Labor Positions

[Dragon Lady]

They teach us in med school that lying on your back is basically the worst position to labor in. That's why labor and delivery beds fold up and come apart so that you can get into more of a sitting or a squatting position, and they have a grab bar that comes up so that the woman can sit forward and hold onto it, and there are birth balls and stuff available too. Once I got lost on the labor and delivery ward and ended up in the room with all the birth balls and I felt like I had wandered into a giant Chuck-E-Cheese ball pit. It was pretty awesome. I haven't done my final labor and deliver rotation yet (starts in a couple of weeks, actually), but in the births I've seen, there has been a lot of encouraging women to get up and move around and to be in a different position than lying on their backs - ANY position, even just being on one side or the other for a while. Obviously some women prefer to just lie on their backs, and that's totally their choice and is especially understandable if they've had an epidural (I've only seen one vaginal birth with an epidural so far, though) or if they are really tired. But I think if I ever get to give birth (which I probably won't because of the scary drugs I have to take to keep my body from destroying itself), I would be all over the turning the bed into a chair and holding onto the grab bar, which makes it so that you're basically squatting, which is probably the best position to labor in, but you don't actually have to get out of bed to do it. And the births I've seen in that position seem to go quicker once the baby is actually coming out and have less tearing.

[Like]

[Portia]

http://www.newrepublic.com/article/1165 ... childbirth

The typical birth narrative that you read online is a tale of harrowing disappointment. The mother had “spent months—if not years—dreaming” about her baby and her pain-medication-free birth. Often, it’s at home, where the mother fantasizes that she will be “surrounded by my family, in an environment where I was free to walk around.” Ideally, the mother would even be able to reach down and pull her baby into the world herself. But, by dint of fate and unhappy circumstance, these moms are forced by medical professionals—sometimes even midwives or doulas—to have C-sections or epidurals. They are “treated disrespectfully or without compassion at that most vulnerable time.”

Read enough of these narratives and you’ll be convinced that the baby-industrial complex is a cold and harsh machine, where epidurals are pushed like marijuana from an aggressive street vendor and individual agency is dismissed.

But the reality is quite different. A new book, Lamaze: An International History by the historian Paula A. Michaels, explains that the vast majority of modern American women are satisfied with their birth experiences. She doesn’t get into specifics on this particular matter, but she notes that according to a 2013 national survey of women’s childbearing experiences, “Mothers generally rated the quality of the United States maternity care system very positively.” 47 percent said it was good, and 36 percent said it was excellent.

[Portia]

Grantly Dick-Read wins in the "Best Name" category.

[pillowy]

By reading that article you posted, Portia, and a couple others, I just found out today that Lamaze originated from post-WWII Russia, where they couldn't afford medicinal anesthesia for Russian women, and so the Russian government set out to convince women that non-medicinal methods of pain relief were equally effective and morally better.

If the woman tried these breathing/relaxation techniques and still felt pain during labor, they branded the woman as having "failed." They said that she wasn't "prepared enough." It was either that, or admit that communism wasn't as good of a system as capitalism (which was able to offer effective pharmacological pain relief to women).


Childbirth Pain Relief and the Soviet Origins of the Lamaze Method
What does contemporary midwifery have in common with Stalinist Russia?

[tenpounds]

I just thought I would jump in and clarify something. I posted the anecdote about giving birth on my back to a ten pound baby. I labored in many different positions, none of which were on my back. I pushed the baby out on my back, holding my knees to my chest. I am a small person and I had a very large baby. It truly is a miracle that both of us made it out unscathed (I didn't tear and baby didn't get stuck). I didn't lay on back for 29.5 hours, which was the length of time between when my water broke and my baby was born. I pushed for over an hour. I am not sure if any of that makes a difference of your interpretation of my comment.

It is really interesting to read this discussion, but also kind of weird. Every woman experiences birth differently and each is ok. There isn't a right way to give birth, in my opinion. But I think it is unkind to pass judgement on the way another woman's birth panned out. What felt natural for one woman might have felt horrible to another.

