Filed under: birth, breech (posterior baby), labour | Tags: posterior, turning baby in utero, painless childbirth, posterior baby, relaxation, painfree birht, odent, pelvic rock, occiput posterior
Two facts regarding posterior position have been authoritatively confirmed by published prospective studies.
The first fact is that worrying pregnant women about the position of their baby in the womb is useless. A large Australian randomized controlled trial involving 2547 pregnant women has eloquently demonstrated that hands and knees exercise with pelvic rocking from 37 weeks’ gestation until the onset of labor does not reduce the incidence of persistent occiput posterior position at birth.
The second fact is that fetal position changes are common during labor, with the final position established close to birth. This is the conclusion of a prospective study of 1562 women to evaluate changes in fetal position during labor by using serial ultrasound examination. Among babies who were posterior late in labor, only 20.7% appeared to be posterior at birth.
Finally, when the mother had no epidural, the overall rate of posterior position at birth was only 3.3%, although this study was conducted in conventional departments of obstetrics, where the basic needs of birthing women could not easily be met. The rate was 12.9% in the epidural group.
When taking into account these two well-documented facts, focusing on the right question becomes easy: what factors can influence the rotation process during labor?
The answer is simple: The factors that can facilitate the rotation process are those that make a typical fetus ejection reflex possible.The passage toward the fetus ejection reflex is inhibited by any interference with the state of privacy. The ejection reflex does not occur in the presence of a birth attendant who behaves like a “coach,” an observer, a helper, a guide or a “support person.”
The fetus ejection reflex can be inhibited by a vaginal exam, by an eye-to-eye contact or by the imposition of a change of environment. It does not occur if the intellect of the laboring woman is stimulated by rational language (e.g., “Now you are at complete dilation; you must push”). It does not occur if the room is not warm enough or if the lights are bright. The best situation I know for a typical fetus ejection reflex is when no one is around but an experienced, low profile, silent, motherly midwife sitting in a corner and knitting.
The image of the “knitting midwife” should not be understood in a literal sense. Instead, it symbolizes the authentic midwife as a protective mother figure whose own level of adrenaline is maintained as low as possible.
Noticeably, when the conditions for an ejection reflex are met, most birthing women find spontaneously complex and asymmetrical bending-forward postures that probably play an important part in facilitating the rotation of the baby’s head.
Persistent posterior position at birth will become exceptionally rare on the day when the meaning of privacy is understood and authentic midwifery has been rediscovered.
- Michel Odent, MD, excerpted from “Occiput Posterior Position Should Be Exceptionally Rare at Birth”
Filed under: labour | Tags: benefits of labour, bonding, function of labor, Ina May Gaskin, labour, oxycotin, prolactin, unmedicayed labour
Ina may Gaskin on “why is labour important?”
Labor is important, because during labor, both the mother’s and the baby’s body is prepared for birth. The levels of certain hormones rise and ebb during labor. For instance, the mother’s oxytocin levels rise markedly just before the baby is pushed out of her body. This protects her against postpartum hemorrhage. High oxytocin levels in the mother (which are accompanied by higher levels in the baby, too) prepare the nervous systems of both to be attuned to each other. This creates a special “sensitive” period during which these special hormones remain at high levels in undisturbed birth, and this period is best spent by mother and baby in skin-to-skin contact with each other as the baby begins to nuzzle and nick the mother’s breast or the two just look into each other’s eyes and adore each other. The euphoria that follows an unmedicated labor is a very special time for anyone who is privileged to witness it. It’s even better for those who get to experience it.
When the mother experiences labor, she also has higher levels than usual of beta endorphin. This hormone then triggers another hormone, prolactin, which prompts her body to get ready for milk production at the same time that it prepares the baby’s lungs for more efficient breathing.
Labor also gives the baby’s torso a good squeeze, which helps to dry out the lungs and make them ready for breathing air in the outside world. Cesarean-born babies typically have wetter lungs, which can mean a higher rate of needing breathing assistance at birth.
