Is it better to lay down and give birth or squat?

Answer 1

Squatting is actually a more natural position for our bodies to give birth in. I had planned on giving birth in the natural way, the way my Cherokee ancestors did, by squatting...but I had some major complications and had an emergency c-section at 27 weeks...so that obviously didn't work out like I'd wanted it to!

But really, it's a personal decision. You should do some research, asking doctors or midwives or nurses (or doulas) and weigh out which would be better for YOU.

Answer 2

Without question squatting opens the pelvis and is a natural position for pushing + force of gravity. However, doctors in the hospital prefer the lithotomy position (on your back, legs up like a bug) and if you have an epidural that is exactly where you'll be.

Answer 3

It really depends on which gives you the most comfort...yes, squatting does have it's benefits, such as gravity and opening up your pelvic area to give baby more room to come down...however, if everything is going smoothly and you haven't been pushing long, whatever you are more comfortable with is best for you! Good luck!!!

Answer 4

I'd totally squat had I been given a choice. No point in neglecting the benefits of gravity.

Answer 5

It really is such a personal decision. Squatting gives you the advantage of gravity, and I have heard that it helps speed the delivery.

Answer 6

I belive they say that squatting helps the baby go down the birth canal a little easier. icould be wrong thuogh.

Answer 7

Girl,
You are gonna do whatever makes you feel more comfortable at the time of the birth! There is no sure way to give birth without excrutiating pain! Pray and get the epidural! When you see that beutiful baby, you will know it was all worth it!

Answer 8

just bend over and pop that sucker out.

Answer 9

Pregnant women are told to avoid laying on their back late in pregnancy as laying on their back can deprive the baby of oxygen. Yet women are often left on their back for long periods while waiting in OB offices, undergoing ultrasounds, and the longest period of all: during birth.

Does it make any sense to lay on your back during the period when babies are under the most stress, oxygenation of the mother's blood is at the lowest and the cord may be compressed from contractions. No.


http://www.birthpsychology.com/messages/lithotomy/lithotomy.html

Roberto Caldeyro-Barcia, past president of the International Federation of Obstetricians and Gynecologists, states unequivocally, "Except for being hanged by the feet, the supine position is the worst conceivable position for labor and delivery" (1975:11). There are a number of problems generated by this position: (1) it focuses most of the woman's body weight squarely on her tailbone, forcing it forward and thereby narrowing the pelvic outlet, which both increases the length of labor and makes delivery more difficult (Balaskas and Balaskas 1983:8); (2) it compresses major blood vessels, interfering with circulation and decreasing blood pressure, which in turn lowers oxygen supply to the fetus (for example, several studies have reported that in the majority of women delivering in the lithotomy position, there was a 91% decrease in fetal transcutaneous oxygen saturation (Humphrey et al. 1973, 1974; Johnstone et al. 1987; Kurz et al. 1982); (3) contractions tend to be weaker, less frequent, and more irregular in this position, and pushing is harder to do because increased force is needed to work against gravity (Hugo 1977), making forceps extraction more likely and increasing the potential for physical injury to the baby; (4) placing the legs wide apart in stirrups can result in venous thrombosis or nerve compression from the pressure of the leg supports, while increasing both the need for episiotomy and the likelihood of tears because of excessive stretching of the perineal tissue and tension on the pelvic floor (McKay and Mahan 1984).

Studies comparing women's preferences for supine vs. upright positions for delivery reported, without exception, more positive responses from women using the upright position. These women tended to experience more ease in pushing, less pain during pushing, fewer backaches, shorter second stages, fewer forceps deliveries, and fewer perineal tears (Gardosi et al. 1989; Liddell and Fisher 1985; Stewart et al. 1983; van Lier 1985). Advantages for the baby included higher levels of oxygen in the umbilical cord and higher Apgar scores than babies whose mothers delivered them in the lithotomy position. There were no adverse effects from delivering in the upright position, "although a few birth attendants reported that this position was inconvenient for them" (McKay and Roberts 1989:23). In one study, by far the most popular upright position among women given the option was the supported squat, in which the woman gives birth on a bed supported in a squatting position by a special "birth cushion," which allows most of the woman's weight to rest on her thighs instead of her feet. 95% of the subjects in this study wanted to use this position in subsequent births; the researchers found that if women not originally assigned to the study heard about the birth cushion from others, they would often request it for themselves (Gardosi et al. 1989).





http://www.canadiandoulas.com/pushing_positions.htm

When a woman is in a lithotomy or semi-sitting position the Foetal Ejection Reflex is impaired and the increased pain caused by the sacrum’s inability to move as the baby descends can be intolerable. For anyone who has seen women giving birth, the inability of the mother to "keep her bottom down" on the bed is common as the baby moves past the sacrum. If she does continue to sit or lay in this position, her baby’s head is unable to move past, or descent is markedly slowed, by the now smaller pelvic outlet due to her impacted sacrum and her tailbone being forced inwards. According to Dr. Todd Gastaldo DC, the impacted sacrum decreases the pelvic outlet by 30%. This is often compounded by epidural anaesthesia, which impairs the mother’s ability to feel her baby’s descent and thus does not move to accommodate her baby’s descent through her pelvis.

