth on their side post epidural and felt more control despite not feeling much control in other positions.

The bottom line of all research seems to be that women should feel empowered to labor and push in whatever position feels right to them at the time. So moms-to-be advocate for yourself and do what feels right!

For more information:

Gupta et al. Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database Syst Rev. 2012;2:CD008070.

http://www.acog.org/Patients  Patient resource page from the American college of obstetricians and gynecologists

http://www.acnm.org/ official website of the American college of nurse midwives