The following is a post republished with permission from blogger, doula and mother of two, Kristen Oganowski of Birthing Beautiful Ideas. This post also appeared on our sister blog, Science & Sensibility, as part of their Healthy Birth Practices blog carnival.
According to the Lamaze Healthy Birth Practice paper on [moving during labor], research shows that:
…when compared with policies restricting movement, policies that encourage women to walk, move around, or change position in labor may result in the following outcomes:
- less severe pain,
- less need for pain medications such as epidurals and narcotics,
- shorter labors,
- less continuous monitoring, and
- fewer cesarean surgeries (Lawrence et al., 2009; Simkin & Bolding, 2004; Simkin & O’Hara, 2002).
In fact, no woman who participated in any of the research studies said that she was more comfortable on her back than in other positions (Simkin & Bolding, 2004). No study has ever shown that walking in labor is harmful in healthy women with normal labors (Storton, 2007).
So it is easy to see why walking, moving, and changing positions is a healthy birth practice!
For this post, I’d like to document and describe the ways that I walked, moved, and changed positions throughout my labor. And this is because I think that it is important for women to have access to images of real women who are really laboring and who are really able to walk and move and change positions throughout their child’s birth.
Worth noting is that for most of my labor, I just followed my body’s signals and natural instincts when changing positions. Sometimes, I also changed positions based on what my doula suggested.
And for the entire time, I found my labor to be an intensely powerful, empowering, and healthy experience.
A few “stats” about my labor before I begin:
- Even though this was my second child, I was a “first-time laborer” since my first child was born via a pre-labor cesarean section.
- My labor began with my membranes rupturing.
- My contractions began approximately 1 1/2 hours after my membranes ruptured.
- My entire labor lasted a little over 14 hours (or 15 hours if one were to count the irregular, painless contractions I was having in the hour before my water broke).
- I labored at home for approximately 8 1/2 hours before leaving for the hospital.
- My cervix was 1-2 cm dilated and nearly 100% effaced by the time I was checked at the hospital.
- Three hours later, my cervix was dilated 4 cm.
- Just over one hour later, I was fully dilated.
- I actively pushed for about 35 minutes before delivering my healthy 8 lb. 3 oz. baby.
- And I moved and grooved all throughout my labor.
This is what it looked like.
Here I am in early labor, kneeling over the armrest of the couch. Obviously, the contractions weren’t terribly intense at this point since I could still talk on the phone. (I do believe, however, that I ended up throwing the phone onto the end table about ten seconds into my next contraction!) Nonetheless, even though the contractions weren’t very intense, I still found that this position helped to relieve the discomfort that they caused.
What else does kneeling help to do?
It can help to relieve backache, it can encourage the rotation of the baby, it can help a mom to move and/or rock through her contractions, and it also provides a mom’s labor support team with access to her lower back for counter pressure. One can also kneel over a birth ball or over the back of a raised hospital bed.
Here I am laboring on my side. I was still in the early phase of my labor, so I wanted to relax as much as possible before the really hard work began. I used one of my hypnobirthing deepening exercises to help me do just that.
How does side-lying help a mom during labor?
It helps to promote rest and relaxation in early labor, it can help to improve fetal oxygenation (especially when a mom is on her left side), it can help to slow down a precipitous second stage, and it can help to encourage fetal rotation. It is also a good “alternative position” (instead of lying flat on one’s back) for a mom using epidural analgesia.
Here I am standing to stop for a contraction after walking around the house for a while.
Standing and/or walking throughout labor gives a woman the advantage of gravity to help the baby descend, it encourages the rotation and descent of the baby, it can help to bring on more productive contractions, and it also helps the baby to be well-aligned with the mother’s pelvis. What’s more, it is yet another position that gives a mom’s labor support team access to her back for counter pressure and/or other touch-based comfort measures, if she desires them.
One of the other great standing movements is to slow dance with one’s partner, doula, or other labor support person. (I slow-danced with my husband, Tim, right after this picture was taken!) Besides providing emotional closeness(especially if one is dancing with one’s partner), dancing can offer a mother all of the benefits of walking or standing while allowing her to take some of her weight off of her feet.
