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It's All About Position!
In the Western, industrial nations, for many decades, it has been the norm for laboring mothers to be sitting in a reclined position in order to give birth. Until the seventies in America, women were very discouraged from changing positions from the reclined pose, in some cases being strapped down. Thankfully in large part to the midwifery movement, which has been based on women's well care for its existence, that has changed. Water birth is much more prevalent, along with birthing balls, and other forms of support for the mother while she is in labor.
What is so potentially bad about the recline position anyway? Most women give birth this way in the hospital, and they're all alright.
This is true that most women give birth in the recline position. But it has a disadvantage as that it is working against gravity. Another disadvantage is that it is harder for the mother's sacral promontory to open during labor.
Think about it. If you are laying in a reclined position, there is pressure against your back. There are two joints in that area that don't relax at all except during hard labor: the sacroiliac joints. These two joints are the strongest ones in your whole body. They do not relax nearly as much as the symphysis pubis does during the course of pregnancy. But during labor, the pressure from the baby descending allows the mothers back to open, by the relaxing of the sacroiliac, and facilitate easier birth. The sacrococcygeal joint, which is your tailbone, is also affected, as it flares out during descent, and crowning to help widen the pelvic diameter. This joint is also smothered during the recline position.
If you are laying on your back, sitting up, you are not allowing your body to fully relax these two joints, which helps to keep the diameter of the pelvis more narrow than the pregnancy hormones allow them to be. Women have these hormones for a reason, to widen our hips to facilate the passage of the baby! It's why our pelvises are shaped different from those of men. The difference between pre-pregnancy pelvic diameter, and laboring diameter is incredibly dramatic.
When doctors are delivering the baby (a stupid term, they're not delivering, the mother is!) they often tell the mother to "push towards the ceiling!" If you think about it, which makes more sense? Pushing something out of your body down, or pushing it up? It's the law of gravity.
Doctors also tell mothers to push when fully dialated, because we need to get the baby out as soon as possible! Well, if the fetal heart tones are checking out alright, along with the vitals of the mother, it is best to allow the mother the chance to push when her body tells her to! The doctor does not know precisely what her body is doing at that moment. Her uterus may need a rest from the hard work it just did. Pushing the uterus with labor augmentation such as Pitocin or Cytotec is dangerous, as it greatly increases the chances of uterine rupture, or amniotic fluid embolism, both of which are fatal to mother and baby. The mother's body is perfectly capable of telling her when it is time to push. She will push when she's ready!
So, in light of this very brief overview, what are good positions? Squatting is a good position, as it helps to open the pelvic floor. Forward kneeling is good as well, as it is a position that is able to be maintained for longer periods of time. Birthing balls are good as well, as it gives a supported squat, and the ability to bounce, which can be soothing to the mother while in labor, and helpful for the baby's descent. Sometimes a knees-chest position is good as well, which is kneeling on the floor, then leaning forward to place your chest on the ground.
Hope that this is helpful!
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Originally Posted by Frigga's Spindle
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