The Importance of Using Gravity to Your Advantage in Childbirth

When you picture a woman in labor, where is she, and in what position? If you're like most of the American population, in your mind's eye you see a sweating, hollering woman in a hospital gown, lying on her back in a hospital bed, legs spread wide in stirrups, with monitoring devices strapped to her belly. If she's quiet, it's because she's already got her epidural and is behaving nicely for the medical staff because she can't feel anything. She is a "good patient"--submissive, easy to deal with, and totally vulnerable to medical management.

Unfortunately, while that picture has been presented to us as the norm, it is a serious hinderance to natural labor, and potentially harmful to mother and baby. The people who really benefit from that position are the medical staff, not the mother or her child. Consider this: From 4 months gestation on, pregnant women are warned not to lie down or sleep on their backs. Why? Because the pressure from the uterus and baby rest on essential arteries in that postition, and the uterus can also move into a position that puts pressure on the mother's various breathing mechanisms.

Most of us naturally eschew lying on our backs, especially later in pregnancy, because it is incredibly uncomfortable. Mom gets breathless and oxygen deprived, and baby gets oxygen deprived as well. If lying on one's back is not a healthy or sensible position for a pregnant woman, why are so many pregnant women forced into that position when they most need the ability to breathe well and get enough oxygen, during labor?

Worse yet, laboring in a reclining or semi-reclining position can reduce the size of a woman's pelvic outlet by as much as 20%. That's right, although the pelvis is made of bones, those bones are designed to open and separate to allow the passage of even a large baby. Ever wonder why so many healthy, strong, well-fed, modern women are diagnosed as having an inadequate pelvis for passing a baby? You'd almost think we were still in the Victorian era, and all our pelvises had been destroyed by corsets and malnutrition! It would be interesting to see what outcomes would have been if these women with CPD (cepalo-pelvic disproportion) had been allowed to labor and push in positions that open the pelvis to it's greatest width--positions like standing, squatting, or hands and knees.

Even sitting on the toilet is preferable to lying on one's back in a bed. Primitive cultures world-wide have understood this for centuries. They may not have had all the technology we have now, but they had less need of it, too, because they understood what is good for labor, and what is not. Like other mammals, they did what came naturally, and strapped to a bed is not natural.

Giraffes labor standing up, and literally drop their babies from a great height. Imagine what would happen if we decided that was far to dangerous and primitive, and zoos began to force laboring giraffes to lie down to birth. It simply wouldn't work, and we know it. Sadly, it seems that we have forgotten that we are part of the natural world and that what works in nature works for us (and what hinders in nature hinders us).

There is no perfect, never-fail position for labor. Every woman is different, and each must find the best position for her individual body and her baby's presentation. Any woman who intends to give birth at a hospital and wants to have the best chance at a natural birth experience must understand that being restricted to bed in a reclining position is by far the worst possible position for her.

Women who want to birth naturally must also understand that permitting constant fetal monitoring, or internal fetal monitoring, will be the first step in restriction of their movement. As long as both mother and baby are known to be healthy, there is no medical reason for anything beyond intermittent external fetal monitoring. As well, being connected to an IV will restrict movement. If hospital policy requires a needle in your arm, insist on a hep lock, and have your partner or birth attendant make sure you stay hydrated by offering you water or juice.

If you want a natural childbirth, walk, squat, walk some more, "dance" with your partner, sit on the toilet, take a warm shower, and walk some more. But whatever you do, stay off your back!