Questioning Childbirth Status Quo, Part One: Common Labor Positions

The following blog is a repost of Ashley Brichter’s original blog post. Ashley is a  birth educator, birth and post-partum doula, lactation counselor, and friend of the practice. She hosts many classes on childbirth, lactation, and much more. We will provide more information at the end of the post on how you can get in touch with Ashely and how you can sign up for her excellent classes. 


Ashley Brichter

Originally posted: January 22, 2019 

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Hollywood misrepresents a great deal about the childbirth process, but the fact that they show everyone delivering babies while lying on their backs in a hospital bed is accurate. As Ross clearly demonstrates above, lying down with knees apart is the most common way for someone in the United States to deliver. Here’s why you may want to question this:

A baby’s job in labor is to rotate and descend through the pelvis. If we can maximize the amount of space a baby has within the pelvis, we can not only speed this process along but minimize the stress on muscles and tissues within the pelvic bowl (and therefore minimize the risk injury).

How do you maximize the space in your pelvis to encourage the baby’s rotation and descent? The pelvis has four boney landmarks that determine the maximum circumference a baby has to fit through: the pubic bone at the front, tail bone or coccyx at the back, and two sitz bones at the bottom. Let me walk you through two very simple movements to see how you can create the most space between the pubic bone and tail bone and two sitz bones.

If you’re in a location where feeling around on your pelvis would be immodest, make a commitment to try it the next time you’re in the bathroom or back at home.

First, find the space between your pubic bone and tail bone: 

Place one hand on your pubic bone (it’s very low down under the belly, right between your legs. Isn’t it wide!?). Place your other hand on your tail bone. To find your tail bone, invite your hand to feel between the crease of your behind. It is often higher up than most people realize.  You can walk your fingers all the way down the bottom of your spine until you reach the end – and/or lean back on your fingers in order to feel it more.

Once you have fingers on the pubic bone and fingers on the tail bone, lean forward and feel the space between your fingers. Then lean back. In which direction to you have the most space between your fingers, between your pubic bone and tail bone?  When you are leaning forward or leaning back? Try this a few time before you move on.

 Then, find the space between your sitz bones: 

This is best done sitting down on the edge of a chair. Place your hands underneath your bum and your should feel your sitz bones protruding down. If you don’t feel them right away wiggle side to side a bit. You should feel boney points digging into your hands. 

Now, spread your knees out wide (like you’re having a baby!). Feel the space between your fingers. Then, bring your knees in close together (keeping your feet fairly separated). In which position do you have more space between your sitz bones? With your knees together, feet apart, or your knees and feet wide?   

Hopefully when you tried it you were able to feel that there is more space in your pelvis when you are leaning forward and that there is more space in the pelvis when your knees are closer together than your feet. 

WAIT. What? That’s right. I said it. 

Most people deliver their babies on their backs with their knees spread wide because this is the most convenient position for hospital staff. If you’re thinking about a physiological birth, looking for ways to possibly shorten your labor, or looking for ways to reduce the risk of tearing, give some serious through to positions that lend themselves to forward leaning and keeping feet wider than knees!

Let’s take one more look at the tail bone specifically: leaning backwards makes the tailbone stick in. It limits the amount of space a baby has to rotate and it asks your body to push a baby uphill!  Upright and forward leaning positions will allow the tailbone to get out of the way.   Granted, you have to deliver with a provider and in a location that is supportive of this. But that’s for another post!

You can learn more about Ashley on her website: http://overwhelmingmoments.com/

Her blogs are available here

Click here for a list of upcoming events with Ashley

 

 

You’d Prepare for the Marathon: Why Not Your Birth!

 

– Ashley Brichter

Fall always makes me excited for the New York City Marathon. What’s not to love? Cheering for thousands of people who have chosen to participate in an awe-inspiring test of endurance. I leave the sidewalk full of endorphins, adrenaline pumping! You may be surprised to find out how often I reference the marathon in childbirth preparation classes. Here are the eight ways I think running a marathon is analogous to having a baby:

You can prepare, mostly.

First time competitors never run 26.2 miles before race-day. They do, however, spend at least 16-20 weeks preparing physically and mentally for the main event. By running regularly and practicing complimentary strength training and stretching they move their body towards optimal conditioning. Pregnant people can work towards optimal conditioning by staying active throughout their pregnancies and receiving massage, chiropractic care, physical therapy, or acupuncture. And, like distance runners, hydrate and nourish their bodies well. Taking a comprehensive childbirth education course to understand what lies ahead, learning about pelvic floor muscles to understand pre and postnatal physiology, and exploring mindfulness practices to reduce anxiety and decrease pain are all essential preparation tools.

 Breathing is essential

Muscles need oxygen! That is probably more obvious for runners than for those in labor. The uterus is a broad muscle, contracting regularly in labor, pushing the baby down while helping the cervix dilate. Deep breathing also reduces anxiety!

The pain is temporary

The vast majority of pain in labor is caused by uterine contractions, not the baby passing through the birth canal. Labor contractions last about 60 seconds and are followed by minutes of rest and relaxation. It can be helpful to know that both individual contractions and the process as a whole will not go on forever!

Find your rhythm, stay steady.

Don’t start out too fast! When running a marathon, the excitement and adrenaline can lead you to do too much too soon. Similarly, in childbirth you are in it for the long haul, and early on your focus should be on conserving energy. Contractions should become ritualistic and having coping strategies is essential. Some people need music, others mantras. You can practice many different coping strategies ahead of time so you’re comfortable on game day.

Stress can slow you down

Oxytocin is the our love and trust and bonding hormone. It is released when we feel safe and relaxed. Oxytocin causes the uterine contractions of labor. Fear and stress diminish the amount of oxytocin produced in the body in turn slowing down or stalling your labor.

There will be moments of self-doubt

Because it ain’t easy. And endorphin production is on a slight delay. But, you can do it!

Support can make a huge difference

It’s always a good idea to have people cheering you on. No one can “run this race” for you, but people by your side can make it more possible.

It’s worth it

For Inspiration: Sarah Moore, Founder of FigTree Childbirth Services and Doula extraordinaire ran her first New York City Marathon last year, She wrote the names of 26 clients/friends/mentors on her arms so she could look down and thing of each of them  and the power they were able to muster when things got hard. doula

Ashley Brichter is a Certified Cooperative Childbirth Educator, Certified Lactation Counselor, Birth and Postpartum Doula in New York City.