Birth Position

jennakg

My Dr is on board with me not wanting to give birth on my back, but from what he said he seems to only be comfortable with me doing it on my side.  I want to have the liberty to move around and do what's comfortable for me, although I'm not opposed to giving birth on my side.

Yesterday at my HypnoBirthing class, the instructor said that if the doctor wasn't willing to let you give birth in the most comfortable position to you, whatever that may be, she thought it was reason enough to find a new dr or mw.  

Do you guys think that it's a huge deal?  I don't know that he's opposed to me kneeling on the bed, for example (although I had 2 knee surgeries last year, so I don't think that would go well).  But what if I find that lying on my side just isn't working for me and I do NOT want to give birth on my back.  What do you think?

TIA 

cyclek8bride

I would try to clarify with you OB.  It may be easier for him on you side or back, but he still may be willing to deliver you any position you may be in. He probably worries more about dropping a baby when the mom is on her hands and knees or squatting.  If he said I will only catch your baby if you are on your back or side then I'd worry.

Besides, planning birth positions is like trying to predict anything in birth. I know before hand I didn't want to deliver on my back, but when the time came, I did.  I was so beat when pushing came around, I fell asleep between contractions.

Sawyerplus1

I think if you like your Dr in other regards and trust him to respect your birth plan/desires, then it may not be a big deal. You could clarify with him what he means or what his concerns are, but if you're in the throes of labor and pushing the baby out while kneeling beside the bed, or on all 4s on the bed, etc, I doubt he'll force you into a different position. And I agree with PP that trying to plan your pushing position is a little futile anyway. With DS, after 29 hours of labor I was able to squat in the birth tub and it worked well. But with DD I was most comfortable laboring AND delivering on the bed, in a semi reclined position. I just didn't want to move and I lay there vocalizing through the contractions and it's what worked best for me at the time, though it's not likely what I envisioned. FWIW, these were both med-free deliveries. 

dosafyre

I had back labor, so being on my back in bed was a no-go for most of my labor. But at the very end, DD flipped...and they asked me to try getting on my back. I was surprised when it actually felt comfortable, and I was getting great progress with my pushing (20min!)...so yeah, you just never know what will work.

KateLouise

I would clarify what your Dr is comfortable with and what his reasons are before you think about switching.

I gave birth to both my babies on my back. DD1 was more semi reclined, DD2 was flat on my back on bathroom floor. I was comfortable and had no problems. So, although I know all the reasons why birthing on your back is "bad", I personally wouldn't rule anything out. 

annabelle.27

Personally I think it's something worth fighting for. I delivered DS2 on my knees.

lilyaster

The only position I've wanted to birth in has been squatting (in the water, with DH supporting me).  I love my family practice doctor, but when I saw the practice's OB who could have ended up being on call, she said "we'll let you deliver in any position you want...but we won't get on the floor, our backs can't take that".  It just turned me off to know that I'd probably be told to stay in the bed.  So we switched to a midwife for a home waterbirth like our last birth.  As long as there are no complications or emergencies I think they should help you get your baby out however you feel best.

ridesbuttons

You don't know how you want to deliver until you are in the process.

So long as your Dr is ok with being flexible re: changes of position, don't make any plans about exactly HOW you'll get the job done.

Nechie122

I think when NB advocates talk about "not giving birth on your back," they mean it as code for legs-up-in-stirrups. That doesn't mean you need to avoid your back entirely if that's what works for you. I gave birth on my back and barely tore and it was fine. Other women prefer other positions. As long as you're free to labor as you want and move around as you want, I don't see this as a an issue per se. He may also be up against hospital policy that doesn't want you to deliver on the floor. I'd have another conversation and ask him about it.

LindseyJW

it concerns me that your HB instructor would give such advice. I am also a HB instructor and I would never tell a student to find a new provider for this reason. I would offer that I see it as a red flag and that it warrants further discussion and investigation as to your provider's true thoughts/capabilities about unmedicated birth. what are your provider's rates of unmedicated birth? cesarean birth? what are his rates of interventions like pitocin applied to a labor that started spontaneously and under what grounds would he administer? use of forceps or vacuum? at what point will he suggest an induction? and for what reasons?

these are probably better indications of how willing and capable he is of assisting you in an unmedicated birth. when the moment for birthing comes, you should just assume whatever position you are most comfortable in and the rest will fall by the side. your birthing companion (and hopefully, esp bc you are planning a hospital birth, you have a doula as well) can intervene if the doctor wants you in a different position. there is absolutely no medical reason in a normal labor with a healthy mom and baby for you to need to be on your side for birthing. 

all this said, you may be surprised at what feels comfortable and works for you during your labor. there is a reason that the majority of the HypnoBirthing moms in the videos we watch in class are birthing semi-reclined. it is quite comfortable for them to be in that position and their bodies are working so harmoniously together with their babies that it is not necessary for them to use gravity to assist.  

