Choosing the position of delivery is something very personal that will depend on each woman. If we think about the ideal birthing position, the reality is that there is no one specifically, because the best one is the one with which the woman feels most comfortable at all times.
You can even perform a combination of various postures throughout the birthing process. Let’s see then what are the different birthing positions that we can adopt and what advantages each one has .
In general, birthing postures are usually divided into two main categories: horizontal and vertical .
Horizontal birthing positions
We begin with the postures of childbirth in which the mother is in a horizontal position :
- Gynecological position: also called supine decubitus or lithotomy, it is a position in which the woman is lying on her back on the bed or delivery table, with her feet subject to the stirrups.
- McRoberts position: lying on her back, the mother flexes and brings her legs towards the abdomen (alone or with the help of medical personnel). This position is rarely used, since it is usually used in cases of shoulder dystocia, as it helps to free the sacrum and increase the diameter of the pelvic area.
Although the gynecological position is currently the most used in hospitals, the truth is that it turns out to be an uncomfortable and limiting position for women during childbirth. In addition, in recent years, various studies have found that it may not be the best option at the time of the baby’s birth.
The disadvantages of horizontal posture are, to begin with, that it goes against the law of gravity. Instead of the pressure of the baby’s weight facilitating the expulsion, the mother does not have this natural help, having to push the baby through the birth canal in an upward plane, increasing the possibilities of the use of forceps or cesarean section.
When lying down, the weight of the uterus compresses the large blood vessels, interfering with the baby’s circulation and oxygenation. In addition, the pelvis flattens as the coccyx flattens against the bed, narrowing the pelvic outlet, which, in addition to interfering with delivery, damages the mother’s spine.
Something that we can say in favor of the gynecological position is that there is research that assures that it presents a lower risk of blood loss during childbirth and bleeding after delivery, compared to other vertical positions.
Vertical birthing positions
Unlike horizontal postures, vertical postures give women greater freedom of movement , one of the rights that every mother should have during childbirth.
- Standing : when the woman is standing, she has the support provided by her two legs. In this position you are looking for a support base that can be a wall, a bar, a rope or better, the couple. This position favors the oxygenation of the baby.
- Squat : the pelvic outlet opens to its maximum capacity, facilitating the rotation of the baby and the descent in a difficult delivery. It may require less pushing effort on the part of the mother. It can be done on the stretcher or directly on the floor.
- Semi-sitting : it is a position that allows the woman to rest, allows fetal monitoring while being a good alternative for the midwife or the doctor. By being upright, the mother can visualize the delivery. There are hospitals with delivery chairs that allow this position.
- Sitting : sitting on a stool or on your partner’s knees allows you to lean forward to rest after each contraction. You can also receive massages to relieve lower back pain.
In vertical postures the law of gravity favors the descent of the baby through the birth canal . In turn, the pressure exerted by the baby’s head softens the pelvic floor, facilitating dilation and reducing the chances that an episiotomy will be performed, that is, that a cut will have to be made to enlarge the opening of the vagina.
Precisely because of the help that the baby himself provides when descending through the birth canal, some research shows that the dilation time is shorter and the delivery is shorter and less painful in a vertical position than in a horizontal position, although the threshold depends a lot on that. of pain of each woman.
On the other hand, and according to a study, voluntarily choosing an upright posture during childbirth helps to have a more positive experience, as it provides a sense of strength and empowerment in mothers .
Other birthing positions
There are other positions that do not quite fall into either of the two aforementioned categories, but that are certainly worth mentioning:
- Lateral position: the mother lies on her side with her legs spread or apart.
- Quadruped (on all fours): the mother can have her hands and knees on the table, or her hands may rest on someone or something higher and her knees on the table.
Both positions as an advantage that there is no pressure on the sacrum, allowing the pelvis to expand and facilitate the expulsion of the baby, which makes them better than vertical positions, although the support that gravity would give in a totally vertical position is somewhat limited. .
Which one is the best?
We said it at the beginning: there is no ideal position for childbirth, and as we can see, they all have their advantages and disadvantages. The advantage is that during labor the mother can try different postures , until she finds the one with which she feels most comfortable with the help of the medical staff.
Photos | iStock
In Babies and more | Birth Rights: the rights of the mother and the baby to have more humanized births
