Although the idea that women must giveflat on their backs has fallen out of favour in recent years, it is common hospital policy to deliver women in bed, propped against a pile of pillows. While this semi-upright position is better than lying down – especially when pushing – some experts believe that other methods of labour and are even more efficient, such as kneeling or squatting on the floor, with the woman supported by her partner or medical staff, or sitting upright in a specially designed ing chair. When upright, the outlet of the pelvis is increased so the baby may be born with less effort, episiotomies may be avoided and any tears are likely to be small and superficial.
The blood supply to the placenta is increased so the baby gets more oxygen, and some doctors have found that contractions tend to be more effective thus shortening labour.
The evidence for the benefits of the vertical positions is impressive, and many doctors now agree that the mother should be free to move about during labour and choose the position in which she feels most comfortable to give birth. If the mother decides that she may want to deliver squatting, she may need to have made some preparation long before labour starts. Squatting does not come naturally to most Western women but exercises duringwill help to give her the muscle strength and confidence to squat without discomfort for relatively long periods.
Attitudes to labour
Other changes have occurred in medical attitudes to childbirth. These are all part of the growing awareness that women need to have more control over what happens to them and their babies. Some specialists feel that the conventional, in the operating-theatre atmosphere of the delivery room under bright lights with the baby held upside down and the cord cut straight away, is too traumatic. They believe the lights should be dimmed, voices hushed and the cord not cut
until it has stopped pulsating, thus making the birth a calmer, gentler experience for both mother and baby. They also advocate wrapping the baby at once before the mother holds it, or placing it in a warmto further lessen the shock of coming out into a cold, hostile world.
It is also suggested that labour and birth are easier and more enjoyable if the mother stays immersed in water for the whole time. There is considerable evidence that warm baths make first stage contractions less painful. Even giving birth under water may be possible, and quite safe, in expert hands.
Not all doctors are happy with these more enlightened attitudes. There could be risks which, although seemingly small – and negligible in institutions in which staff are experienced in dealing with these ‘alternative’ methods – may still outweigh the benefits. However most concede that the feelings of mothers and babies have been ignored too often in the past and they are making amends. Most women find it very helpful and comforting to have their partner present during labour and delivery.
Also, it is now standard practice to give the baby to its mother to hold and cuddle the moment it is born. This alone makes for a calmer and more loving welcome.