LindseyJW

Nechie122:

I think when NB advocates talk about "not giving birth on your back," they mean it as code for legs-up-in-stirrups. That doesn't mean you need to avoid your back entirely if that's what works for you. I gave birth on my back and barely tore and it was fine. Other women prefer other positions. As long as you're free to labor as you want and move around as you want, I don't see this as a an issue per se. He may also be up against hospital policy that doesn't want you to deliver on the floor. I'd have another conversation and ask him about it.

i've been in a dozen hospitals in my lifetime. not a single one of them would i want to birth on the floor! they are totally disgusting. the last hospital room i was in had someone else's blood on the sink in the room and dustballs on the floor.

 

jennakg

LindseyJW:

Nechie122:

I think when NB advocates talk about "not giving birth on your back," they mean it as code for legs-up-in-stirrups. That doesn't mean you need to avoid your back entirely if that's what works for you. I gave birth on my back and barely tore and it was fine. Other women prefer other positions. As long as you're free to labor as you want and move around as you want, I don't see this as a an issue per se. He may also be up against hospital policy that doesn't want you to deliver on the floor. I'd have another conversation and ask him about it.

i've been in a dozen hospitals in my lifetime. not a single one of them would i want to birth on the floor! they are totally disgusting. the last hospital room i was in had someone else's blood on the sink in the room and dustballs on the floor.

 

Bahahahaha!  No, I don't think I will be birthing my baby on the floor.  Thanks for a good laugh! 

jennakg

LindseyJW:

it concerns me that your HB instructor would give such advice. I am also a HB instructor and I would never tell a student to find a new provider for this reason. I would offer that I see it as a red flag and that it warrants further discussion and investigation as to your provider's true thoughts/capabilities about unmedicated birth. what are your provider's rates of unmedicated birth? cesarean birth? what are his rates of interventions like pitocin applied to a labor that started spontaneously and under what grounds would he administer? use of forceps or vacuum? at what point will he suggest an induction? and for what reasons?

these are probably better indications of how willing and capable he is of assisting you in an unmedicated birth. when the moment for birthing comes, you should just assume whatever position you are most comfortable in and the rest will fall by the side. your birthing companion (and hopefully, esp bc you are planning a hospital birth, you have a doula as well) can intervene if the doctor wants you in a different position. there is absolutely no medical reason in a normal labor with a healthy mom and baby for you to need to be on your side for birthing. 

all this said, you may be surprised at what feels comfortable and works for you during your labor. there is a reason that the majority of the HypnoBirthing moms in the videos we watch in class are birthing semi-reclined. it is quite comfortable for them to be in that position and their bodies are working so harmoniously together with their babies that it is not necessary for them to use gravity to assist.  

At my last appt (at 22 weeks) we did go through our birth preferences with my dr.  I haven't written my birth plan yet, but we brought up pitocin, episiotmies, Hep Lock, birth position, and more things that I can't even think of right now.  I didn't ask his rate of natural birth, but I know he has done several recently, and he's perfectly comfortable.  He's completely okay with me not wanting to get induced, and said he'd wait as long as needed for me to have the baby.  He obviously brought up the fact that when things happen that are medically necessary then we need to be flexible, which I'm completely fine with.

I felt really good about his answers, and so did DH.  However, when we brought up birth position he said he wouldn't get in a tub with me (I don't want to deliver in a tub so that's a non-issue), and that he wouldn't climb under me.  So, when my HB instructor said that for her, that was reason enough to switch providers, then it got me thinking that what if I'm not comfortable on my side.  I certainly don't want to be arguing with my dr while I'm trying to get a baby to come out of me.  LOL

So, when you say that most HB moms deliver in a semi-reclined position, doesn't that tilt the pelvis up and make it more difficult for the baby to find his way out?  I'm not opposed to a semi-reclined position either if that isn't the case.

Thanks!  You're response made me feel better.

I think I will write in my birth plan something along the lines of me wanting to deliver in the position that's most comfortable to me, and see what he says about it in my next appointment. 

SWBs Wifey

*I* would want a new Dr.  Or at least a really long conversation about the whys I can't deliver in the best manner for baby and me.  

I say that because I just delivered Baby #2 last week and that child was NOT coming out with me on my back or my side.  No way.  No how.  He didn't like it when I was laying that way- he'd face OP (Occipital Posterior) and not drop/engage.  I tried it that way and I know it sucked to be in that position knowing it wasn't working to turn or push him down.  I tried pushing in several positions... most any one I can think of, really... and THE ONLY position that put Baby in the right position and pushed him out was standing up.  Before I got into that position, the MW in the VERY pro-natural birth center Iw as in, contacted an OB because she was worried I would need forceps, episiotomy or vac delivery.  Once I was in the right position though, baby was out within a few short minutes.  I pushed a total of an hour 16 mins and only 3-5 of those minutes were putting baby where he needed to be...

 

choppinbroccoli22

I would absolutely take issue with this. Not that you will necessarily deliver in the position that you hope for (for me, I wanted any position BUT my back, but...I was too exhausted to support myself in any other position when the time came!!) but having the freedom to do so is in my mind very important.

I'm sure you are aware that the whole reason being on your back became all the rage in hospitals was because some doctor decided he could see better. Since, you know, he was the one in control of the situation and not the woman, that's what mattered most. Don't let your doctor do the same thing to you.