When you have a bowel movement, do you lie down on your back, put your knees to your ears, hold your breath and push? I didn't think so. So why is it that the majority of women end up in this position when it comes time to deliver their baby? Childbirth is an elimination of sorts and, just like when you have a bowel movement, birth is typically most successful with gravity, movement and listening to the body's natural urges.
When you are squeezing ketchup onto your food or shampoo onto your hand or syrup onto your pancakes, you hold the bottle upright and allow gravity to assist. You may not be thinking about gravity as you do it, but you know that it makes most sense to hold something upright to get whatever is inside to come out. You know it would be harder to get syrup onto your pancakes if you laid the syrup bottle down and tried to get the sticky sweetness out. The labouring mother is no different. It is much easier to be upright, allowing gravity to assist the baby moving into and out of the pelvis than it is to lie down and push against gravity.
A back-lying position, or lithotomy as it is known, makes labour and birth harder for mom and babe. When a woman lies down on her back, she needs to push harder because she has removed the influence of gravity and also because her sacrum (the triangle bone at the base of the spine) loses its ability to move in response to the movements of the baby and, therefore, there is less space for the baby. A smaller space and lack of movement make it harder for babe and for mom.
Upright movements such as walking, belly dancing, pelvic rocking on a ball or leaning on a ball when on all fours are all ideal choices for a labouring woman. A dimly lit environment where the birthing mama feels safe, surrounded by a strong birth team, will also support a normal physiologic birth and allow the woman to listen to her body and feel when she needs to change her position. She will also be "listening" for the urge to push. Too often media show us that we need someone to tell us when to push, but pushing too soon and pushing when told as opposed to when you feel the urge can stop the natural progression of birth.
Bringing it back to bowel movements now – pooping with a crowd of people watching or where you feel inhibited is not ideal and if you try to push the poo out before you feel the urge, it will often interfere with the elimination process and then require you to push harder with little success. Same goes for birth. Bright lights, many people coming and going and pushing before you feel the urge do not support the transition of baby from womb to world.
So pregnant mamas, listen up: Choose your birth team wisely, birth where you feel safest and turn the lights down. Listen to your body and stay upright as much as possible.
Kim Vopni is known as The Fitness Doula and is an authority on helping women get through birth in one piece. Based in Vancouver, she is a certified pre/postnatal fitness consultant, co-founder of Bellies Inc and owner of Pelvienne Wellness Inc offering innovative products for a better birth and recovery. You can follow her on Twitter at @FitnessDoula