'After studying midwifery, I refused to give birth lying down during my fourth labour.'

As told to Cindy Lever by Holly Stephenson, 32, from the Hunter Valley.

After being forced to birth lying down for three of my babies, when the fourth was due, I made sure I did lots of research and put clearly in my birth plan that I wanted an upright birth.

Birthing on a bed for me felt like a very submissive position, while upright felt like I was taking control and it was the most comfortable for me.

When I had my first baby, I was very young and didn’t know anything. I thought lying on your back was the only way to give birth.

Mums and non-mums answer questions about childbirth… and their responses are very different.

My labour was arduous because the baby was in the wrong position and I was forced to birth her on my back as I didn’t know the benefits of being upright. I had prolonged pushing and a second-degree tear to my perineum and a first-degree tear upwards into my labia. It made recovery very painful.

With my second one, I still didn’t know too much about positioning and birthed in a semi-recumbent position on the bed and as a result my son was born compromised due to a mild-moderate shoulder dystocia which required manoeuvres to release his anterior shoulder.

I went from lying on my back with my knees jammed up to my chest to being flipped on my hands and knees which with some assistance allowed me to birth him. I suffered mild PTSD afterwards as a result and went wild researching the best positions for birthing ‘big’ babies.

I read plenty of articles and fell in love with Ina May Gaskin, who very quickly demonstrated through her practice that birthing upright was extremely beneficial, particularly in scenarios where women may potentially be expecting a bigger baby and or have had a previous shoulder dystocia complication.

I then went on to birth my third baby. However, I found myself in the same semi-recumbent position. I was induced. My birth plan went out the window because I was only 36 weeks and pre-eclamptic.

I felt devastated that my education and knowledge went down the drain with my health. So when I unexpectedly fell pregnant with baby number four at the end of my second year of midwifery studies, I was hell bent on doing things my way.

My birth plan was very simple – stay upright. I was staying as far away from the bed as possible. I spent most of my labour upright, swaying and bouncing on a birthing ball.

I only got on the bed to have an electronic foetal scalp monitor popped on which I requested as I hated having two monitors strapped to my belly.

Within minutes, I had a sudden urge to push. I instinctively turned around and knelt on the bed. I started to feel my baby move down within my body. I was breathing her down. There was no active pushing, as there had been when I was on my back.

I had a 54 minute labour which was easily the most empowering experience in my life. Not only because I instinctively went to this position to birth my baby but because every decision made during labour was mine.

Birthing upright had incredible benefits for me. I was able to control the birth of my baby. I could actually feel pressure in the right areas and know she was moving down and I suffered no physical trauma.

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Professor of midwifery at Western Sydney University, Hannah Dahlen, said 78 per cent of women still birth lying on their backs. This is despite evidence that birthing upright has better outcomes for mum and baby.

Professor Dahlen said lying down to birth is a relatively new phenomenon dating back to around 300 years ago when the use of obstetric instruments, episiotomies and anaesthetics became commonly used. The move from home to hospital births in the 1900s changed things on a grand scale.

She said labouring and giving birth upright had numerous advantages, with the help of gravity being one of the main ones. Others include, more efficient contractions, shorter labour, better oxygenation of the baby in the mother’s uterus, increased pelvic diameter, especially when squatting, less maternal pain and less use of forceps and episiotomies.

“We discovered that the way we have constructed the birth environment, such as putting the bed in the centre of the room and having little supportive equipment (such as birth balls, birth stools or mats) had a major subliminal impact on both the way women and midwives acted,” Professor Dahlen said.

Founder of Birth Beat, an online antenatal class, registered midwife Edwina Sharrock, said it is about what the woman wants to do and being respected and giving her the tools in her toolbox.

“It is about what feels right for the woman. Who are we to say how women should give birth.

"At Birth Beat we teach women the practical tools, so they know the benefits of those tools. Upright, keeping mobile helping gravity can lead to a more comfortable and more efficient labour and birth.

"We are talking about upright positions which can include on all fours on a birth ball, squatting on a birthing stool."

Sharrock said women should get educated and practice positions.

“I liken it to preparing for your wedding dance. If you and your partner or support person don’t practice the moves, they won’t come naturally to you on the day.

"If you don’t think about the positions and practice them, when you are in pain in front of strangers, you won’t feel comfortable to do it then, which highlights the importance of knowing your care provider. Doing classes is critical.

"We don’t have a village with our mothers and aunties sitting around teaching us about birth."

Have you ever considered giving birth while standing upright? Tell us in a comment below.

The views, information, or opinions expressed in this article are solely those of the individuals involved and do not necessarily represent those of Mamamia. For further information on birth positions please consult a health care professional.