Birth poitions

Body: 

Hi ladies,
I wonder what you think here about birth positions.

I saw here a while ago that Christine wrote that women experienced some problems after pushing in the squatting position. Would be happy to hear more about it please...

What about pushing on one's side? I learned that it allows the sacrum to move freely and creates more room for the baby.

One of my students complained about hip pain that started after she gave birth, in the side she was lying on while pushing.

The same thing happened to me, but I spent 6 months in my last pregnancy in bed rest, lying mainly on my left side... so I didn't even think about the position that I was pushing on as a cause to my aches till my student complained. I wonder what you think about it.

One more thing… Christine explains in the Fundamentals video, about slight counter notation while toileting. Is it recommended for pushing too?

I did it in my home births instinctively, but learned later from an excellent teacher that there are benefits in anterior pelvic tilts (bringing the ASIS forward) while pushing, when the baby is low in the pelvis. I saw it helping one of my students when I was with her in labor a few weeks ago.

So now I'm confused... maybe it depends on the baby's position in the womb?

Thank you so much for your wisdom!

Childbirth educator

Nutation and not notation..I believe she said slight tilting of the pelvis.

Any insight about birth positions and the Whole Woman will be very appreciated ☺

Hi Childbirth educator,

It’s an intriguing subject and one of the many aspects of women’s health that remain under-studied by the medical system.

It has been observed and written about in the obgyn literature that the baby drops deeply into the pelvis during the very last weeks of gestation, which we call lightening. It has also been reported in orthopedic studies that the lumbar curve decreases in advanced pregnancy, which surprised researchers because it was assumed lumbar curvature becomes more and more pronounced as the belly expands forward.

If you put these two observations together, it seems likely that the fetal head is forcing the pelvis into counternutation during the last weeks. In order for the head to move through, the sacrum must move up and out of the birth canal.

During birth the opposite must happen: the ischial spines must widen for the baby to move out the back. Yes, we have had women (Granolamom comes to mind) report that they tore terribly trying to birth in a deep squat, where the tailbone is tucked under.

It is true that the pelvic wall must be slightly relaxed in order to distend to release feces. Only after stool moves through does the wall automatically contract.

You are right that something similar must take place during the birth process. Perhaps the pelvis achieves full nutation when the head and shoulders move through the ischial spines (most narrow part of the passage) but then the muscular wall slackens a bit during birth of the head and shoulder girdle in order to protect the integrity of the perineum.

It’s very useful to know how the bony pelvis moves, but I think the wisest action is to allow the woman freedom to birth in a forward position like hands and knees or hinging at hips. The pelvis will move optimally on its own.

Many a woman and child have survived birth in supine and side-lying positions, but these are obviously less anatomical.

Hope this helps.

Christine

I really appreciate it!
Have to read it a few more times☺