It's many years since I gave birth...on my back.
This seems a mad position now as surely that way you are pushing up hill!
I am interested to know if this is still the usual custom as having learned about Christine's approach to pelvic anatomy I imagine this is the hardest way to do it.
Hands and knees plus gravity would seem to be the common sense way to help the body deliver a baby with the help of gravity and least strain on the pelvis. Have things improved in this regard? In my day we did what we were told...not always a sensible idea.

I'm not sure when 'your day' was, when I was born my mother was in 'twilight' and I'm sure she was on her back (and probably strapped down too).
I had my youngest three babies at home, squatting and hands/knees.
my sister's obgyn 'allowed' her to birth kneeling on the hospital bed, so things have definitely changed since my mother's day (depending on where you are I guess).

and I agree with you, it is mad to push out a baby while laying on your back! also agree that its not always sensible to just do what the dr/nurses tell you to.

I had my first baby in 2008, and ended up on my back at the very end because the external fetal monitor wouldn't stay in place when I was moving around as I wanted. So not ideal, but I have to say the birth was incredibly fast even if it was pushing uphill.

I think it is important to ask in a prior hospital visit what their normal procedures are. My babies back in the 1980's never had foetal heart monitoring of the electrode in the scalp variety. There is really not a lot they can tell from a foetal heart monitor that they can't hear with one of those cone things, BUT foetal heart monitors do have a serious effect on the woman's ability to move around during labour, particularly towards the end where we often get restless, cross and impatient.

That is one very good reason for not having it. A woman who is on a drip, has a foetal heart monitor; has to be near gas; or has an epidural, ends up with so many tubes coming out of her that any sort of change of position is a major cognitive and physical effort, when she should be 'in the zone' labouring according to what her body needs, and the signals it is giving her.

It is these sorts of seemingly simple, routine interventions which mess a woman's labour up, and I think contribute to the foetal and maternal stress that calls for all the interventions, ie they are self-serving.

My first labour was planned by my obstetrician to be fully managed. I did not play a single, active part in it. I felt like an observer at someone else's Christmas celebrations, which was very disappointing after planning an active, natural labour and birth.

My second labour and birth were planned to be active and natural, and even though my labour was started artificially at 39.5 weeks with rupture of membranes, so my husband could be there, and proceeded actively and naturally. I felt a little uncertain of my ability to pull this off, and remained open to absolutely necessary intervention which, as it turned out, was not necessary. I was *allowed* to labour without invasive intervention. The birth was great.

By the way, these first two births were at a major women's hospital in Perth, where they handled all the high risk pregnancies and labours, but there was no drama about having interventions pushed on me.

For my third labour I did a deal with the midwife. I told her I would labour in my own way, wherever I wanted to, and had arranged to bring a double foam mattress into the delivery room where I was labouring. I said she could use her little cone thing to monitor the baby's heart for a brief period on the delivery table as often as was needed, but she would have to warn me when she wanted to do it so I knew that she wanted me on the table for 30 seconds during the next contraction. I wasn't the most compliant mother in the world but I wasn't going to let a lady in a uniform dictate the terms of my labour. It was a posterior labour right up to transition, but I was feeling very powerful right through the labour and was not worried about her intervening more than she needed to. The deal had been done, and we were both happy. As it turned out the baby flipped while I was dry-retching on hands and knees during transition, and he was born safely in normal presentation without too much drama.

I think, like Alemema says, (wherever you labour and birth) ensure that you know as much as, or more than you need to. Know what the norm is in this particular hospital. This puts you in a position of *power* which enables you to make decisions, confident that you have enough information at your disposal to make them responsibly. It also means that you do not feel threatened or patronised by the Midwifery Staff.

During that third labour I experienced the most exquisite feeling of power and innate ability that I have ever felt during my life. I wouldn't have missed it for quids!


I went to a birth center in 2004 ... Had a horrible midwife and after giving me an anti anxiety which rendered me useless, but still in pain ... She yelled at me like a football game and didn't help me move from laying on my back for the WHOLE time. I was quite unable to say or do anything due to fatigue coupled with the drug (I was groggy and completely out of it). I kept picturing the page in the Bradley method book that said only push when you feel the urge and the others that said squat/hands and knees whatever ... But I just couldn't function enough to let them know what was on my mind. I thought I was in the best facility possible for my "natural" birth, which was anything but natural to me. My husband was there and he was way out of his league. Seems to me location is just one variable. I'm still a tad angry about the whole affair in case you couldn't tell :)