Photo by Ian
Filed under: birth, labour | Tags: contractions, empowered birthing, how to push, labour, natural childbirth blog, natural delivery, pushing the baby out, when to push
Releasing Your Baby From Your Body
Once you are dilated to ten centimeters, and perhaps even before ten centimeters, your body may begin involuntary pushing efforts. Some women never get this urge to push at all. Whether you do or don’t, it is NOT necessary to add your own pushing efforts to that of your body. By staying totally relaxed and upright, the combination of gravity and the contractions of your uterus can birth the baby.
Women who have heart conditions are not allowed to push to birth their babies because of the strain this puts on their hearts. Yet, their bodies still birth their babies without help.
As the baby makes its way down the birth canal, this is a very intense time. Many women find that they have very primal feelings. They feel the need to make vocalizations, and some even report feeling like wild animals trying to get free. At this point, the intensity of the contractions is calling the shots. The intensity dictates your position, your breathing, everything.
As the baby’s head nears the opening of the birth canal, the perineal tissues will start to bulge. If you have remained upright and allowed gravity to bring the baby down and fan the tissues out naturally, there is very little chance you will tear. However, some women prefer to massage the tissues with oil and warm the tissues with warm, wet washcloths. A good way to keep these hand is to have two crock pots - a small potpourri size pot for the oil and a large one for water and washcloths so they can be ready any time needed. Both should be set on low.
The perineal area is the area below the vaginal opening and above the anus. As this tissue starts to bulge, the birth partner can, at the request of the woman, support the tissue with firm pressure from a hand covered with a warm washcloth. The warmth usually feels very comforting. Pressure against those tissues as the head is emerging can often prevent tearing and can guide the head gently out. However, if you have remained upright, and are giving birth in an upright position, you will probably not have a need for support and there is little chance you will tear. Birthing in the squatting position gives the baby the maximum amount of room available. The position also maximizes the pressure of the diaphragm on the top of the uterus so that the baby is literally propelled down the birth canal without extra pushing. The position pulls the tailbone out of the way so that there is no obstruction of the birth canal. The position normally provides 2 to 3 extra centimeters, which is more than enough room to birth any baby. A standing supported squat also will allow the baby’s head to fan out the birthing tissues so that there is no tearing.
As the head emerges, the perineal tissues will be stretched around the largest diameter of the baby’s head. At this point, some women experience a burning sensation that has been termed the “Ring of Fire.” This burning sensation is only momentary and passes as soon as the baby’s head moves past this point and the vaginal opening closes around the baby’s neck. Once the head is out, the body should be born within the next couple of contractions.
Once the head is out, the baby’s body must rotate so that the shoulder is released from under the pubic bone. Once the shoulder is released, the whole body is immediately born.
I encourage the birthing woman to be the one to catch her own baby. Once the head is out, the woman can reach down and guide the baby out as the body is release from the birth canal. If she does not feel able, the birth partner can be the one to “catch” the baby. As soon as the baby is out, he/she should be handed directly to the mother. If the baby does not take a breath immediately, the mother should stroke the baby, rub his/her back, speak softly and gently to him/her, and soon the baby should begin to breath and his/her color should pink up.
Babies born to mothers who have remained upright throughout their labors rarely need to have nose or mouth suctioned because the fact that they have been head down the whole time means mucous has been draining from the nose and mouth throughout the entire delivery. As the baby descends through the birth canal, his chest and lungs are tightly squeezed so that any fluid or mucous is naturally expelled.
Filed under: birth, labour | Tags: birth positions, birthing positions, cervical dilation, dancing during labour, free birthing position pictures, massage, moving during labour, reducung the length of labour, relieve back pain, rocking motion
Positions for Labor, for Back Pain, and for Pushing
Why are different positions important?
Changing positions, and moving around during labor and birth, offers several benefits. Some are obvious to the mother in labor: increased comfort / reduced pain, distraction, and an enhanced sense of control: merely having something active to do can relieve the sense of being overwhelmed and out of control.
Beyond these advantages, there are equally important effects on the baby and on the progress of labor. Changing positions during labor can change the shape and size of the pelvis, which can help the baby’s head move to the optimal position during first stage labor, and helps the baby with rotation and descent during the second stage. Swaying motions such as walking, climbing stairs, lunging, and swaying back and forth are especially helpful with this.
