A couple of days ago, Babies and More talked about the suffering of the spine in childbirth in lithotomy position (lying down). There are other contraindications that show how giving birth in this position makes labor difficult making it less physiological.
Some of them are:
● When lying, the baby, by gravity, is lying on the mother's large vessels, interfering with circulation, lowering her blood pressure and decreasing, therefore, fetal oxygenation. It is logical, if the mother's pressure drops, the pressure in the placenta-fetus nutrient exchange drops.
● The birth canal is transformed into a upward curve which forces the woman to push the fetus down an inclined plane.
● By avoiding continuous pressure of the head of the fetus on the perineum, distension of the fetus is not allowed to be paused and effective causing a more abrupt distension at the time of the expulsive which leads to unnecessary episiotomies.
● The coccyx has the ability, in a vertical delivery, to move up to 2 cm. (see image on the right) to improve space. While lying down, not only cannot he do so, but he compresses himself against the birthing bed and moves forward, narrowing the pelvic outlet.
Childbirth is part of a woman's sexuality and should be an intimate and relaxed moment in which the woman can forget about her environment to be aware of her own body and look for the position that gives her more security and less pain. The lithotomy position makes women vulnerable, passive and often creates insecurity since it is a submission position, something like "Here I am, do what you want".
The vertical position, on the other hand, offers a plane of spatial equality against the rest of the people who interact with it. The woman feels that she is at the same level and takes part and awareness of her rhythms and the needs of her body, looking for the position that best makes her feel in each moment and owning her instincts and her birth.
Already in 2001, WHO, in the "Principles of the World Health Organization on perinatal care" said that it should "Use a raised position if the woman chooses it during childbirth. Avoid using the supine position for childbirth, and particularly the lithotomy position (with the legs raised). Abandon traditional birth beds for normal deliveries. Use a standard bed if a bed is chosen for delivery. "
