If being upright makes giving birth easier why do less than 4% of women give birth standing up?
Studies tell us that when a woman is upright, the baby gets more oxygen as there is less risk of a major blood vessel being compressed. This means less fetal distress. Any woman who has ever been in labor can tell you that the contractions are stronger and more frequent when the woman is up and moving around. This means less Pitocin. And evidence tells us that being upright shortens both the first and second stage of labor. Common sense tells us that when a mother stands, squats or kneels that gravity can help the descent of the baby through the birth canal. This means less dystocia; the inability to move through the pelvis; the most common reason for unplanned cesarean birth. Most importantly, when the woman stands or squats the pelvic diameter is actually larger and allows for a bigger head to move through the pelvis more easily than when the mother is lying down.
This past Saturday the San Diego Birth Network, hosted a talk at the San Diego Archaeological Center. The archaeologist in residence did her Master’s thesis on Childbirth in Archaeology and she shared with us some ways of ancient cultures that support this idea of being upright when pushing out a baby. Of the 19 early ethnographic studies of childbirth around the world, none of them gave birth lying down. Some stood, some squatted, and some knelt. Many of the mothers tried multiple positions. This freedom of movement allows the mother to feel her power and to manage her pain. She can do what needs to be done to help her baby come down and out without drugs or instruments. Upright mothers are 23% less likely to need a vacuum and 21% less like to have an episiotomy.
I decided to discuss this issue in my blog because the cesarean birth rate is too high. While there are many reasons for this, I believe that limitations on women’s movement and freedom to do what needs to be done in labor, is a primary reason. I gave birth 5 times and the first time I was restrained and restricted. After that birth in my head and my heart I said, “Never again”. I preferred to manage my own pain, rather than have a spinal that took every bit of control away from me. Now spinals are no longer used for vaginal births, but even with today’s epidural requiring IV’s, catheters and fetal heart monitors, women give up their freedom to move once the anesthesia is given. And with the epidural, it is usually the doctor or nurses who dictate the birth position.
Interestingly, studies show that the doctors, (not the mother’s) preferred birth position is the one that the mother is most likely to use. I was determined to have all natural births, so that I could move freely and give birth in any position I desired. I was determined to be the one deciding which position I would use. I also became a midwife. Luckily for me, I had midwives with my other four births and I moved constantly during labor and tried different pushing positions until I found the best and most comfortable position for me. It just so happened that I was a natural born squatter.
I was lucky enough to be in attendance of a wonderful home birth recently, where the mama went from hands and knees in the garden, to squatting on a birth stool, to side lying on the bed, to standing while hanging on to her husband, to kneeling and squatting in a small space between the bed and the wall, to hands and knees in her birth tub where she gave birth 5 mins later. My midwife heart grew with the pleasure of seeing a powerful woman in her element. She was a birthing Goddess, knowing just what to do, what was just right for her and her baby. This was only possible because she was supported to move freely and let her body guide her with beautiful abandon. This midwife was in awe.
So how will we be able to help the 96% of the women who now feel compelled to get in bed, stay in bed and TRY to give birth on their backs? We can do this….. More childbirth educators to help mothers understand what is normal and natural, and what all women are capable of. More doulas to support the woman during labor so that she can claim her power and her pain and forgo anesthesia in most situations. Doulas help women find the transformation in birth. We need more midwives (and doctors) empowering women at home, birth centers and the hospital to be the one that determines where and how she will give birth. More caregivers who respect and honor the woman’s innate birthing wisdom and protect her from harm by allowing her to do what needs to be done her own way.