By Cathy Daub, CD, CCE (BWI)
Laboring in birth is hard work but today we are making it harder than it needs to be. The secret is to find ways to create optimum space for the baby to move into and through the pelvis. BirthWorks philosophy believes that “Birth is Instinctive” and that includes the baby knowing how to move through his mother to be born. Remember that the baby was conceived in the uterus while low in the pelvis. As he grows he moves up through the pelvis with the uterus into the abdomen where there is more room to grow. So in an instinctive way, we can know that since the baby has already made that journey once, it is familiar to him. What is familiar feels safe.
After moving up to his mother’s abdomen and reaching his birth weight, he is ready to move back down through the pelvis to be born. But now there is one difference – he has grown. At this time it is essential that a mother positions herself in ways to optimize the space in which he can move.
One position to avoid is the deep squatting position. In this position, the pelvis is tipped backward as western women squat sitting on their heels which moves the pelvis into a posterior position. This is a way to decrease space in which the baby can move. Any position that tips the pelvis backward is a way to make descent of the baby through the pelvis more difficult. It is desirable to have a forward pelvis in labor which offers more room for the baby.
There is another reason to avoid a deep squatting position in labor. In labor, it is advantageous to increase the angle between the mother’s spine and the opening of the pelvis so the baby can position himself optimally. In order to do this, the woman in labor needs to keep her knees below her waist. In a deep squatting position, the knees are above the waist. Keeping the knees below the waist is the BirthWorks Third Principle of Optimal Pelvic Positioning that all women of childbearing age need to understand.
There is a great position called “The Dangle Squat.” (see diagram) In this position two people can sit on the bed or high chairs with a space in between. The woman in labor stands between them and places her forearms on their thighs. Then she drops down into a partial squat, keeping her knees below her waist. She can feel the stretch in her upper body so that the forces going up are balancing the forces going down. This is a position that opens the pelvis. She stays there for the duration of the contraction and then comes back up to a standing position and walks. The Dangle Squat is an easy one to maintain for her helpers as well which is an important consideration in any birth.
Saying “No” to positions that decrease space in the pelvis and saying “Yes” to those that increase space in the pelvis makes a significant impact in the birth experience. Mom, baby and family will be thankful.