Remember how I mentioned the “really hard work” that was on my horizon?
It had definitely begun by the time this picture was taken.
And laboring on my hands and knees felt like the most comfortable and most natural position for me to be in at this point.
Being on one’s hands and knees during labor can help to relieve backache (which I was definitely experiencing here), can encourage the rotation of the baby, and can also allow access for back massage and/or counterpressure. Doing pelvic rocking while on one’s hands and knees is also an especially good exercise for encouraging the rotation of a baby in the occiput posterior position.
Here I am standing and leaning against the stairs.
As with most upright positions, this position gives moms the advantage of gravity, it can encourage more productive contractions, it can help with fetal rotation, and it can be more restful than standing alone (and putting all of one’s weight on one’s feet).
Since the stairs are pictured here, I should mention that I also made quite a few trips up these stairs during my labor. Climbing stairs can also enhance rotation of the baby and pelvic mobility, and it may help to “speed” up one’s labor even more than walking does.
Worth noting is that most of those trips up the stairs were taking me to our bathroom, where I spent a good deal of time laboring on the toilet. (For obvious reasons, I have no photos of this!) Laboring on the toilet gives a mom the assistance of gravity while still allowing her to “rest,” and it may help her to relax her perineum. (It is usually not recommended for moms who have trouble with hemorrhoids, however.)
Here I am sitting and swaying on my birth ball. This proved to be tremendously helpful during the time that I labored at home.
In addition to offering a mom the advantage of gravity, swaying on a birth ball can help to enhance pelvic mobility. It is also much more comfortable than merely sitting on a chair!
As you can see here, using this particular position with the birth ball also allowed me to gain the advantages of leaning, to receive some emotional support from Tim, and to get the back-relieving benefits of counterpressure from my amazing doula, Chris. So this was really the “mother” of all laboring positions! (Sometimes I can’t help myself when it comes to silly birth-puns…)
Here I am at the hospital, lying on my side just as I did at home during early labor.
I was strapped to the wires and transducers needed for the electronic fetal monitor (and didn’t have access to the telemetry unit yet), so my range of mobility was significantly limited. And even though I needed to rest and “re-group” after a night of laboring and after discovering that I was “only” 1-2 centimeters dilated, the very fact that my range of motion was limited seemed to make coping with my contractions more difficult.
In fact, the time that I spent in the hospital bed, strapped to the monitors, was the only time that I ever considered asking for pain medication during my entire 14-hour labor.
But then I got in the water.
Oh, the water! Take a moment to review the look on my face in the above picture and then the look on my face as in the picture to the right. These pictures were taken within about three hours of each other. And in the one to the right, I am a little less than two hours away from holding my baby in my arms.
Hydrotherapy during labor (which also includes laboring in the shower) can be very relaxing and can help to reduce the intensity of the pain of contractions. Notably, women are generally advised to avoid getting into a tub or jacuzzi until they are at least 4 cm dilated since getting in the tub “too early” can contribute to irregular and/or less frequent contractions.
In addition, although these items are not visible in the above photograph, moms laboring in the water should also have access to a cold drink (my choice was Gatorade) and cool washcloths so as to help regulate their body temperature.
(Although a bigger tub–or an actual birthing tub–would have been preferable to the hospital’s small bathtub, I was still able to float in between contractions and to move my body during contractions. In other words, I was still able to move and change positions while in the tub!)
I began pushing while lying on my side. Although I did not find this to be the most comfortable and advantageous pushing position for me, pushing on one’s side does have some specific benefits. In particular, this position encourages good fetal oxygenation, it is helpful for moms with elevated blood pressure or who are using epidural analgesia, and it allows the mother to rest in between contractions.
I eventually moved to my hands and knees while pushing and then rested in a sitting position in between contractions.
As one of the many optimal birthing positions, pushing on hands and knees can help to improve fetal heart tones, it can assist with fetal rotation (especially for a baby in the occiput posterior position), it is an excellent position for a woman expecting a large baby, and it can help a mom to avoid a laceration or an episiotomy.
And it was certainly a position that helped this first-time-pusher to deliver her 8 lb. 3 oz. baby after only 35 minutes of active pushing!