[pillowy]

I also want to chip in that I really hope I don't sound like I'm judging the way others labor/give birth - I'm not. Whatever works for each woman is what works for them, and that's great and that's what they should do. I guess I'm pushing back against what I feel is judgement for not laboring/birthing a specific way, and I really hope I'm not coming on too strong. I do that easily (get too riled up about stuff).

[Dragon Lady]

I guess I'm pushing back against what I feel is judgement for not laboring/birthing a specific way, and I really hope I'm not coming on too strong.

And yet you told me that you'd convince me to change my mind about home birth if you could?

[pillowy]

I guess I should specify that by "in a specific way" I mean judgement against laboring with pain relief. I don't often hear judgement against those who choose not to use pain relief in labor (and that's good! I don't want judgement on either side!) but I do hear judgement (direct or implied) against those who do use pain relief in labor. For example, one of my friends had her baby this week. Her husband posted on Facebook "She labored at home 12 hours and at the hospital 12 hours. No epidural. So strong." To me, the implication is that she is strong because she did not have an epidural. Wouldn't you interpret his statement that way? No pain relief=strength, epidural=weak.

DL, you made it very clear that you were not judging those who choose pain relief. I hope to make it clear that I'm not judging those who choose to go without it. (I'm also not judging you for choosing home birth, not in the slightest. I would not make that choice myself, and because I fear for their safety I will try to persuade everyone I know not to choose that option. The only judgement I have about home birth is for the leaders that tell women it's as safe as hospital birth - that is not true and it is not informed consent. No information should be withheld from women when they're making their choices.)

[Portia]

I judge! I'm the childless woman glaring at the obnoxious kids in SmashBurger. I am certainly not going to pretend to be unbiased. Balance restored!

[pillowy]

[Dragon Lady]

As for your friend's status, I can see what you're saying, but I disagree. He is proud of her. She wanted to do something *really* hard and she was doing. And yes, it does take strength to do it. A lot of strength. She *was* strong. I don't think he was judging anyone else by that statement. He was letting the world see his pride and admiration for his wife. Some of my favorite memories of birth were Yellow's pride in me. Seeing in his eyes that he was amazed and proud of the work I went through to get those babies here. What absolutely got me through DB's birth was his constant encouragement and pride. I think it only natural that any husband want to express his love and pride for his wife during labor. But just because he thinks his wife is strong doesn't mean he thinks women who make other choices aren't.

It's Olympic season, so let's make an analogy here. A woman trains and trains and makes it to the Olympics. She works really hard and medals. Her husband is insanely proud of her and calls her strong to the media. Their neighbor is also an athlete. She has worked equally as hard, but has chosen different priorities. Perhaps she has decided to spread out and become good in many different sports instead of focusing on one. Or maybe she's focused her attention on training others. Maybe she didn't want the pressure of the Olympics on her and her family. She works equally as hard, but didn't medal in the Olympics. She chose to focus her attention on something else. She didn't feel the same pain. She didn't take the same path. She didn't have the same pressure. That doesn't mean her trials are less. That doesn't mean her success is anything less amazing. It just means its different. And just because the Olympian's husband calls his wife strong doesn't mean he's saying their neighbor is not. It's simply that he's showing his pride in his wife for the specific path she chose.

Epidurals come with a completely different set of trials. I have a neighbor who it doesn't work completely on, so she ends up feeling like she's done it mostly natural, but without any labor practice or training. Another neighbor got an epidural and ended up feeling high as a kite and acted as such. She loved it during labor, but even now, 20ish months later, she is mortified by the way she acted in front of complete strangers. Some women are terrified of needles and it's an amazing feat of strength to simply allow the anesthesiologist near them. Holding still during labor long enough to get an epidural in would be So Hard. Not being able to walk after labor is hard. The cost is hard for some families. Epidurals aren't a walk in the park either. Having never had one, I can't give any personal experience. But I don't think getting an epidural is a cop out. I don't think it means she isn't strong. She simply had different priorities. Perhaps her priorities were to conserve her strength for pushing. Perhaps her priorities were to not feel pain. Perhaps her priorities were medically necessary. But just because she made different choices doesn't mean she's any less strong. And if her husband got on Facebook and said, "My wife has been pushing for 2 hours and is doing amazing! She is so strong!" would you feel like he's saying that women who only push for 20 mins are not strong?

