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Why Do Women Give Birth Laying Down

by Lyndon Langley
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Why Do Women Give Birth Laying Down

Why Do Women Give Birth Laying Down

The old saying “lying down makes you feel like a log” has never been more true than in modern obstetrics. The supine or lying down birth position has become the universal and standard practice for giving birth because it’s believed to be the safest, easiest way to give birth. In fact, some midwives even claim that they can’t remember another time when women have given birth standing up. This belief comes from a study done by Dr. John R. Beeching in 1946 which showed that if the mother was upright during childbirth, she would experience an increased incidence of shoulder dystocia (a condition where the baby’s head gets stuck at the junction between the upper arm bone and collarbone). He concluded that this could only occur with a woman who was not relaxed enough to lie down.
So why do so many pregnant women choose to lay down? For one thing, there are practical reasons, such as having easy access to the bathroom and being able to stretch out comfortably on the bed. But perhaps the biggest reason is psychological — women find it easier to relax while laying down. Not only does it help them cope better emotionally, but also physiologically — studies show that the relaxation response occurs faster and more completely in the lying down position than it does in any other position [Source: Bradley].
In addition, lying down makes midwifery much simpler. It allows continuous monitoring of both the labours’ progress and the health of the newborn. Midwives say that they’re able to keep close tabs on the foetus’ growth and well-being through noninvasive means like ultrasound and palpation instead of relying solely on physical examinations and measurements. Another advantage of the lying down position is that it allows efficient use of medical resources like hospital beds.
But what about women who have difficulty using the lying down position? What happens if a woman has trouble relaxing or needs support getting into the right position? Luckily, there are alternative positions that may work just as well for these women and their babies. These include the lithotomy position, squatting and sitting. Read on to learn how these positions differ from each other and how they apply to new mothers.
Birthing positions come in two forms, natural and assisted. A natural position is one that is used naturally without assistance from others. An example of an assisted position is pushing. Assisted positions are those that require external pressure applied by someone else. Natural positions are believed to provide better comfort, but some people argue that they actually interfere with the process of labour and pose risks to the newborn.
Lying Down Position Variations
There are several variations of the traditional lying down position. If a woman feels uncomfortable in the supine position, she might want to try one of the following alternatives.
Sitting – Sitting is probably the best option for a woman who wants to avoid the discomfort of lying down. However, it requires her to put weight onto her legs, which may cause leg cramps. Also, since the pelvis must rotate forward to accommodate the birth canal, the angle of the vagina will be altered and the muscles surrounding it may be stretched beyond capacity. Finally, it doesn’t allow for constant fetal surveillance.
Squatting – Squatting is generally considered safe for all stages of pregnancy. It allows for optimal positioning of the body for both the fetus and the caregiver. As opposed to the lithotomy position, however, it may put the mother at risk of hemorrhage. Therefore, it should only be recommended after consulting your doctor first.
Knee-chest Position – This position involves placing the hands behind the back and bending the knees towards the chest until the hips are positioned above the level of the shoulders. While some physicians advocate its use, others consider it dangerous because it restricts blood flow to the uterus and the bowel.
Other Positions – There are several other methods of delivering a baby that were developed over the years. They range from the prone position (the same as the lithotomy position) to various combinations of positions. Some doctors recommend the use of these positions, especially when there’s no room in the labour ward due to overcrowding.
It’s important to note that none of these positions are officially recognised by the International Federation of Gynecology & Obstetrics (FIGO), although some hospitals may employ them under certain circumstances.
The Knee Chest Position
One variation of the classic lying down position is called the knee-chest position. To perform the knee-chest position, the nurse or caregiver lifts the mother’s buttocks off the bed while supporting her lower back. Then, the mother bends forward slightly and places her palms on the floor, forming a 90 degree angle with the ground. She then tucks her feet under her bottom. Once the mother is comfortable in this position, the midwife supports her back with her own elbows.
Some researchers object to this method on account of the lack of proper spinal alignment. They suggest that the ideal position for childbirth is one in which the pelvic tilt is neutral and the sacral base remains horizontal. In the knee-chest position, the pelvis tilts backward and the lumbar spine becomes inclined. Since the lumbar region contains nerve roots responsible for controlling bladder function, bowel movement and sexual activity, it’s possible that the nerve roots may be affected by this position. Furthermore, the rotation of the pelvis puts undue stress on the vertebrae and intervertebral discs. Lastly, since the mother’s back is supported only by her elbows, the position exposes her back to injury.
To counter these problems, some experts advise patients to extend their legs straight out in front of them while maintaining the bent knees. This helps correct the pelvis’ tilt and protects against injury to the spine. Other options they propose include allowing the patient to sit in a chair, reclining the bed, or resting the patient’s buttock cheeks against pillows.
While these positions may seem safer than the classic lying down position, they still don’t offer complete freedom of movement. Many women who use these techniques complain of sore backs and necks afterwards. One solution to this problem is to use painkillers to relieve the pain, but some critics point out that this leads to dependency on medication and reduces the effectiveness of treatment.

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