Movement and upright positions can help with the frequency, length, and efficiency of contractions. The effects of gravity can help the baby move down more quickly. Changing positions helps to ensure a continuous oxygen supply to the fetus, rather than causing supine hypotension (low maternal blood pressure) by lying on your back or even semi-sitting.
Changing position can reduce the length of labor. Mendez-Bauer and Newton (1986) state: “duration of labor from 3 to 10 cm cervical dilation was about 50% shorter in patients who alternated supine and standing, standing and sitting positions.”
Positions for First Stage Labor
For Resting:
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Side-lying. Try placing pillows between your knees for comfort. |
Semi-sitting, in bed, on a couch, or leaning against your partner with his arms around you. |
Sitting with one foot up. Asymmetrical positions help enlarge the pelvis on one side, and change the shape of the pelvis, which helps the baby find the best position. |
Rocking, Rhythmic Motion: In labor, it just feels better when mom rocks and sways in rhythm to her breathing. Partners sway with her, or do massage in rhythm with her breathing, or sing in rhythm.
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Rocking Chair |
Sway on ball |
Slow Dancing |
Dance with Belly Lift |
Activity: Walking, climbing stairs, lunging. Activity helps baby to descend, helps baby to rotate into position for birth. In early labor, be active occasionally, but don’t exhaust yourself by walking all through early labor. Walking is more effective in active labor and transition when baby has descended far enough to put pressure on mom’s cervix and encourage the cervix to open.
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Lunge. |
Stair Climbing |
Tailor Stretching |
Positions for Back Labor (when mom has back pain, irregular contractions, or is progressing slowly)
Leaning Forward: Many women, especially those with back labor, find it most relaxing to lean forward during contractions.
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Straddle a chair (or the toilet), and rest your arms and head on the back |
Leaning against a wall, or your partner, or leaning over a table. Can sway. |
Raise the head of a hospital bed, then kneel on bed with arms resting on top of bed. |
Hands and knees / kneeling. Can relieve back pain, help a posterior baby rotate, allows easy access for backrubs / counterpressure massage; makes it possible to sway side to side, rock back and forth, or do pelvic tilts to aid rotation and increase comfort. Having knee pads or kneeling on something soft will help knees. Can rest upper body on pillows, chair, or birth ball.
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Hands and knees |
By a chair |
Over birth ball |
Knee-Chest |
For second stage, an ideal position would: open the pelvic outlet as widely as possible, provide a smooth path for the baby to descend through the birth canal, use the advantages of gravity to help the baby move down, and give the mother a sense of being safe and in control of the process.
Try out a position for a few contractions. If it works, stay with it. If not, switch to a new position in between contractions. Depending on the caregiver, they may ask you to move to a specific position just prior to the birth.
“Standard” positions. These can be done by anyone. These are the positions that most OB’s are used to delivering babies in.
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Semi-sitting. With pillows underneath knees, arms, and back. During contractions, can wrap hands around knees and pull knees up toward shoulders (as in squatting). Most common in hospital setting. For mom and baby: some help from gravity moving the baby down; mom feels more in control than in lithotomy position. Benefits for caregivers: good view of perineum, easy access to perineum. |
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Lateral / Side-Lying. Back curved, upper leg supported by partner. Gravity neutral, good for fast second stage. May be a comfort position for mom. |
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Kneeling positions. These work fine if you have no pain medication, or narcotics only. [If you have epidural anesthetic: These may be possible with a light epidural. You can ask your caregiver if it would be possible to try these positions, but you will need help getting into these positions (moving the IV tubing, catheter tube, monitor wires and so on so they’re not tangled around you is a production in and of itself!). Once you are in these positions, you would need to be “spotted” (have one person on each side of you, making sure you stay balanced and stable.)]
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Kneeling. Hands on the bed, and knees comfortably apart. Or one knee up. Good for reducing tears and episiotomies. May be restful for mom. |
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Hands and knees. Arch your back occasionally for increased comfort. Great for back labor, big babies, posterior babies. Many find it most comfortable. |
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Upright positions / Squatting. These will not be possible if you have had an epidural, because with an epidural, you typically can not get up out of bed.
