As a Labour and Delivery Registered Nurse, I have seen first hand the effect maternal positioning has on fetal positioning and length of labour. Why does it matter what position the baby comes out? Well, we like babies coming looking at your back. When babies are facing this way we call it occiput anterior. You will feel contractions in your belly and babies come out more easily as this position as it encourages the smallest diameter of their head to come out.
When babies come out facing up towards your belly, we call this occiput posterior or “sunnyside up”. This fetal position causes a lot of back pain in labour, slows labour and pushing as a larger diameter of their head has to come out in this position, however, babies can still come out this way.
So how can I get my baby in the right position?
Get moving! Change positions frequently and stay off your back! It is not natural or preferable to lie on your back in the bed for the duration of your labour. Positions that are more upright and leaning forward encourage baby into that awesome facing down position.
In a study comparing upright versus lying back labour positions, women that laboured in upright positions had a 1 hour and 22 minute shorter first stage of labour! (Lawrence, A., Lewis, L., Hofmeyr, G., & Styles, C., 2013). In another observational study comparing lying back labour positioning to alternative labour positioning, there were significant differences in labour length, need for analgesia, type of delivery, need for an episiotomy and fetal occiput rotation.
Therefore, it was concluded that alternative maternal positioning may positively influence the labour process, reducing maternal pain, operative vaginal delivery, caesarean section, and episiotomy rate. Women should be encouraged to move and deliver in the most comfortable position (Gizzo, S., Di Gangi, S., Noventa, M., Bacile, V., Zambon, A., & Battista Nardelli, G., 2014).
So what positions do you encourage your patients to use?
Ultimately, whatever positions feel comfortable for them and every pregnant mama is different. I encouraged pregnant mamas to try hands and knees, side-lying, standing while swaying with a support person, lunges, standing leaning over the bed, squatting, sitting on the toilet or rocking chair, standing leaning over the bed and utilizing the shower or bath. I have seen it time and time again, those who are willing to use alternative positioning, relaxation and breath, usually have shorter labours, less intervention, better pain tolerance and ultimately a more positive birthing experience.
Over the past few years, I have noticed an improvement in the birthing experience. I can’t speak for every hospital but nurses are supporting and encouraging labouring mamas in a hands-on and caring way. We are passionate and pour ourselves into giving you a positive experience. We are getting far away from that old school on your back in the bed, feet up in stirrups that you have seen in movies. Sign up for a prenatal class, be informed and advocate for yourself!
Looking for an intimate prenatal class with an in-depth focus on positioning and relaxation? Contact your friendly neighbourhood Mama Coach!