Everything you need to know about labour positions
Labour & birth

Everything you need to know about labour positions

Midwife Tracy Donegan gives advice on the best labour positions to help you through.

Changing positions during labour can help to ease your baby’s journey into the world and also makes the process a lot more comfortable for mum too.

Everything you need to know about labour positions

There is an old Jamaican midwife’s saying, “the baby will not be born until the mother opens her back”. In other words when mum is upright, the pelvis opens and we make the exit for baby about 30% larger. It makes sense to make baby’s exit as easy as possible. Being upright and mobile in active labour (6cm) means mum is maximising the use of gravity and optimising blood flow to that amazing muscle doing all the work. You’re also providing lots of oxygen for your baby. Being on the bed reduces oxygen to your baby, the uterus and can make labour more painful and more challenging for your baby, especially in the pushing stage as your baby is having to move uphill against gravity to get under the pubic arch (think of the bend in a welly boot) and how your foot has to be angled in a certain way to get it in.

Trust your body’s intuition

Often mums ask which is the best position to labour in and I tell them “your baby and body will tell you”…. Just like when you get uncomfortable sitting in one position too long….or in bed at night…you don’t need anyone to instruct you on what feels best – there’s very little thinking involved you just do what feels rig ht and shift your position. Being upright also means we’re ‘hacking our hormones’ to reduce stress hormones and increase testosterone (associated with confidence). Being upright means mums feel more in control. Sometimes, monitoring can make being mobile more challenging for staff but that’s their worry, not yours yours – staff almost always facilitate monitoring while mum sits on the ball or stands.

Everything you need to know about labour positions

 

All fours

If baby has moved into a less than optimal position and you’re experiencing back labour, the knee the knee chest (all fours) position is great. Being on all fours means your partner can apply counter pressure on your lower back if you are experiencing back labour. Forward-leaning versions can also help if mum is healthy and well – www.spinningbabies.com has some great videos to encourage baby into a more optimal position.

Pushing position – whatever is easiest

When it comes to pushing, choose whatever position feels best for you, but your partner may need to facilitate with staff for positions other than on your back in the bed. Squatting sounds ideal, but most mums haven’t had a lot of practice training those muscles to support you. A birth stool can be really helpful if this position feels good for you and if there’s no birth stool available getting into a supported squat position between your partners knees is amazing.

The peanut ball

Mums can still change position even with an epidural and the use of a little known magical labour tool call the ‘peanut ball’. With a light epidural, mums can even give birth upright leaning over the back of the bed. At the moment only the Coombe uses the peanut ball – but you can purchase them online and bring it with you if you are planning on having an epidural.

For mums with pelvic girdle pain be sure to let the staff know especially if you have an epidural to protect your pelvis from any damage in labour as you won’t feel if your legs are overextended.

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Ask Sarah

Q I’ve heard a lot about the Paleo diet and as I am very interested in reducing the amount of processed foods and grain based meals my family eats, we are considering following this diet. From what I read it seems to be a back-to-basics type of eating. Is a Paleo diet safe for children? My kids are aged seven and nine.

A The Paleo diet is one of the most fashionable diets around at the moment. It is also known as the ‘caveman diet’ and is based on cutting out processed foods, starchy foods like bread and potatoes and eating more meat, vegetables and fruit.
As fad diets go, it is not the worst but there are some good and bad sides to it. Reducing the amount of processed foods we eat is always a good idea and by doing that you will usually reduce the amount of fat, salt and sugar you eat, which is a good thing! The problem with the Paleo diet is that it also cuts out dairy (on the basis that cavemen didn’t drink milk) and this means that the diet is very low in calcium. For this reason it is really not suitable for children who do need a lot of calcium for growing bones. How did cavemen manage without dairy? They ate a lot more food than we do (up to 10,000 calories per day compared to the 2,000 most of us eat). By eating that amount of food they were able to pick up just enough calcium from green vegetables and seeds. To put it in perspective, you would need to eat 16 servings of broccoli a day to get all the calcium you need. This is easier to do if you eat 10,000 calories per day rather than 2,000.
The other problem with the paleo diet is that it is not entirely based in science. Many of the Paleo diets out there say you should not eat wheat, even though we know that cavemen did in fact eat wheat and other grains. These diets also don’t recommend that you eat blubber and the big lumps of fat that were also a large part of the caveman diet!
A final problem is that many Paleo diets encourage people to cut out beans and lentils and to get their protein from meat and fish instead. Many studies over the last few years are clear that eating too much animal protein is linked with more cancer and heart disease. Eating some vegetarian meals based on beans and lentils is a great way to get your protein without always going for meat.
Is this a diet we should follow? I think there is a lot we can learn from the Paleo diets. We could all do with eating less salt, sugar and processed foods and adding in more nuts and seeds as well as more vegetables. However, I think following a strict Paleo diet could lead to low levels of calcium and vitamin D and so it is not suitable for children or teens and adults would need to think about a calcium supplement.

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Ask Tracey

Midwife Tracey Donegan answers your questions about pregnancy and birth

Q When should I have my first pregnancy scan? And how many scans should I get throughout my pregnancy?

A
Your first scan is known as your dating scan and is routine in all hospitals. Most mums will have this scan at their booking visit, which can be anywhere between 12-18 weeks. The earlier the scan the more accurate it will be. If you have experienced recurrent miscarriages some hospitals will scan you earlier. Contact your antenatal clinic for more information. In Ireland, most women will have two scans in a healthy pregnancy – a dating scan and an anomaly scan at around 20 weeks. However, some units provide a dating scan only. Private scans are also available in most cities and many parents use these services for additional reassurance and to find out the sex of their baby.