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Sitting: On the toilet, on thighs of support person, on birthing stool/chair, on partner’s lap. Opens pelvis, gravity enhancing, natural pushing position. |
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Squatting / Supported Squat. Opens pelvis, gravity enhancing, sense of control for mom. During squatting, the average pelvic outlet is 28% greater than in the supine position. Stand, or sit back to relax in between contractions. |
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Dangle. Gravity, no external pressure on perineum / pelvis. Feeling of being well-supported. May be difficult for mom to see or touch baby during birth. |
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Compiled by Janelle Durham. Source: The Labor Progress Handbook by Penny Simkin and Ruth Ancheta. Several other books, classes, etc. ** Starred illustrations by Ancheta. All other illustrations, Janelle Durham.
Filed under: birth, labour | Tags: birthing alone, easy labour, homebirth, natural childbirth, natural childbirth blog, pain free birth, pregnancy, relaxation during labour
When my wife became pregnant with out first daughter, we did a lot of research into my wife’s family birthing experiences and other cultures. We found that her grandmother gave birth in a Hawaiian sugar plantation by herself.
Two children were born to her in this manner. There was no pain or distress. Labor was a matter of minutes once her waters had broken, she took a day off work, and resumed work the next day with her baby strapped to her back.
To her such an outcome was unremarkable. A later birth in the local hospital was another matter. She reported that as very painful and the labor took 10 hours. She found the whole experience very unpleasant, and demeaning in how she was treated.
We found several cultures where birthing is gentle, quiet, relatively painfree, and labor is measured in minutes once the water bag has broken. (This is not to say that conditions are ideal in many other areas in these cultures. They are not.)
We decided after comparing home birth with hospital birth to have our baby at home. We found a very supportive and kind midwife and ignored the warnings of disaster and threats of prosecution for manslaughter if anything happened to either mother or child!
When her waters broke her contractions were strong and regular and birth seemed imminent. Then as soon as the midwife and two friends arrived everything stopped. My wife was displaying symptoms of fight or flight. So I sent everyone out of the room to make tea, and as flight was impossible I got her very angry and for quite a while she pounded the pillows and mattress and shrieked her rage as loud as she could.
Once she had discharged her rage her contractions restarted and her cervix dilated, and she had a very easy birth. This experience gave me a new perspective on birth and how the birth process can be effected. From then on whenever I was called upon to attend a birth I began to suggest and apply some techniques that I had developed for mitigating or resolving chronic pain.
For a while I was quite puzzled as to why so many birthing mothers went into fight or flight when midwives, Doulas family or friends arrived or they went to a hospital. Particularly as so many these days have undergone extensive preparation for the birth with relaxation classes. Then I realised that the adrenalin rush is a primitive response designed for survival and we have probably underestimated it’s power, and while conscious training will help under some conditions, if a birthing mother unconsciously senses danger, birthing will cease until either the threat has left or the adrenalin has been discharged with violent exercise, and no amount of training will inhibit it.
We are almost certainly the only species that allows relative strangers into the birthing environment. The cultures that appear to have benign births are those where the birthing mother is attended by people who she has known all her life, or she is encouraged to give birth by herself. Even then, if the wise woman or midwife of the tribe senses a family member present who stimulates tension for the birthing mother she is asked to leave. Which brings me to a very important aspect which can have disastrous consequences for the neonate. It is to do with that we are also the only species which allows strangers into the nurturing environment before maturity.
Happy birthing and nurturing.
Rayner Garner <intuit@ncal.verio.com>
Photo by Madaisa
Filed under: labour, video, waterbirth | Tags: birth in water, free water birth movies, water birth, water birth video, water birth videos, water births, waterbirth, waterbirth at home, waterbirth video sharing, woman giving water birth
Filed under: birth, homebirth, labour, video, waterbirth | Tags: birth in water, birth video, free waterbirth information, free waterbirth video, laboring in water, labour in water, labouring in water, water birth, water birth blog, water labour, waterbirth, waterbirth at home, waterbirth blog, waterbirth video, woman gives birth in water
Lyle:
Our second son’s welcome into this world.
This is the mommy in this birth video. I’m giving background info for viewers understanding. My husband posted this but I’m glad to share this wonderful exp. This was our 2nd birth (1st was Taylor now 5 born at home in tub too after 12 hours of labor). If mom and baby are healthy and you have all the necessary pre-natal care and are fully educated on labor/birth and what to expect and really want a homebirth exp. (no fear) than this is the way to go man! It was the most empowering exp. of my life.
