21.06.2021

How to give birth without pain

How often do women giving birth recall their birth in dark colors:  “It hurt to horror!”, “To lie unbearable!”, “From the fights, I thought, I would lose consciousness!”, “The CTG hour seemed like an eternity!”, “The midwife bent me so on the exertion, she thought she had broken her spine! ”,“ When I climbed onto the obstetric table, I was afraid to roll my daughter’s neck! ” .

Happy mummies who have tried vertical labor on themselves tell otherwise.

From the depths of centuries

How long has a woman in the delivery room been “laid on the shoulder blades”? It turns out quite recently… Also, our great-grandmothers – great-great-grandmothers gave birth on their haunches or hanging on the neck of her husband. The contractions of the mother in labor were carried out in a well-heated bath, where midwives forced them to constantly walk, raising their legs high. It was believed that active walking with overcoming obstacles contributes to the rapid disclosure of the cervix and improves labor.

In general, this method of delivery is considered traditional for the Northerners, the peoples of Central Asia, they give birth in Africa, Mexico, and China. In Europe, too, 200 years ago they gave birth while sitting: in Holland, for example, a bride and a dowry were given a special chair for childbirth. In France, until the 16th century, women gave birth, standing on all fours.

Everything changed when the midwife was replaced by an obstetrician-gynecologist with obstetric forceps, anesthesia and other progress. The woman was immediately transferred to a horizontal position, simply because it was more convenient for the doctor to take the baby and use honey. inventory and medicines. Actually, they forgot about the main participants in this process (mother and child), their convenience. True, there is a more interesting historical variation: according to some reports, the French king – the sun Louis XIV first ordered to lay a woman in labor on the bed, because he wanted to personally observe the birth process of his beloved favorite.

Since then, about vertical childbirth, as about the traditional and most physiological way of the baby being born, have been safely forgotten, and childbirth in the “lying” or “half-sitting” position has become “traditional”. But for some time (about 10 years), this method was begun to be practiced by doctors again, and, it should be noted, very successfully. So what is this new (well-forgotten old) way?

How does it go

At the first stage of labor, when the cervix opens, a woman can do anything that will help her to distract from pain or reduce them: walk, “swing” on the fitball (sports ball), sit on a special chair, “hang” on her neck husband or just stand. Now, most doctors have come to the conclusion that a woman should not lie down during contractions, and not only those obstetrician-gynecologists who practice vertical delivery think so, but also supporters of the traditional approach.

At the second stage – the stage of expulsion of the fetus or attempts, a woman can actually stand, sit in a specially-designed chair, kneel or squat. Since delivery is a natural process, it is believed that the woman herself feels (at the level of intuition) which pose is most optimal.

Doctors categorically forbid, until the moment of the birth of the child, to decide on the only right position, but it’s still worth considering options in advance.

The most physiological pose is the one in which a woman is half sitting on her knees on the bed, turned towards her back and leaning slightly. A good position can be called a pose in which a woman in labor squats down facing the doctor. In any case, none of these provisions is a panacea: if necessary, mommy will be moved to a lying position.

The third stage of childbirth – the birth of the placenta, also takes place while sitting: the young mother is placed on the baby’s breast, the uterus is actively beginning to contract and the separation of the placenta is more intense, and the “gravity” helps the quick birth of the placenta.

The benefits of a “vertical approach”

The advantages of this method are undeniable and among them can be noted:

  1. There is no uterine pressure on the abdominal organs and blood vessels. Squeezing large blood vessels, including the aorta, which carries oxygen-rich blood from the heart to tissues and organs, as well as the inferior vena cava, which is responsible for the outflow of blood from the lower body back to the heart, harms both the mother and the fetus. In a horizontal position, the occurrence of a child’s hypoxia, i.e. oxygen starvation, is often observed. In the case when a woman gives birth vertically, hypoxia due to compression of the vessels is excluded: both during contractions and during attempts.
  2. The duration of contractions is significantly reduced. Vertical childbirth presupposes the active participation of a woman: she walks, crouches, relies on something, can swim (if the opportunity is provided for in the hospital), swings on a gymnastic ball, in general, does everything that our great-grandmothers forced to do (midwives), with some correction for time). Due to such passive physical activity, as well as the most vertical position of the woman in childbirth, in which the bladder and fetal head put more pressure on the uterine pharynx, the neck opens more quickly, but smoothly, and the labor time is reduced by 3 hours. By the way, reducing the time of labor has a positive effect not only on the well-being of the mother, but also on the child, as the number of short-term cessation of oxygen intake decreases.
  3. A significant reduction in injuries, both of the woman in labor and the fetus. If the duration of contractions decreases, then the time of attempts, on the contrary, increases, on average, up to half an hour. However, one should not think that from this “giving birth” it becomes painful – not at all. With this method, the child moves along the birth canal smoothly, which reduces the risk of injuries to the mother (for example, only 5% of women in labor need an episiotomy, when, as in “traditional births”, 25%). Moreover, it is also easier for a child to survive such childbirth: he moves smoothly with minimal energy costs. Mother and baby are helped by nature itself: the force of gravity.
  4. Reduced blood loss. The birth of the placenta is faster, therefore, the woman giving birth loses 150 ml of strength.
  5. Active behavior of women in childbirth. Vertical childbirth allows a woman to observe the progress of the process, after the birth of a baby, she immediately picks it up and puts it on her chest. Clamping (clamping) of the umbilical cord is carried out only after the end of its pulsation.
Now about the shortcomings and contraindications

