January 26, 2018 2 min read

People have a variety of opinions on the ideal position from which to give birth. In the United States, and other developed nations, women often are automatically placed in a semi-reclined position during labor and delivery. But is this practice outdated? Does is go against the basic mechanics of the female reproductive system? Are we causing harm by putting the convenience of the birth attendant ahead of the woman? Some say yes.

The complications from childbirth can range from mild to severe, with severe tearing of the vagina and perineum, up to critical obstetric emergencies like postpartum hemorrhage. The reasons why the lure of the lithotomy seemed ideal in the 1950’s now should give us all pause. Let’s look at some of the more obvious contraindications for the semi-recumbent position:

  • The semi-recumbent position means that not only do women NOT utilize gravity and use the baby's own weight to help it move down, but it actually makes the mother work against gravity in order to push the baby out.
  • The major vessels leading to the uterus can be compressed, restricting blood flow to the baby

Historically, women in labor delivered their babies in squatting, supported squatting, kneeling and even standing positions.

One group's efforts indicate it’s time to push back against pushing during childbirth.

With the support of the Royal College of Obstetricians and Gynecologists, The Royal College of Midwives’ implemented a trial program at Medway Maritime Hospital in Kent. By simply not pressuring women to lie on their backs and “push,” the hospital reduced the number of third and fourth-degree perineal tears from 7 percent to 1 percent, an 85 percent reduction.  Dot Smith, the hospital’s head of midwifery, blames the high number of tears on the misconception that women in labor need to “push, push and then push harder.”

We’d love to hear your experiences from the field. Have you encouraged women in your care to adopt a more natural childbirth position? Let us know!

 

 

 

Leave a comment

Comments will be approved before showing up.


Also in The Maternova Blog

A Point of Care Bilirubinometer Using Blood: BiliDx
A Point of Care Bilirubinometer Using Blood: BiliDx

January 16, 2024 2 min read

The BiliDx is a novel system for diagnosing jaundice.  The device uniquely meets the Target Product Profile (TPP) developed as part of the NEST 360 initiative in that it allows blood-based testing at the bedside.   This initiative is part of an emerging global consensus in the Every Newborn Action Plan that countries need functional WHO level-2 inpatient units to care for "small and sick newborns." 
Read More
NASG as a life-saving medical device to stabilize women with postpartum hemorrhage
Clinical Indications for Applying (and Removing) the NASG: Rule of 20

January 15, 2024 2 min read

The garment must be removed upon reaching hemodynamic stability for at least two hours, where it is evident:

  • Blood loss less than 50 mL/hour
  • Pulse less than 100 beats per minute
Read More
MaternaWell Tray: Revolutionizing Postpartum Hemorrhage Care
MaternaWell Tray: Revolutionizing Postpartum Hemorrhage Care

November 06, 2023 3 min read

Now as a next step, we ask what could be done to lower the costs of the implementation of the E-MOTIVE bundle? The most obvious answer is to consider displacing the tens of thousands of disposable plastic drapes with a purpose-built reusable device. 

Fortunately one of the obstetricians involved in the E-MOTIVE study, Dr. Justus Hofmeyr, had been innovating around this very issue, designing a tray with wells that could fit under a woman’s buttocks, collect and accurately measure the. blood. This tray, the MaternaWellTray was conceived as a device that could be sterilized and reused, and is manufactured in South Africa by Umoya.

Read More