Lately my childbirth students have been teaching medical professionals all about birthing positions.
1) A first time mama was her OB’s first natural birth. Seriously, first natural birth EVER witnessed. And my student gave birth standing up! Providing her own counter-pressure while her husband sat on the bed and held her from behind. She gave birth to an 8lb+ baby without any tearing. She said she felt her OB and nurse believed her to be a giant liability disaster waiting to happen!
The next day, her OB had lots of questions about the birth. The OB was surprised the woman did not “blow out her vagina.” OB: I’ve always supported the use of epidurals so I can control pushing and you don’t blow out your vagina. But you didn’t seem to have a problem. Mom: I had instant feedback from my body about how fast/slow to push.
2) This mom was a VBAC who never got to active labor during her induction with her first baby. And she wasn’t “allowed” to get out of bed. This time, she stayed at home and birthed 17 minutes after arriving at the hospital. She chose a hands/knees position. There was no doctor on the floor so three nurses assisted. The one catching had never done a hands/knees births. I could pick up on some anxiety about the position but mom did all the work. She made it easy for the nurses. And thankfully, they were supportive of her choice–not that I think she would have willingly changed positions at that point! The nurse passed the baby straight to mama where she snuggled skin-to-skin for over an hour.
3) A resident had only done back births. Her words: “I see that you’re pushing well on your knees. But what I like to do for natural births is break down the bottom of the bed, scootch you down and have you pull your legs back.” I wanted to ask, “Um, how is that different from medicated births?” Mom was tricked onto her back “so we can check you.” But she rolled to her side. And instinctively gave herself her own counter-pressure. This clearly made the resident uncomfortable but the mom ignored the nurse’s attempts to move her hand. I heard the attending whisper to the resident “the manuevers are the same for a side birth as a back birth.” When the resident gave me some instruction I can’t remember now, I replied, “Oh, ok. I haven’t done a back birth in a long time. The last birth I attended the mom was standing up.” Wide-eyed resident shook her head in disapproval. Sigh. I hope that one moves on to a hospital far far away.
I’m so proud of my students and other families who are changing the way birth is “managed” in the hospital. It can be a tricky place to navigate and the balance of power can be overwhelming. I think of my client who had a breech baby. While she knew cesarean was her only option in the hospital, she also insisted on delayed cord clamping and skin-to-skin contact. She made a path that other women can more easily trek.
These amazing families inform and change one birth at a time.