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Napier Courier - 2021-06-09

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Benefits of upright births

NEWS

For most ofhumanhistory (until recently), womenwere free tomoveabout during labour, they were in tune with their bodies and used upright positions that felt comfortable, eased the pain of contractions andmadebirth easier. Someof the earliest records of labourshowwomenadopting a sitting, squatting or standing position while in labour. Anancient sculpture from Egypt shows Cleopatra (69-30BC) kneelingdownto give birth, surrounded by five attendants. Evidence of birthing stools and chairs date back to Babylonian times, and surveys conducted in 1882 and in 1961 haveshownthat the lyingdown position has never been thenormin traditional cultures. Whenyou think of birth, there’s usually acommonimage that flashes tomind— awoman, red in the face, lying on ahospital bed with her legs in stirrups. This image, whichweget from movies, TVshows, ads, commercials and just about every other type of media out there, has shaped thewaywethink about childbirth andhowweare conditioned today. Well, it turns out that the rise in popularity of the lying position didn’t havemuchto do with women’s experiences at all. According to several medical articles, royalty could have been to blame. King Louis XIV, whoruled France from 1643 to 1715, played a huge hand in popularising the lyingdown position, for a very odd reason. According to legend (and ahandful of medical scholars), Louis XIV— who hadmorethan 22 children by both wives and mistresses alike— had a fascination with watchingwomengive birth. Lauren Dundes, a professor of sociology, wrote that Louis XIV “enjoyed” watching his mistresses give birth, and disliked the upright or squatting positions for “obstructing” his view of the process. “Since Louis XIV reportedly enjoyed watchingwomengiving birth, he becamefrustrated by the obscured view of birthwhenit occurred on a birthing stool, and promoted thenew reclining position,” wrote Dundes in the American Journal of Public Health. “The influence of the king’s policy is unknown, although the behaviour of royalty must have affected the populace tosomedegree.” It is reported that knowing the king was a fan of the lying position, the womenfrom the kingdom, surrounding lands and lower classes began to adopt the practice to follow suit. Hence our conditioning to lying downto birth. Birthmovedfromhomeinto hospital during the 1900s. The medical model of maternity care became entrenched in society, along with the expectation thatwomenwould labour on a bed. Flat on their back, and sometimes with their legs in stirrups. There is a complete lack of evidence to support this physiologically dysfunctional birthing position, which simplycamedownto doctor preference, and subsequently, how they were then trained. However, there are plenty of reasonsNOTto lie downwhile in labour, which is fully backed by evidence and most of it comesdownto gravity. Thesignificant advantages of giving birth upright are: ■ Allows gravity to assistyou Whywork harder thanyou need to? Your uterus contracts out— or forward — fromyour body. Whenyou’re upright, you can work with gravity and your body’s natural functions in labour. Whenyou’re lying down, you’re bearing the brunt of weight and force, which is going against gravity. ■ Fewerinterventions likely Whenyou’re giving birth upright, making use of gravity andmore effectively using your muscles, you’re less likely to need interventions such as forceps or episiotomies. When you’re working against gravity in a dysfunctional position, both you and your baby aremorelikely to need help. ■ Contractions will bemore efficient Whenyou’re upright, leaning forward and working with gravity, your contractions willbecomemuch moreefficient. If you’re lying on your back, your uterus will be contracting upwards, which is not working with your body, but against it. ■ It’s going to hurt less Whenyou’re off your back, you’ll experience less pain than you will giving birth lying down. This is because you have all the weight on your back and you’re working against gravity. ■ Howabout faster labour? Whenyou’re working with gravity, in a position that your body and baby is designed to work well, your labour will likely bemuchshorter— lying downmay slow your labour down. ■ Betteroxygenflow for yourbaby Whenyou’re lying on your back, you’re bearing the full weight of the baby, your uterus, placenta and all that comes with it. Doing so puts pressure on important blood supplies in your ownbody. Compressing the blood supply also compresses the oxygen supply to your baby. Bybeing upright, you’ll provide a better oxygen and blood supply to your baby. In turn, this meansthat your baby will be less likely to experience fetal distress whichmay result in an assisted labour. ■ Increased pelvic space Lyingdownreduces pelvic diameter by about 30 per cent. Being upright opensup your pelvis, whereas lyingdowncloses it up. So it makes sense that if you’re upright to deliver your baby, you can openupyour pelvis by around 30 per cent. ■ Lyingdownmeans you’re pushing uphill Pushing “uphill” against gravity can be ineffective and exhausting. Getting uprightmeansyou’re pushing “downhill” instead. It starts with having a conversation with your partner, birth support and LMC, practise, practise, practise and then practise a fewmore. Before you’re in labour, practise a few upright positions, there aremanygreat graphics online which will give you plenty of ideas if you’re stuck for inspiration. Trying these beforehand will give you added tools so you’re not scrambling in the middle of labour. That’s the thing with birth, you can plan, and think, and dream, and imagine what it’s going to be like, but until it happens— it’s auniversal experience where everyone says “I didn’t think it would be like that”. Womenneed to be confident that they canmoveinto different positions. The rightwayiswhat feels comfortable at the time. For information about antenatal classes near you, check out From Bellies to Babies www.hbantenatalclasses.co.nz or phone 022 637 0624. Medical disclaimer: This page is for educational and informational purposes only and may not be construed as medical advice. The information is not intended to replace medical advice offered by physicians.

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