For decades, women have given birth, bocarriba, "legs up", with the sole objective of allowing professionals to have perfect vision and good maneuverability when it comes to attending labor.
This position is beginning to be supplanted by others more respectful for women, basically because they offer more freedom of movement and more control of their own birth.
Faced with this freedom, many women arrive confused in the delivery room because, waiting for someone to say “come, lie here”, they receive a “how do you want to give birth” that many do not wait to arrive willing to give the total control of childbirth to the professionals. As professionals are beginning to fight, precisely, to give this control to the true protagonists of childbirth, which are the baby and the mother, mothers should inform and prepare for it. A woman with previous information and with more or less clear things is much more able to decide if, when the time comes, she is asked for her opinion about some process of childbirth.
For this reason it may be interesting to explain what is the most comfortable position to give birth.
Lithotomy position
We have already spoken on other occasions of the lithotomy position, which is the name given to the traditional position (lying with your legs raised). This position has the mission of improving the care of the professional, controlling the delivery better and preventing possible problems. However, with the passage of time, it has been shown that This position, whose objectives are so commendable, ends up causing precisely what is supposed to prevent problems.
The fact of lying down makes the birth canal take the form of a cylinder upwards. Something like a slide lying down. If the woman were still lying with her legs hanging, the channel would be flatter, but the position would be uncomfortable. As the channel is in that position, the baby has to go out against the force of gravity (uphill, to be more graphic).
In this position, moreover, the baby's weight falls on the blood vessels that provide blood and oxygen to the same baby, pressing them. In the same way, the mother's circulation is hindered, resulting in a decrease in blood pressure that can make many mothers feel dizzy and nauseous (that is why pregnant women do not usually tolerate sleeping bocarriba). If we add to this that many women are given epidurals, which also tends to lower tension, childbirth can be quite complicated.
The most suitable position
I know you are waiting for me to tell you what is the most appropriate position to give birth, well, the answer is that The most appropriate position to give birth is that which a woman naturally adopts because it is the one that makes her feel more comfortable or that the body or her own instinct is asking for at that time.
This position is usually standing upright, on all fours or squatting. In this way the birth canal is shorter, the bones of the pelvis can be opened (not lying down, because the stretcher is butt behind) and the baby has the help of the force of gravity that, curiously, exerts a force similar to that allowed to perform with forceps.
In a respected birth, in which the woman is allowed to be in an environment with few stimuli (dim lights, no beeps, no people continually entering to ask things to expect - such as the DNI of a woman in the process of dilation) and she feels calm and confident, most likely she will adopt the position that best makes her feel, which will be precisely the one that will make the baby fit and be born in the easiest way.
If instead the delivery takes place in a cold room, too bright, with the constant noise of beeps and monitors, with voices of health professionals in a little warm attitude (remember, in our second delivery, a midwife shout: “This She does not know how to squeeze, call the pediatrician that we have a cesarean but now! ”), with people entering and leaving or with those actions that annoy or decentralize the mother, the woman cannot“ let herself go ”and stops“ listening ”to his body, probably avoiding the need to change posture and giving birth management to third parties.
And the professionals?
When talking about the lithotomy position we said that it is the one that offers the best level of vision and work to professionals. If the woman now changes her postures to give birth, won't the work of the people in charge of giving birth be too difficult?
The truth is, by adopting women the position that suits them best, possible problems are being prevented and, therefore, professionals are being saved work. However, when it comes to serving women, professionals must adapt to their needs (and not adapt women to the needs of the professional).
For this, many hospitals are modernizing and many already have obstetric stools (a moon-shaped stool, that is, open, in case the woman wants to sit down to give birth in a squat), wide beds with cushions (for those women who prefer to give birth in bed, on the side, semi-incorporated, etc.), bathtubs (to promote dilation relieving pain with hot water and if the woman wants to give birth inside), balancing elements, such as balls, ropes that hang from roof, etc. and, what is more important, with committed professionals who are updated and prepared to give the prominence of childbirth to women.
And in all this, where is the epidural?
The epidural is a highly valued resource, and rightly so, since it allows giving birth they are pain. The problem is that the epidural prevents the woman from adopting a comfortable posture and, therefore, increases the risk of problems in childbirth and its duration (by eliminating the force of gravity the baby's head stops pressing). This increases the chances of ending up instrumentalizing labor with the use of oxytocin, forceps or cupping.
A medium term, for those women who want the epidural, could be the use of the call epidural walking. It is a lumbar puncture, just like the traditional epidural, but with a lower dose of anesthetic and a higher dose of opioid. In this way the woman can walk and move without noticing pain in the contractions, maintaining a certain sensitivity of what happens in childbirth.
Photos | Flickr - Paul Schultz, Eyeliam
In Babies and more | Birth postures, Births in an upright position, Delivery in vertical, better than in lithotomy