Of course, in addition to the pros, there are also disadvantages:

  1. It is difficult for medical staff to control the process of promoting the fetus through the birth canal.
  2. It is impossible to use epidural anesthesia as anesthesia (however, anesthesia, as such, is not required with this method, since the woman’s pain is reduced).
  3. Long attempts exhaust the woman in labor, which makes it impossible for her to be constantly in the same position.
  4. It is difficult to control the fetal heartbeat at the stage of actual delivery. This is important, as it is considered necessary to listen to a heartbeat after each attempt.
  5. In giving birth to women, a standing or sitting position can provoke a rapid birth, which is quite negative for the condition of the child.
  6. This method is contraindicated: those with diseases of the internal organs, with complicated pregnancy or premature birth.
Birth Positions

And yet, if the flaws were not confused, and there are no contraindications, then, when planning a vertical delivery, it is worth paying more attention to positions.

There are many courses for preparing pregnant women, where future mothers will be happy to tell and show everything they need to know, going for the baby to the hospital. If there is no time to attend classes, then you can study the poses and practice on your own.

So, the main positions:

  1. A woman in labor is facing her husband, leaning on him or clasping her neck and “hanging”.
  2. A woman stands with her back to her husband, who supports her arms. This position helps to relieve tension from the back muscles and relax; the cervix opens more actively; the fetus moves faster; reduced risk of oxygen starvation. This pose is good for weak contractions, a narrow pelvis and a large child. The pose is undesirable when trying, as there is a risk of rupture of the perineum; it is more difficult for a midwife to monitor the degree of cervical dilatation, and pain may increase.
  3. Standing position, leaning on the table. This pose is ideal for starting fights. The child quickly moves along the birth canal, the pain is significantly dulled. In the second stage of labor, the position is undesirable, since the birth of the head is difficult.
  4. Sitting on a fitness ball or a special chair without a bottom (yes, nothing has changed since medieval Holland). Vertical birth is best to start from this position. It helps to reduce pressure on the spine, reduces soreness. Doctors recommend making hips rotate to relieve tension on the back muscles. During an effort, the pose must be changed, as the muscles of the perineum tighten, while they must be relaxed.
  5. Squatting or in a “crow pose.” Pros: it is easier to push, the time of contractions is reduced, the birth canal is expanded, the baby is born faster. Cons: legs get tired quickly, there is a high probability of ruptures. The pose is recommended for weak labor and head presentation of the fetus.
  6. Sitting on your knees, with one hand resting on the partner’s shoulder and the other on the midwife’s shoulder, the knees should be wide apart. The pose is good for head presentation. In this position, the pressure of the uterus on the spine is excluded, the perineum is protected from tears, attempts are facilitated, the woman is less tired. Nuances: it is necessary to periodically stand up to rest the legs, and lower the head in order to relieve tension from the shoulders and muscles of the neck.
  7. A woman in labor is sitting on a bed or table, leaning on pillows or a back; feet rest against the mattress (table surface). When trying, it is recommended to press the divorced knees to your hands and lower your head. The pose is good when the child has pelvic presentation, perineal dissection is necessary, the process proceeds rapidly. Pros: optimal for relaxing between breaks, the risk of breaks is reduced. Cons: not suitable for weak labor.
Is it worth it or not?

Vertical delivery is certainly preferable when the future mother and baby do not have any complications, the pregnancy proceeds well, and the birth passes accordingly. If medical intervention is required, then the usual way is needed. The horizontal position of the woman in labor is more convenient for the doctor to provide the necessary assistance in delivery, in other words, in the event of any complications (for the mother or the fetus), vertical birth is contraindicated.

However, if a woman and a baby are healthy, then it is worth remembering that standing or sitting gives birth to nature: contractions are easier to carry, and at the second stage of delivery, all the muscles of the back, abdominal, pelvic floor work more smoothly and optimally. For the mother, childbirth becomes less painful and tiring. The child, on the other hand, experiences less hypoxia and stress, which means that he is born more calm and healthy (studies have shown that children born in a vertical way are less prone to neurological disorders and are much more likely to be ahead of their peers in development).

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