[Portia]

I don't think having a kid is analogous to making it to the Olympics.

[pillowy]

But see, even in that analogy you equated labor without pain relief=medal worthy, labor with pain relief=not medal worthy. Is there not judgement there? Of putting one above the other? Both women accomplished the same thing. They carried a baby in pregnancy and they delivered the baby. One chose pain relief, and did not. And one deserves a medal, and the other does not?

[Marduk]

So wait, pillowy, is your position that birth with epidural is equally as hard as birth without? Because that seems odd to me.

Obviously something is harder to do if you're in greater pain while doing it.

[thatonemom]

I think measuring the level of "hard" is a challenge because different people experience things differently. Dragon Lady herself described the birth of her second as a pain-free unmedicated birth. I've known other people who had unmedicated births and felt a lot of pain. Does that make their labors "harder" than DL's? Or was Dragon Lady's the "harder" one because she managed both the labor and the pain?

I don't know that there's a way to compare, or that there's any value in trying.

[Dragon Lady]

I think measuring the level of "hard" is a challenge because different people experience things differently. Dragon Lady herself described the birth of her second as a pain-free unmedicated birth. I've known other people who had unmedicated births and felt a lot of pain. Does that make their labors "harder" than DL's? Or was Dragon Lady's the "harder" one because she managed both the labor and the pain?

I don't know that there's a way to compare, or that there's any value in trying.

I agree. And that was kind of my point. Clearly the Olympic analogy failed. Let's just forget it. My point was that it's ridiculous to compare. Different priorities, different choices, different situations, different pain tolerance levels, different monetary ability, different preparation, different mental situations, different spouses, different locations, different bodies, different babies, different laws ... there are so many parts of the equation, all of which add into the difficulty level, and many of which aren't visible to the public. It's hard, and pointless, to try to compare them.

My point is that the husband was proud of his wife. I don't think he was trying to judge other women by his statement.

[pillowy]

So wait, pillowy, is your position that birth with epidural is equally as hard as birth without? Because that seems odd to me.

Not saying they're equally as hard, just that neither one is better or worse. (Same as thatonemom and DL just said.)

[Tally M.]

Just throwing in my two cents here: This discussion is incredibly enlightening, because, to be completely honest, I have never considered the different options of giving birth. Granted, I'm not in a position to have children, but I think I have always assumed that the hospital was the only option.

[Dragon Lady]

Just throwing in my two cents here: This discussion is incredibly enlightening, because, to be completely honest, I have never considered the different options of giving birth. Granted, I'm not in a position to have children, but I think I have always assumed that the hospital was the only option.

This! Birth is becoming so institutionalized that most women don't even realize they have choices. I didn't. I thought my option was with or without an epidural. The end. And even when I realized there were options I still felt like the hospital was the "right" way to go, because that's what everyone did. (I still struggle with this idea that there is a "right" way to do everything. It's ended with many tear-filled nights in parenting as I try to figure out nursing and sleeping and everything and I'm always worried that I'm doing it "wrong". Yellow has had to remind me many times that there is no Right Way Police. Just because that's what all my friends do doesn't mean it's right for me or my family.)

That's all I ask. Women, be educated. Your body is incredible. Modern medicine has come so far. Knowledge of birth in general has increased in leaps and bounds. The internet is at your fingertips. Local libraries are free. Just use them. Be educated.

[Marduk]

Now I want to ask about circumcision after birth, but I'm worried it might blow up the internet.