Tag: birth positions

Things For You To Try That Could Shorten Labour

If you’re pregnant, you may be wondering what you can do to shorten labour – because who wants to spend longer than necessary in labour rather than meeting your baby?! The good news is that there are several things you can do to help prepare your body for labour and potentially shorten the process, which can last between 14-21 hours depending on whether it’s your first baby or not. But of course, all bodies are different and there are lots of factors that affect how quickly a baby comes.

Stay Active In Pregnancy

Staying active throughout your pregnancy can help you prepare for labour and birth. Exercise strengthens your muscles, including your pelvic floor muscles, which can make pushing easier. Walking, swimming, and antenatal yoga are all great options for staying active. People who exercise 3 times a week in pregnancy can reduce the length of their labour by 50 minutes!

Antenatal Yoga

Yoga and other forms of stretching are excellent ways to help get your body for labour and birth. A lot of the movements help to keep you upright and open up your pelvis, as well as stretching and releasing the psoas muscle which supports the pelvic floor. If any of the muscles in your pelvic area are tight or imbalanced it can cause suboptimal positioning for baby, which in turn can cause labour to be longer. Yoga can also help turn your baby into an optimal position with their head down and chin tucked, and if baby’s in a great position then that can help reduce the amount of time it takes to meet them.

Antenatal Education

You wouldn’t head off to a job interview without doing some prep work first would you? Giving birth is exactly the same – birth preparation can help you prepare for your labour and birth. Knowing what your body does when giving birth, how you can optimise your birth physiology and what you might encounter if your birth throws you a curve ball can really help you reduce your stress hormones when the big day arrives. And we know stress hormones impact oxytocin and can slow your labour right down. The good news is we cover all of that and more in my classes – check out the store page to see what options suit you.

Eat Dates

Research tells us that eating dates can reduce the length of your labour as well as increasing your chances of going into spontaneous labour rather than being induced. Eating them also decreases the chance of having heave blood loss after birth. Around 7 dates a day from 36 weeks of pregnancy might mean you get a little bit bored of dates, but not bad for a humble fruit!

Raspberry Leaf Tea

Many women and birthing people swear to the power of raspberry leaf tea to tone the uterus and make contractions more effective, and in doing so making labour shorter. The evidence behind it isn’t robust but we do know it’s not going to cause any harm. Worth a shot, eh?

Oxytocin Boosters

Oxytocin stimulates contractions. Having a good healthy dose of oxytocin in your system will ensure your contractions are as effective and as efficient as possible leading to a shorter labour. Without enough oxytocin in the system, your contractions will slow and things will take longer. Find out ways you can encourage oxytocin here.

Breathe!

Breathing is a very powerful tool when giving birth. Not only does it help you relax which reduces physical tension and soreness, it trips your parasympathetic nervous system and reduces stress hormones – allowing oxytocin levels to rise and the wonderful positive feedback loop mentioned above to start. But that’s not all! A steady breathing pattern makes sure your body has plenty of oxygenated blood to carry to the birth muscles, and well oxygenated muscles work more effectively.

Continuous Support Partner

Whether this is from a birth partner, a doula, or both, research tells us that having a continuous support during birth can help improve outcomes. Having a non-medical person to help support you in different positions, with oxytocin boosters, to help you relax, and to make suggestions if things seem to be slowing down can help you optimise your birth.

Stay Home

We know that people who plan home births have fewer interventions because things aren’t progressing as quickly as expected as well as a whole heap of other benefits. Even if you’re not planning a home birth, staying at home for longer helps keep your oxytocin levels up which can reduce the amount of time you’re in labour (and hospital) for.

Try Different Birth Positions

Changing positions during labour can help ease pain and pressure and encourage your baby to move down. Some positions to try include squatting, kneeling, or standing and leaning forward. You can also try using a birthing stool or a birth sling. Positions that help you be upright and open are great ones to try. Being on a bed on your back generally slows things down as your body has to work against gravity and the pelvis doesn’t have space to open.

Use a Birthing Ball

Sitting on a birthing ball can help open up your pelvis and encourage your baby to move down. The gentle bouncing motion can also help ease pain and discomfort during contractions. If you don’t have a birthing ball, you can use a regular exercise ball or even a chair.

Eat, Drink and Be Merry

Staying hydrated and fuelled with calories is important during labour, as dehydration and not having enough calories can slow down the process. Make sure to drink to thirst (or have someone remind you) and snack on calorie dense food throughout labour.

Consider Medical Intervention

For some people, no matter what they try, labour will be slow progress. This might be due to lots of different factors such as baby’s position. If your labour isn’t progressing your midwife or doctor may suggest medical help such as an oxytocin drip or rupturing your membranes. When interventions are offered they must always discuss the benefits, risks and alternatives with you so you can give informed consent.

There are no guarantees when it comes to giving birth but we do know that lots of things can help – and hinder! – the process. Make sure the team around you know how they can help you with some of these things.

Birth Positions Which Can Help You Give Birth More Easily

Many women enter pregnancy having only seen labour occur on television, where women are laid on a bed, knees up, chin to chest, ‘purple pushing’ interspersed with screaming. Understandably, this can lead to some nervousness on the pregnant woman’s part!

