May 2015 Moms

Pushing Positions/Some venting

Like most of you, I've been doing a lot of reading.  :)  One of the things I've come around in even the most mainline pregnancy literature recommends pushing in positions other than flat on your back.  Now, I know that pain relief choices really play a large role in how mobile you are during labor and delivery, but if I make it to the pushing stage without an epidural (that's the goal, but you never know, I could have a low pain tolerance/need to get some rest), I'd like to try squatting.  I've read that it makes your pelvis larger, in addition to working with gravity.

That said, I asked during our hospital birthing class about pushing positions (because all they were showing was a bed with stirrups) and she said I could push in any position I wanted.  The hospital even has squat bars (just three, but at least they've got them).  BUT--I have to deliver in bed on my back "for safety".  I'm thrilled they aren't banning squatting altogether, but don't really understand how they can force me to deliver flat on my back.  Can I even get into the stirrups at that point in the pushing process?  It's not like I'm asking to push my son out onto the hospital floor!

Obviously, if I get an epidural, I'm fine with the whole stirrup situation since it comes with the territory, but really would like to have my own say if I'm going med-free (especially since I'll want to be in what position works best for me, and--heck--it could be on my back in stirrups...I just want options).

Thoughts?  Anyone in a similar situation?  Any STMs who gave birth naturally in stirrups?

Re: Pushing Positions/Some venting

  • I haven't gotten a clear answer on this either. You should talk to your doctor and find out what they will let you do and also ask about any other docs who might be covering. I think you should advocate for what you want.
    Pregnancy Ticker
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  • If you go pain med free, you won't want to be on your back for long! My daughter was born without pain medication (this was what I wanted for various reasons) and I pushed her out on all fours because all other positions hurt and/or were ineffective. You have the right idea (and questions) about positions- just make sure your doctor is on board. I found the only natural birth advocates in my area were midwives, so that's who I used. I actually switched during the 3rd trimester because I didn't like the answers I was getting from my previous doctor. Make sure you choose someone who is going to encourage you in the ways you would like. It does matter how you give birth! And don't be afraid to switch this late if you need to. 
  • My hospital discourages pushing on your back. They want gravity to help (which you don't get on your back). I'm surprised yours wants you to. I'm sorry to hear that. I hope you'll be able to find the answers you're looking for.
  • I heard that on your back or slightly leaning on your left side will actually help slow the baby down from coming out too fast and will help prevent tearing. Of course, that's not why the hospital makes that rule. They make it to cover their own asses. I think if you're in the middle of good, strong pushes- your doctor will probably ask you to get on your back, but if you can't- what are they gonna do?? Also, stirrups arenn't always needed when you're on your back. Though you may appreciate them. 

    It's smart of you to be looking into all this ahead of time!! I'd def ask your doctor. And while delivering while squatting (or any other position) would be preferable to on your back when you're med free, I think on your back really won't be so bad. It will help things to go a little slower, doc will be able to really massage you and stretch you around baby's head to prevent tearing, and doc who is delivering will have you in the position that he/she practices the most with. So lots of positive points to the least desired position. Stinks the hospital has that rule, though!
  • From my personal experience of my DS's birth, I would recommend avoiding your back if possible. My water broke and nothing else happened. So basically by the time I started real contractions that were induced from Pitocin I had been up and on my feet trying to get things going for 14 hours. Once in the process of haveing active contractions I wanted to lay down just to rest because my legs were physically exhausted and I just wanted a break. Well....in my opinion once I laid in that bed I lost control of my pain management and it got really hard. I ended up getting an epidural (which may have happened anyway at some point, there is no way of knowing). This now meant I was in bed on my back. However what I felt was successful was using the birth bar with a towel looped around it and for every contraction i basically pulled myself into a crunch while pushing. I still pushed for 2 hours and 40 min, but average FTMs are about 2 hours and I think my LO got stuck on my pubic bone because he had a little abrasion on his head when he was born. I definitely felt the pulling in my upper body and was very sore post birth as if I had done a wicked rowing workout lol!
    So in summary my recommendation is this:
    1. While labouring, avoid laying down if at all possible
    2. If you end up on your back there are still options and it can still feel empowering to push your baby out. It took us a few positions (side lying etc) to find the towel thing that worked best for me.

    Hope that gives a little insight
  • Thanks for all the wonderful thoughts and perspectives, ladies!  :)  Feeling a little better about things!
  • The thing they don't tell you about epi's is that *you* are in control of the amount of meds you receive. You have a little button to push when you need more, just like people sometimes get with drip meds. Hopefully, you may be able to find a balance between taking away the pain, but not pushing it so many times that you lose all sensation. Last time around I was able to feel a lot of the pressure, but it didn't *hurt*, and I could still move my legs. I had to stay in the bed but was able to try different positions for pushing, even kneeling, I think he was ultimately delivered on my side.

