LivingA midwife designs a cushion that corrects the position...

A midwife designs a cushion that corrects the position of the baby in labor, avoiding caesarean sections

In some deliveries, the baby is placed in the maternal pelvis facing up instead of down, a fact that makes it difficult to exit and increases the risk of caesarean section and instrumented deliveries.

A midwife at the Vall d’Hebron Hospital, Vanessa Bueno, has designed an ergonomic cushion that facilitates the rotation of the baby’s head during delivery and also helps to rest in the third trimester of pregnancy.

In two months of testing , 120 pregnant women have used it and it has reduced caesarean sections and the use of forceps by 16% , according to data from the Barcelona center.

How does it work?

At the time of delivery, the baby needs to be looking down. But, in about 40% of women, it is looking up. If this incorrect position is not corrected, it is necessary to perform a caesarean section or use forceps.

This is explained by Vanessa Bueno, the midwife in the delivery room of the Vall d’Hebron Hospital in Barcelona. And he adds that:

“This posture cushion is designed in such a way that women, lying on their side, place it between their legs to open the diameter of the pelvis and cause internal rotation of the knee of the upper leg. In this way, the cushion helps to turn the head of the fetus downwards, since it finds more space in the pelvis and the delivery can be vaginal ”.

The delivery midwife also explains:

“The use of this cushion during the hours of dilation is also very useful if the orientation of the fetus is correct, because by causing the pelvis to open, it has more space to come out.”

Improves rest in the third trimester

In addition to its application to facilitate vaginal delivery, this cushion helps any pregnant woman to improve her rest during the third trimester of pregnancy. Vanessa Bueno points out:

“The resting posture that is recommended for pregnant women, to improve the oxygenation of the fetus and reduce maternal drops in blood pressure, is the lateral decubitus position. Therefore, this pillow is ideal to achieve and maintain this position for many hours, since it avoids discomfort and lumbar pain ”.

Proven benefits

The origin of this cushion is found in a clinical trial carried out by the midwife on ‘how to facilitate the rotation of the fetus during delivery when a malposition occurs’.

The ideal position to achieve this, according to Vanessa Bueno, author of the study, is that of Sims modified, with the woman in lateral decubitus (lying on her side) and the upper leg parallel to the lower one and the knee rotated inwards. Hence the name of the cushion Easysims (which makes it easy to maintain Sims posture).

“To evaluate the effects of this posture on childbirth, we did a study using the legs of the stretcher to elevate the leg with the woman on her side. The results showed that there were more vaginal deliveries, cesarean sections were reduced by 16%, and maternal and fetal morbidity was reduced, as well as hospital stay and subsequent visits to the emergency room, because fewer complications occur ”.

The research involved 120 women who went into labor with the baby misplaced, looking up. With 60 of them, the Sims position was used, while the other half were able to choose the position that was most comfortable for them.

The results of the trial, published in the journal Birth showed that:

  • Babies rotated their position in 50.8% of cases when the mother adopted the Sims position , while only 21.7% of the children of pregnant women who opted for a free position during dilation did so.

  • The number of vaginal deliveries with the Sims position were higher compared to another position (84.7% vs 68.3%).

Only the only data available because currently, according to the midwife, they have six cushions in the Vall d’Hebron maternity and their use has already been internalized within the delivery practice since May 2018, so they do not keep current records of the benefits of its use.

The midwife explains that the women felt satisfied with the labor carried out in this position, although the use of the legs of the obstetric chair reduced comfort. Hence, the idea of the cushion, which can be provided by health personnel to the pregnant woman, even if she does not have childbirth training.

“The cushion is designed so that the woman adopts the correct position, whereas before we had to manipulate the opening angle of the knee, turning it in the leg” , explains the midwife.

At the moment, EasySims is not yet available to all pregnant women. The intention of its creator is that “that the model be acquired by a company for its commercialization and distribution, and in this way it can reach other hospitals and homes”.

Via and Photos | Vall d’Hebron Hospital

In Babies and More | Cesarean section of the province: a pioneering initiative of the Hospital Vall d’Hebron, Induction of labor: in which cases it is performed, when and what risks it entails

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