Most of us have a mental image of what a typical birth looks like. Right now, you may be picturing a screaming woman lying on her back in a hospital bed surrounded by nurses and a doctor. In recent years, much of what we see in this picture has been re-evaluated. The types of couples giving birth are changing, and some women are choosing to give birth at home or somewhere other than a hospital.
More unexpectedly, ideas regarding the safest and most efficient birth positions are expanding. Read below for an overview of the birth positions and learn why a mother on her back may not be the safest position for her or the baby.
Potential Birth Positions
According to Fit Pregnancy, there are 11 common labor positions that aid in childbirth:
- Standing supported squat
- Sitting on toilet
- Leaning or kneeling forward
- On back with legs raised
Each of these positions assists in the birthing process in different ways. For example, the standing supported squat helps to realign your pelvis to increase the opening by up to 15%. The semi-sitting position gives your healthcare provider easy access to fetal heart tones.
Some positions can also hinder the birthing process or be harmful. For example, sitting may not be possible if you have high blood pressure, and squatting is often tiring.
Common Hospital Birth Positions
While out-of-hospital births are on the rise, 99% of babies in the United States are still born in hospitals (NPR). If you give birth in a hospital, staff will most likely assume you will push on your back and will position you that way. However, hospital births may be done in a semi-squatting or hands-and-knees position so that gravity can help speed the process along. Some hospitals also have equipment to assist with other birthing positions, such as a squat bar that attaches to the hospital bed. However, the further away you get from the "standard" on-your-back position, the more likely it is that you will have to specifically ask for accommodations.
The Worst Birth Position
Unfortunately, even though mother-on-her back-also called lithotomy position-is considered "standard," it is objectively the worst position for giving birth. It can make the birthing process longer and more difficult, and increase the chances of injury to the mother and baby.
So why is this position most hospitals' first choice when preparing a mother in labor? Because it is easier for the doctors and nurses to handle the mother and baby when they have a clear view. Healthcare workers, however, should not sacrifice a mother's safety in order to make themselves more comfortable.
Because lying on your back restricts blood flow, decreases the size of the pelvis by 20%, and takes away the power of gravity, the mother is at a much higher risk for injury, and the baby of prolonged labor. The World Health Organization called use of the lithotomy position "clearly harmful." According to parenting magazine Babblepossible birthing injuries in this position include vaginal tearing, increased risk of episiotomy (surgical cut to increase opening), and even fetal distress.
Understanding Your Rights
While doctors should be flexible and accommodate your desired birthing position, there is a chance a doctor may try to pressure you into the on-your-back position. When you are in a high-stress situation, it can be hard to know what to do when your body is telling you one thing and your doctor is telling you something else.
The fact of the matter is that in almost any situation that is not a medical emergency (your life or your child's life is in danger), it is your right to call the shots. Hospital staff cannot force you to stay on your back if that is not working for you. Consider speaking with your doctor in advance regarding your desire to be flexible in your birthing positions. Getting reassurance from your doctor that he or she understands can give you peace of mind before you ever enter the delivery room.
In the unfortunate event that you are mistreated by doctors, nurses, or other hospital staff while giving birth, it is important to keep your rights in mind. While extreme and rare, there have been cases of women who were physically forced to remain on their back, or were even restrained so they could not move. Doctors should know the risks of on-the-back labor. If you suspect your or your child's birth injury was due to the wrong or negligent response of a healthcare professional, it is important to speak with a knowledgeable attorney who can help you stand up for yourself. If you have any questions, please call Norton & Norfleet, P.C., at (816) 607-4750. Our Kansas City birth injury attorneys would be happy to speak with you in a free consultation.