pregnancy

"Am I being unreasonable to refuse to lie down during labour?" An obstetrician answers.

A mother has shared her concerns about giving birth whilst lying down, on the parenting forum Mumsnet. The woman asks: “Am I being unreasonable to refuse to lie down during labour?

The mum, who is due to give her to her second child, was seeking advice on whether or not it is acceptable to state your birth position preference.

“I know they can’t MAKE me lie down if I outright refuse but I don’t want to be pegged as difficult and pressured and eye-rolled at,” she wrote in the thread after explaining that during her last labour, she was strongly encouraged to be on her back.

Not wanting to repeat that experience because she didn’t find it comfortable, the expectant mum asked the group for advice, stating, “I know from last time that I will have no energy to argue once in established labour.”

Part of the woman's thread on Mumsnet. Source: Mumsnet

It's an issue most mums in the thread had experienced. Many commented that whilst they understood it was medically easier to monitor a delivery when a woman is on her back, they agreed that wasn't the most natural-feeling position.

"You’re the one who’s in labour so insist on a comfy position," one mum wrote, encouraging the woman to speak up. This was also the consensus of the group.

So what do the medical experts say?

According to Evidenced Based Birth, "It is thought that most people giving birth are encouraged to push in a back-lying position because it is more convenient for the care provider during the birth of the baby."

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Mamamia spoke to Dr Philippa Costley, a Melbourne obstetrician/gynaecologist and spokesperson for RANZCOG (the Royal Australian and New Zealand College of Obstetricians and Gynaecologists) for her opinion:

LISTEN: Zoe Marshall talks about her family planning on Mamamia’s latest podcast for new parents, The Baby Bubble.

Do you need to lie on your back during labour?

"A woman has the right to choose to birth in any position she wants," Dr Costley told Mamamia. "As long as there's no urgent situation requiring immediate delivery."

"For example, if an urgent instrumental delivery was required if the baby was showing signs of severe distress.

"Women should discuss their preferences and options with their care provider, both before and during labour."

Is lying down the most popular birth position?

In Dr Costley's experience, childbirth whilst being on one's back is the most common, isn't what always happens.

"For some women, they find it more efficient with pushing if they're sitting on the bed," Dr Costley said. "The rate of perineal trauma can be reduced in that position."

"However some women do prefer to birth on all fours or their side, and that's fine."

Is it safe to crouch while giving birth?

It is common in many cultures for a woman in labour to be in a crouching position, so gravity can assist with the delivery, and it's something which Dr Costley has seen too.

"I have patients who birth crouching," she said. "But it's something to be monitored as sometimes you can have poor control in that position."

"As the baby's head is being delivered, the speed and safety can be difficult to control."

The historical reason for giving birth while lying down.

According to a paper written by Professor Lauren Dundes and published in the American Journal of Public Health, women didn’t always give birth lying down; it's a relatively new concept, and we largely have royalty to thank for it.

King Louis XIV ruled France from 1643 to 1715, and he had over 22 children with his wives and mistresses. During those frequent births, he developed a penchant for witnessing the birth of his heirs... and he didn’t like that his view was obstructed by upright positions or birthing chairs.

It's the historic reason why the horizontal back position became so popular.

What position was the most comfortable for you during childbirth? Tell us in the comments below.

If you'd like to hear more from Nama Winston, see her stories here, and subscribe to her weekly Mamamia Parents newsletter here.

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