If you are a person looking for options to explore for your upcoming birth, let's take a minute to talk about the power of standing up. Yes, even for pushing!
Standing and being upright during the first and second stages of labor, while it can limit your provider's view and access to your baby during birth, has long been a traditional position for women and laboring persons to take for as long as babies have been born.
When contractions start to come more regularly, and you creep toward that focused mindset being upright is a huge benefit. Laboring while standing offers practical and physiological advantages over laying down. The pressure of your baby, uterus, and organs is not resting on your back muscles and spine, so there is more blood flow and comfort. And your hips and pelvis can ambulate in any direction, allowing for your baby to more easily enter and turn in the pelvis.
Beyond comfort, studies conducted also show laboring persons without an epidural also had "a lower risk of abnormal fetal heart rate patterns, ..., and less use of vacuum/forceps and episiotomy."
One of the things that Maine Doulas hope our clients explore has nothing to do with a specific decision, position, or delivery method. What other doulas and we know, and what we hope to model and support, is the process of families exploring what it means to make decisions that are best for them can help them to have a more satisfying birth experience.
And one of the choices a family can explore is the choice to put your body into positions that traditional western medicine tends to suppress.
"...Most people who give birth vaginally in U.S. hospitals report that they push and give birth lying on their backs (68%) or in a semi-sitting/lying position with the head of the bed raised up (23%). A small minority push and give birth in other positions such as side-lying (3%), squatting or sitting (4%), or hands-and-knees position (1%)." (source)
A few reasons so many don't explore options for different positions:
they think they have to ask to move
they think if it were an option, someone would tell them
they don't know anything but how birth is presented in media
to some, the idea that standing would make delivery "easier" doesn't seem logical and the big one...
western medicine didn't allow women to birth in any position but on their back for decades.
And what we mentioned above about standing while pushing - that is an option some explore for their birth.
There is evidence to show gravity is in favor, perineal tearing may be reduced, and pain is reported to be less acute. While standing is rarely used in a hospital setting, other upright positions, like squatting and hands and knees, can offer the same benefits.
So when thinking about how you want to have your baby, we hope you expand your vision of delivery to include any movement you are curious to explore. When in the moment, you may be struck to follow your body's urge to move away from the standard inclined lying portion, and to that, we say, yes! You can do it.