The reason midwife is not here is my husband told her it would be 1 hr. when she called to check on us at 4am. what does he know—he’s just a man and I couldn’t really verbalize that is would be sooner. The call you see in the video (where my husband has the head in his hands)at 5am is midwife again, @ 30 min. away still. Well, she’s gonna be late,huh? My sister, best friend & my mom who is tending to our 22 month (Taylor—now 5) were there. He was crying because its 4:45am, he just woke up & wanted Mommy like all kids do at 5am-he also wanted to get in the pool. He was not traumatized by seeing me give birth. I was having a baby–one of the most nautural things in the world.
Filed under: birth, birthstories, empowered childbirth, labour | Tags: birthstories, joy of childbirth, labour, natural childbirth, painfree birth, painfree labour, painless childbirth
by Alice B. Stockham, M.D.
“I know of no country, no tribe, no class, where childbirth is attended with so much pain and trouble as in this country.”
Thus replied a traveler who had been many years in foreign lands, upon being interrogated as to the comparative sufferings of savage and civilized women. His occupation and sympathies had brought him into close relationship with all classes of people, and therefore fitted him for an intelligent and discriminating judgment in this matter.
Neither in India, Hindostan, China, Japan, the South Sea Islands, South America, nor indeed in any country do women suffer in both pregnancy and parturition as they do in this. Possibly among the higher classes in Europe there may be equal suffering; but the peasantry everywhere is comparatively exempt.
The usual testimony of missionaries and travelers is that the squaws of our own Indian tribes experience almost no suffering in childbirth, and the function scarcely interferes with the habits, pleasures or duties of life.
Mrs. Armstrong, one of the early missionaries in the Sandwich Islands, says: “With native women the labor was not long nor severe; the mother, instead of remaining in bed, arose, bathed in cold water, walked and ate as usual.”
Dr. Storer says: “There is probably no suffering ever experienced which will compare, in proportion to its extent in time, with the throes of parturition.” Dr. Meigs says: “Men can not suffer the same pain as women. What do you call the pains of parturition? There is no name for them but agony!”
It is too true that women go down to death in giving birth to children. Thousands of women believe that this pain is natural and that for it there can be no alleviation. “In sorrow shalt thou bring forth children” is thought to be a curse that applies to all women of all time.
If this pain and travail is a natural accompaniment of physiological functions - if it is a curse upon women, then why are the rich, the enlightened and more favored daughters of earth greater sufferers than the peasantry, the savage, the barbarian, and those who we call heathen? Is it not possible, by research and comparison, to learn the natural and true mode of life, so that motherhood may, among enlightened people, be relieved from this burden of suffering? May it not prove that our traditions and teachings upon this subject have been altogether erroneous?
American women in education and enlightenment, in freedom and progress, are the peers of the best and noblest of their sex. From individual, social and national interests, they ought to be conversant with all that pertains to this subject, so closely allied to the interests of the race.
We find in women of superior education and marked intelligence an exaggerated development of the emotional nature, and a corresponding deterioration of physical powers. Weakness, debility, and suffering is the common lot of most of them. Not one in a hundred has health and strength to pursue any chosen study, or to follow any lucrative occupation, and what is vastly worse, most are unfitted for the duties and perils of maternity.
Dr. Gaillard Thomas says: “Neither appreciation of, nor desire for, physical excellence sufficiently exists among refined women of our day. Our young women are too willing to be delicate, fragile and incapable of endurance. They dread above all things the glow and hue of health, the rotundity and beauty of muscularity, the comely shapes which the great masters gave to the Venus de Medici and Venus de Milo. All these attributes are viewed as coarse and unladylike, and she is regarded as most to be envied whose complexion wears the livery of disease, whose muscular development is beyond the suspicion of embonpoint, and whose waist can almost be spanned by her own hands.
“As a result, how often do we see our matrons dreading the process of child-bearing, as if it were an abnormal and destructive one; fatigued and exhausted by a short, walk, or ordinary household cares; choosing houses with special reference to freedom from one extra flight of stairs, and commonly debarred the one great maternal privilege of nourishing their own offspring. These are they who furnish employment for the gynecologist, and who fill our homes with invalids and sufferers.”