The weight of research[1] shows that upright labouring positions can provide advantages to a birthing mother. In an upright position, gravity can assist the baby within the uterus by bringing it down and out, as well as helping keep it in the optimal foetal position when coupled with leaning forward. Being upright can also reduce the risk of aorto-caval compression which could result in a reduced blood supply to the baby. Upright positioning uses gravity to bring a stronger connection between the baby’s head and the cervix, releasing oxytocin and giving more efficient uterine contractions. In traditional squat and kneeling positions the pelvic dimensions become wider, allowing the baby to pass through with more ease. As well as increasing the comfort of the mother and improving the overall birth experience, the positive impact of these positions on the pace and efficiency of labour tend to make interventions less necessary and therefore less common.

The benefits of upright positioning don’t stop there either. Studies have shown that an upright position during the first stage can both reduce pain in the labouring woman[2] and shorten that stage, reducing the need for pain relief and preventing exhaustion in the woman. Interestingly the physical position a woman is in to give birth can also have a psychological impact: being able to find a comfortable position and knowing that the woman’s own movements are helping the baby be born more easily can give feelings of control and stem any fear and anxiety arising from the situation. By reducing stress and discomfort, these psychological responses to a good birthing position can make the whole experience more positive.

Despite the considerable evidence for the benefits of upright birthing positions, the actual positions that women give birth in do not reflect the evidence or national evidence based practice guidelines and nearly half of deliveries are made in a semi-recumbent position[3]. In developed countries where pregnancy and labour has become medicalized, interventions such as foetal monitoring and different types of analgesia can limit the options for position of a birthing woman[4]. A Cochrane review theorises that women are encouraged to push in supine or semi-recumbent positions simply because it is more convenient for the healthcare professional to gain access to the woman rather than being beneficial to the woman. Women ‘choose’ these positions on the basis that they think it is expected of them when presented with a bed in a hospital setting, coupled with the cultural expectation ingrained in them as seen previously, through the medium of television[5]. It is important that the woman knows what positions will help her and to have the confidence to try these positions without being led by the healthcare practitioner in attendance.

A Cochrane review[6] compared the risk of interventions and birth outcomes for upright birthing positions in comparison to non-upright birthing positions and concluded that upright positions can be associated with a shorter length of first stage of labour; a reduction in the use of epidural analgesia; almost a quarter less likely to have an assisted delivery; 20% less likely to have an episiotomy but 35% more likely to have a second-degree tear; 50% of births are less likely to have an abnormal foetal heartrate and 65% are more likely to have a blood loss of more than 500mL. The review found that there was no difference in birthing positions on the length of the second stage of labour; emergency caesarean rates; third or fourth-degree tears; blood transfusion rates; neonatal admissions or perinatal deaths. As there is only a negative impact on second-degree tear rates and blood loss by being in an upright birthing position, it seems clear that upright birthing positions really are the most beneficial, especially as tears can heal more quickly and neatly than episiotomies and there is no knock-on effect on blood transfusions needed.

The birth position chosen by the labouring woman may have a specific purpose. Different positions can bring relief to different complications. For example, if shoulder dystocia presents then the Gaskin Manoeuvre[7] of turning onto all fours and being on hands and knees will cause changes to the pelvic shape which will allow the shoulder to release and the baby to be born.  All fours positioning will be useful for women whose baby is or has turned occiput posterior in labour. Gravity and rotations can help the baby rotate to anterior position[8] although Balaskas points out that when the baby begins to crown each woman should become as vertical as possible to help it out. The use of these positions and a mother’s existing familiarity with them will help to reduce the need for interventions.

There is not just a physiological impact from birth positions on a woman, but psychological too, and these can prefigure the birth itself. Knowing that she can speed up her labour or slow it down if she feels overwhelmed puts her in a position of power. A woman who feels like she is in control of her birth, who feels as though she has a variety of tools at her fingertips to assist a range of experiences she may encounter, will be more empowered to deal with how her labour goes. In contrast, being in a supine position promotes a vulnerability in a healthcare setting that the woman must shed in order to birth most effectively; being upright will automatically help with that.

Ultimately a woman must birth in the position in which she is most comfortable, and the care providers around her must work with her to help her accomplish that goal.

[1] MIDIRS (2008) Positions in labour and delivery. Informed choice for professionals leaflet Bristol: MIDIRS. See also: Gupta, J et al (2012) Position in the second stage of labour for women without epidural anaesthesiaCochrane Database of Systematic Review

[2] Miquelutti, MA, Cecatti, JG (2009) The vertical position during labour: pain and satisfaction Revista Brasileira de Saude Materno Infantil

[3] Royal College Of Midwives (RCM) 2010 The Royal College of Midwives’ Survey of positions used in labour and birth London : RCM

[4] 2016, W.H.O. (2015) Position in the second stage of labour for women without epidural anaesthesia. Available at: http://apps.who.int/rhl/pregnancy_childbirth/childbirth/2nd_stage/tlacom/en/

[5] The Royal College of Midwives (2012) Evidence Based Guidelines for Midwifery Led Care in Labour: Positions for Labour and Birth

[6] Gupta, J et al (2012) Position in the second stage of labour for women without epidural anaesthesia Cochrane Database of Systematic Review

[7] Gaskin, I.M. (2003) Ina May’s guide to childbirth. New York: Random House Publishing Group.

[8] Balaskas, J (1989) New Active Birth: A Concise Guide to Childbirth,London: HarperCollins