Get Off The Bed!
This week’s “One Born Every Minute” again showed women painfully, agonisingly labouring and birthing on a bed despite using pain relief measures such as gas.
Sadly many were on a bed at the direction or encouragement of a midwife, even after they had tried to get off as their discomfort was directing them to do.
Labouring and birthing on a bed is not how birth is intended or should be.Women labouring on their backs, or sitting on a bed to birth is one of many non-physiological or inappropriate hospital maternity practices the Royal College of Midwives is trying to stop in the UK.
Past president of the International Federation of Obstetricians and Gynecologists (FIGO); Roberto Caldeyro-Barcia stated in 1975 that “Except for being hanged by the feet, the supine position is the worst conceivable position for labour and delivery”.
The possible consequences of labouring and birthing on a bed include;
1) Reducing the room for the baby to exit by up to one-third, as the tailbone is forced forward, this also increases the pain and length of labour as well as the difficulty to deliver the baby.
2) Stretching of mainly, or only the perennial tissues (area between vagina and anus), rather than pressure being evenly exerted on all of the pelvic floor, makes perennial tearing more likely. Also the pelvic floor’s contribution to the natural feedback loop or drive of the ‘Fetus Ejection Reflex’ ( nature’s means to birth the baby) is not as effective as when upright.
3) Being less than upright results in various degrees of major blood vessel compression which causes decreased fetal circulation (blood supply to the baby) and increases maternal blood pressure, both of which can lower oxygen supply to the baby resulting in decelerations of the fetal heart rate (fetal distress).
4) Weaker, less frequent, and more irregular contractions as pressure on the cervix is less (impeding nature’s feedback mechanism) so l pushing is harder as increased force is needed to work against gravity than when upright.
5) Venous thrombosis (clots) or nerve compression from the pressure of the leg supports, when the legs are put into stirrups, also increases the need for episiotomy or risk of tears because of excessive stretching of only the perennial tissue and uneven tension on the pelvic floor.
All of the above increase the risk of instrumental (vacuum or forceps) delivery or a caesarean section to get the baby out, all
of which have their own short and long term risks of harm to both mother and baby!
Many studies asking women about their preferences have shown that being upright compared to lying down results in less pain during labour and pushing, less backache, shorter and more effective efforts to birth the baby with less trauma to the mother and the baby is born in a better condition.
The only problem appears to be for those who want to catch the baby, they need to be flexible!
‘Mother’s Advocate’ has published a 6 part series; ‘Healthy Birth Practices’ on You Tube, as well as 4 episodes of their ‘Timeless Way’. The latter explores how most of our ancestors, regardless of their culture, would have birthed in a supported upright position until the most recent generation had hospital deliveries or attempted to birth in a ro0m dominated by a (hospital) bed.
“Get up, stand up: stand up for your rights!” ― Bob Marley