There are a whole bunch of fables we have about childbirth and the biggest one is that women must give birth lying on their back in bed. Contrary to what Hollywood teaches us and perhaps what our mothers went through giving birth on our backs is the most uncomfortable, ineffective and dangerous position for both mum and baby for the following reasons.
- Minimised space in the pelvis, up to 30% smaller
- Forced stretching of the pelvic floor by 3 times what is required
- Prolonged lack of oxygenation for the baby by a longer pushing stage
Being in a lithotomy position (completely flat with stirrups) is the worst but also simply being on our tailbone requires a mum to push a baby UP a birth canal. This means we are pushing against gravity and also needing to stretch our perineum and pelvic floor muscles three times as much.
60 % of women choose an all fours stance
When women are given the choice, freedom and encouragement by their caregivers to find what is most comfortable for them during the second stage 60 % of women choose an all fours stance. This can be in the bath, on the floor with mats or on the bed.
Some mums will birth standing up or with one leg on a step, some lean back in the bathtub and some choose a deep squat but the majority choosing an all fours position makes complete sense for the following reasons.
- A woman naturally brings her hips back over heels when pushing (which creates a squat by definition) and the tailbone can then tilt out of the way (which moves by minimum 4cm)
- The birth canal flows downwards and so can a baby be helped here with gravity and less effort from us, which in turn allows the perineum to stretch easily without the added pressure, time and length found when lying back
I hope this information helps reframe how you see yourself birthing your baby so that you can have an easier delivery. Remember when we listen to our bodies and find what is most comfortable it will also be the most comfortable for your baby. To learn more about how to breath your baby down and the evidence based ways to reduce both pushing time and perineal damage check out the breathing techniques in the She Births Online Course.