What pushing positions should you try during birth?
True or False? You must push out your baby while lying on your back.
Answer: False. You can push out your baby in any position you want!
So why do most people push on their backs?
Since the majority of births in North America are now in hospitals, the easiest pushing position for the doctor to deliver your baby is on your back. Also, since many women now take the epidural, they are less mobile and being on their backs has become the norm. But this is not based on evidence-based practice.
Try positions that use gravity
It is common knowledge in birthing literature that gravity helps tremendously to bring baby down when pushing. Also, your coccyx is mobile and allows space for the baby to come down, so you don’t want to block it by being on your back. Being in upright pushing positions can also help reduce tearing and the need for uncomfortable repairs afterward.
Pushing can last anywhere from a few pushes to 3 hours in a hospital setting. And sometimes longer when birthing elsewhere. That’s why it’s a good idea to try a whole bunch of pushing positions! Some may work better than others. Unfortunately, as soon as you’re on your back, it’s harder for you to change your position. The bed is modified, the docs are geared up in sterile scrubs and it’s often seen as a nuisance.
So what should you do?
Try out the following positions BEFORE getting onto your back:
On Your Side
It’s quite easy for you to get into this position, and it’s only a quarter turn from a lying down position, freeing up your coccyx. You are then able to grab your upper leg, bring it to you and bear down. Being on your side also allows you to easily rest in between contractions. Side-lying positions are also possible to try if you have an epidural, so keep this in mind if you get one.
On Your Knees
When you’re pushing on your knees, bring the head of the bed up and drape yourself over it. In this position, gravity can really help you and baby. You can also easily touch baby’s head and see how effectively you are pushing. Also, I have seen doctors get moms with epidurals into this position, even though it’s a bit harder than on your back, so it is possible.
Similar to the ‘On your knees’ position, being on all fours also uses gravity and liberates your coccyx. However, it can be hard on your wrists. Try it out for a few pushes and see how it feels. You can come back to it later if you want.
Squatting/Using A Squat Bar
Hospitals usually have a squat bar hiding somewhere. I have found it to be handy during many births, though it’s not a tool that is often used. In this position, you are using gravity to help bring baby down and it also allows your legs to be wide open, giving baby more room to rotate and descend.
Using a Birth Stool
A birth stool is a common tool used at birthing centres, and I have been pleasantly surprised to see some in a couple of the hospitals where I work. When sitting on the birth stool, the position is identical to sitting on the toilet (which is also a good place to push). You are sitting upright, using gravity, your legs are open wide and your knees are naturally up, providing space for baby to come down. Also, we are so used to ejecting matter in this position that it can really help when birthing your baby.
Because pushing can last awhile, particularly for first time moms, it’s good to move around and change positions and find what works for you. There can be times when pushing on your back may be the best way for baby to descend, so it’s not something to ignore completely. Just know that you have options and don’t be afraid to let your caregivers know what pushing positions you want to try.
Remember, YOU are delivering your baby, and you can chose the positions that suit YOU best.
Wishing you a beautiful and positive birth,
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