Understanding and following physiological laws, pregnancy ought to be as free from pathological symptoms, and parturition as void of suffering with American women as with any on earth, or even with the lower animals.
Dr. Dewees says: “Pain in childbirth is a morbid symptom; it is a perversion of nature caused by modes of living not consistent with the most healthy condition of the system, and a regimen which would insure a completely healthy condition might be counted on with certainty to do away with such pain.”
The great English scientist, Professor Huxley, says: “We are indeed, fully prepared to believe that the bearing of children may and ought to become as free from danger and long debility to the civilized woman as it is to the savage.”
The following paragraphs from one of the essays in Dr. Montgomery’s classical work on Pregnancy, give practical details of cases in illustration of the belief in painless parturition.
“In a letter to me Dr. Douglas states that he was called about 6 A. M., Sept. 26, 1828, to attend a Mrs. D., residing on Eccles St.
“On his arrival he found the house in the utmost confusion, and was told that the child had been born before the messenger was dispatched for the doctor. From the lady herself he learned that, about half an hour previously, she had been awakened from a natural sleep by the alarm of a daughter about five years old, who slept with her.
“This alarm was occasioned by the little girl feeling the movements, and hearing the cries of an infant in bed. To the mother’s great surprise she had brought forth her child without any consciousness of the fact. “A lady of great respectability, the wife of a peer of the realm, was actually delivered once in her sleep; she immediately awakened her husband, being alarmed to find one more in bed than there was before.
“I have elsewhere mentioned the case of a patient of mine who bore eight children without ever having labor pains. Her deliveries were so sudden and void of sensible effect that in more than one instance they took place under most awkward circumstances, but without any suffering.”
Dr. J. King, in his work on Obstetrics, speaks of attending cases where there was no sensation of pain.
He found that by placing the hand upon the abdomen, the muscular contractions were distinctly felt, and examination proved the progress of labor, while, excepting a suppressed breath, the patient experienced no change from the ordinary condition.
With Dr. Holmes, I believe it will take many years to eradicate diseased conditions which are the heritage of this generation, and thus to produce men and women of physical perfection. Science has proven, however, that any woman possessing sufficient vitality to make procreation possible, can do much, even during pregnancy, to alleviate the sufferings of that period, as well as the final throes of travail. Pain and suffering have so long been the customary attendant upon the maternal functions, that many are slow to believe they can ever be alleviated. Painless childbirth is thought to be an impossibility. The reader is begged to lay aside all previous prejudices, and it is believed that when this volume has been thoroughly studied he will be convinced that women in bearing offspring should furnish no exception to the laws of nature, and that pregnancy and parturition may and ought to be devoid of suffering.
Tokology: A Book for Every Woman
1911 by Alice B. Stockham, M.D
Filed under: aqua midwife, birth, labour, midwifery, waterbirth | Tags: baby, birth, birth blog, birth in water, Cornelia Enning, labour hormones, midwifery, natural childbirth blog, newborn, waterbirth
A healthy baby is able to overcome the distance between uterus and motherly chest by its own strength if the conditions of its birth give it the opportunity. The baby itself gives the impulse to the mother to release labour hormones. In the water her body reacts faster and more easily.
In the stage of expulsion the baby repels itself with his little legs at the wall of the uterus while rotating through the birth channel. In the water the pelvic bones of the mother give way better. Born into the water, the newborn child paddles with its little arms in order to arrive at the chest of the mother.
The baby can already take up the first eye contact in the water with its mother. Water babies are born with open eyes. The transition of the fruit water to the bath water is like a restorative stopover on the birth way. The birth under water is one of the gentlest forms for a baby to see the light of the world.
Translated with permission from aqua-midwife Cornelia Enning’s website hebinfo.de
Filed under: herbal remedies, labour, pregnancy | Tags: blkach cohosh, castor oil, cesarean rates, delayed labour, due date, how to induce labor, how to induce labour, inducing labor, inducing labour, induction, Michel Odent, natural childbirth, pregnancy, pregnancy blog
In Peace
