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Getting in position -- making changes to shake, rattle, and roll

Posted Mar 31 2010 7:10pm

I cannot emphasize how important it is to be as mobile as possible in labor and during the pushing stage. There are such an abundance of different positions to assume in labor , even with an epidural. Maternal position changes will help the baby move into optimal position for the birth process.

Many times, I have women who are laboring with 'back labor'. Back labor is when there is (obviously) pain in the lower back with contractions, and often times, also in between the contractions. This can be quite painful, in addition to the pain felt across the uterus and in the front low pelvic area. It can simply feel unrelenting. (Can you tell that I've been there, done that, bought the t-shirt?) The root cause of the back pain is usually a posterior lying baby, or even an asynclitic lying baby (cock-eyed, off to the side).

I often wonder, why so many posterior babies? Simply put - we're a reclining society. We sit back in our recliners, couches, office chairs, dining room chairs, rocking chairs and more. Our babies get into these funky positions from us lying back.

This is why it is so very important to get up and move in labor. No lying back on the hospital bed if you possibly can! Lying in the bed just lets the baby stay in a sub-optimal position for birth, leading to back labor, long labors, 'failure to progress' and yes, even some c-sections. I cannot tell you just how many c-sections I have witnessed for 'failure to progress' and the baby is in a posterior or asynclitic lie.

Up. Move. Lean forward. Lie on your far left or right side. Squat. Walk. Dance. Hands and knees. Modified lunges. Sway from side to side.

Even with an epidural -- yes, you can do many different position changes! Left lateral, right lateral, squatting with support, squatting with no support (light epidurals, when you can bear your weight on your legs), knee chest, sitting straight up with the foot of the bed lowered.

I am a huge fan of position changes . If one position doesn't work, or doesn't feel right -- MOVE! Change it!

Good bye persistent lithotomy or supine position.

Hello position changes!!

(I need a t-shirt to wear at work that says "L&D Nurses Do It In Every Position")
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