The coccyx is designed to move out of the way as the baby’s head descends. Sitting on the coccyx during birth restricts the pelvic outlet and can lead to dislocation of the coccyx. It may also cause an increased length of labour, make delivery more difficult and slow or arrest descent. These can then develop into oxygen deprivation for the baby, causing distress or worse. If it isn’t resolved forceps/vacuum assisted delivery is turned to as a solution. The uses of these instruments typically incur damage to the baby’s fragile head and neck muscles and nerves. The alternative is caesarean delivery, a major abdominal surgical procedure to extract the baby, which brings it’s own risks into play for the mother.

Semi-sitting and lithotomy pushing positions can also result in another serious problem called shoulder dystocia. Dr. Jason Gardosi MD FRCS MRCOG from the Queen's Medical Centre in Nottingham, UK explains, "The anterio-posterior [outlet] diameter is reduced in recumbent and lithotomy positions where the weight is taken on the sacrum. The sacrum is capable of rotational movement through an axis at the upper part of the sacro-iliac joint." He goes on to add, "Many so called 'shoulder dystocias' are just difficult deliveries caused by a recumbent position. Apart from the sacrum being pushed upward, reducing the AP diameter, it is difficult to allow lateral flexion when the presenting shoulder abuts on the mattress." Dr. Todd Gastaldo adds, "And when the shoulders get REALLY stuck, MDs pull REALLY hard… Could this bizarre MD behavior account for at least SOME of the unexplained cerebral palsy, brachial plexus palsy, low APGAR scores, etc.? How about some of the unexplained DEATHS?" [Emphasis the doctor’s]. Good questions which need to be addressed with maneuver’s beyond the McRoberts Position, placing the mother flat on her back with her knees pulled up and back, simulating an upside-down squatting position. This is the standard position women are placed in when shoulder dystocia is suspected. If women were allowed to birth in positions they assumed naturally, the Gaskin Maneuver, moving to a hands and knees position, would easily be done and thus far has proven to be the most successful position for resolving shoulder dystocia.

The solution? Simple. Allow the mother to assume a position she feels most comfortable in, which in almost all cases does not involve a lying down or semi-sitting position on a bed. It is extremely rare that a woman will spontaneously assume a lying or leaning back position during second stage. the very position most women are expected to assume in a hospital situation. At the same time, obstetrical practices of frequent and/or continuous monitoring with stationary fetal monitors combined with the many interventions and medications used routinely interfere with the body’s natural response to labour. If a woman is unable to assume a naturally active position like a squat, kneeling, or other forward-leaning positions (i.e. hands and knees), then avoiding sacral and coccyx impairing positions like lithotomy and semi-sitting would be wise and only make common sense. Sidelying is an excellent alternative when the situation warrants it, such as when a mother has an epidural.

This is especially important when the baby is in a less than optimal position, such as posterior (baby’s back is to the mother’s back), deflexed, asynclitic (baby’s head is crooked in the mother’s pelvis), or a hand is also presenting with the baby’s head. These are not uncommon considerations as up to 50% of babies present in one or more of these positions. Sadly, this is also why so many cesarean sections are performed, as doctors and nurses do not know the benefits of movement and after prolonged labour due to mal-presentation, a cesarean is often performed citing Failure to Progress or Cephalo-Pelvic Disproportion (baby is too big).

Often movement is all that needed during labour to turn the baby’s head or allow correction of position in order for the baby to negotiate the mother’s pelvis and this is not the case when a woman is not allowed to change position during pushing. "Lying down, sitting or in a semi-reclining position [during second stage] dramatically increases the Curve of Carus [sacral angle] while pulling the large glutoid muscles tight, meaning that the Rhombus of Michaelis [sacrum and tailbone combined or the posterior pelvic wall] is unable to move backwards as it should." Knowing the mother’s pelvic structure and her ability to relax can also really help in determining efficient positions and movements to ease descent. Allowing a birthing mother the ability to move as she needs, providing support and suggestions for both movement and relaxation, and giving her the time she needs, without limits, to birth her baby is the answer. A simple, proven, common-sense approach that will guarantee reduction of interventions, and the risks of an assisted delivery and cesarean section for birthing women and their newborns.

More:
http://www.google.ca/search?hl=en&sa=X&oi=spell&resnum=0&ct=result&cd=1&q=lithotomy+birth+pelvic+outlet&spell=1