    I know not all doctors let you do it that way but an epi itself does not have to limit you to lying on your back.
    Raising a threenager since 11/11
    Baby boy #2 due 5/6/15
  • I had no pain meds with my daughter and had her on my back. I liked it that way since I did not have to worry about her hitting the floor. I think I am sticking with being in bed. Your not really flat and it helps your husband and everyone get to actually see the baby come out. Definitely do whatever makes you comfortable. Oh and I did not have my legs in stirrups. My husband held a leg and my mom held this other. This helped a lot. I used them to push off of. 
    BabyFetus Ticker
  • My Story is similar to @mistyjewel88. I had to lay on my left side bc my DS was having some heart decelerations. I ended up pushing him out (med free) on my left side/back. With my husband holding one leg, and a nurse holding the other. I ended up pushing for 2 hours because DS was sunny side up. My husband liked feeling like he was helping in some way and he got to see our son come out which was a really special moment. I did labor in the tub for a long time before hand. They encouraged me to try different things during labor. My sister had most of her contractions on all fours and I think even a lot of her pushing in that position as well and she said it helped a ton with the pain (also med free). 
    Married 6-1-13
    Sebastian 3-11-14
    Simon 5-2-15
    Baby #3 Due 9-29-16
  • beaseg said:

    I heard that on your back or slightly leaning on your left side will actually help slow the baby down from coming out too fast and will help prevent tearing. Of course, that's not why the hospital makes that rule. They make it to cover their own asses. I think if you're in the middle of good, strong pushes- your doctor will probably ask you to get on your back, but if you can't- what are they gonna do?? Also, stirrups arenn't always needed when you're on your back. Though you may appreciate them. 


    It's smart of you to be looking into all this ahead of time!! I'd def ask your doctor. And while delivering while squatting (or any other position) would be preferable to on your back when you're med free, I think on your back really won't be so bad. It will help things to go a little slower, doc will be able to really massage you and stretch you around baby's head to prevent tearing, and doc who is delivering will have you in the position that he/she practices the most with. So lots of positive points to the least desired position. Stinks the hospital has that rule, though!
    I've actually heard the opposite, that back labor is more likely to cause tearing. I think the Dr. Sears book says this.
    Pregnancy Ticker
  • I tore while on my back. My doc says nothing can actually prevent tearing unless you request to be cut...
    BabyFetus Ticker
  • I tore while on my back. My doc says nothing can actually prevent tearing unless you request to be cut...

    Noo! Episiotomies are not standard practice anymore for a reason and can cause worse tearing. This article cites some good studies https://mobile.nytimes.com/blogs/parenting/2013/01/27/what-you-dont-know-about-episiotomies-can-hurt-you/

    As part of your birth plan you can communicate to your doctor whether you want an episiotomy.
    Pregnancy Ticker
  • I like everything natural. If I could do it at home I would. I would never get an episiotomy was just saying my doc says there is really nothing you can do. Just the sound of being cut to me is worse the tearing not sure why....ouch.
    BabyFetus Ticker
  • @mistyjewel88 ok good! The thought of being cut is awful!
    Pregnancy Ticker
  • I've read a lot about episiotomies, too.  My class nurse said 90% of their FTMs wind up getting episiotomies.  When I heard that, I think my eyebrows disappeared into my hairline.  WHAT?!  (They say to talk with your doctor if you are wanting to avoid.)  And don't get me started on the info they gave on the epidural!  You know how the pregnancy books list all the modern/new and improved options with epidurals (like walking epidurals and being about to turn them down)--I think my hospital is stuck in the 80s!


  • I delivered my daughter without any meds. When she actually came out, I was laying/sitting in the bed with my feet in the stirrups but all the time leading up to that moment I was all over the place. I walked the halls, labored in a jacuzzi (which gave me terrible back labor!), used a birthing ball, laid on my side, all 4s, etc.

    I don't remember thinking that I wanted to be in another position while I was pushing her out....I was in too much pain to think of anything else!
    S- March 09 E- Feb 12 L- May 15


  • The most recent studies have shown that naturally occurring perineal tears heal faster and more effectively than episiotomy cuts, and that one of best things you can do to prevent/minimize tearing is eat nutritious food and stay well hydrated during your pregnancy in order to keep those tissues healthy and elastic!
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