Reasons not to give birth lying down

The WHO advises against giving birth lying down. However, in the world, it is the most common position to give birth. Experts recommend vertical birth because it requires less medical supervision.

The Ministry of Health and the Spanish Society of Gynecology (SEGO) advise intervening as little as possible during childbirth so that the woman has freedom of movement and can adopt the most comfortable position.

Experts have realized that lying on her back, a woman has less control over her body, and giving birth is more difficult. Furthermore, they have seen that excessive medical intervention in a normal birth brings problems.

Current recommendations for care during normal childbirth include the possibility of not monitoring the parturient with cables continuously, not maintaining a drip, not giving oxytocin, nor artificially breaking the amniotic sac if everything is going well. This allows the woman, having freedom of movement, to walk or get into the position she wants, accompanied by the person she chooses.

What position is the best?

Whichever the woman chooses. When the woman is free to move during the birth process, she is placed in different positions during dilation: she walks, swings her pelvis, moves part of the time, and at times lies down in different ways.

You tend to lean on your partner, the back of a chair, or another place during contractions, or on the floor on your knees or on all fours. These two positions are the ones most chosen by women at the moment of delivery, when they feel like pushing for the baby to come out . The person accompanying the woman in labor can help her by holding her behind her so that she can support herself, while massaging her back, caressing her, or accompanying her in silence.

Squatting is easier for the baby

To go outside, the child makes a path in the shape of a cylinder curved upwards, short but very precise, between the bones and muscles of the mother's pelvis.

If the woman is lying down, the journey is longer and contrary to the force of gravity. However, when squatting or on all fours, the path is shortened and the bones of the pelvis open a little more, enough so that in some cases the child can pass and the birth does not end in a cesarean section or having to resort to the suction cup or forceps.

In the drawing, you can see that the bones of the maternal pelvis open slightly when the woman remains in an upright position. The force of gravity helps the baby to descend. However, lying down the bones open less and the child has to make a greater effort to get out.

Lying on your back, less oxygen reaches the baby

Lying down compresses the mother's blood vessels. At the time of contraction, the uterus also closes its arteries for a few moments.

If, in addition to lying on her back, the mother's blood pressure drops with epidural anesthesia, the baby will notice the drop in oxygen. This does not usually affect healthy newborns, but it is not ideal for a baby who is less strong.

The body asks to squat

The enormous amount of hormones that a pregnant woman's body produces at the time of childbirth, mixed with the overwhelming sensation of pushing, makes her behave in an uninhibited and spontaneous way. For this reason, she usually follows the needs of her body by standing, on all fours or squatting, in the position that the baby will most easily fit into.

When a woman can move, it hurts less

The epidural is an advance in the technique and a good method to relieve pain during childbirth.

However, obstetric recommendations are changing and it is no longer considered ideal for a normal birth, since by limiting mobility and preventing the woman from placing herself in the position requested by her body, it can hinder the evolution of labor and lengthen it. , increasing the possibility that forceps or suction cups will have to be used.

In a birth without anesthesia, the lying position on your back is usually very painful. However, many women cope well if they can change positions freely, in a calm environment, and without artificial contractions. The so-called walking epidural (epidural without motor block), a new type of analgesia that does not put the legs to sleep and allows the woman to walk, is a good option for those who want a birth under anesthesia.

Bathtubs in dilation

Some autonomous communities are installing bathtubs in public health network hospitals, because hot water greatly relieves pain during the second phase of dilation, and sometimes shortens it.

The baby is not always born in water, as some women feel the need to go out at the moment of delivery to place themselves on wide beds with cushions, on the floor, or sitting on a short stool with their legs bent.

How is the baby monitored?

If the mother is not taking medication, it is sufficient to perform intermittent auscultation of the baby's heartbeat during and after a contraction. The mother's blood pressure and temperature are taken at the beginning of labor and a vaginal examination is performed every two to four hours, depending on the progress of labor.

An expert midwife usually knows when dilation is complete by the postures the parturient adopts and her way of expressing herself.

What if the hospital doesn't give me any other alternative?

Even if the woman is in bed, with a drip and anesthesia, it is good to change position from time to time and, above all, lie on her side. Many hospitals are being equipped with beds that can be placed almost vertically at the time of delivery.