If you've given birth before — or even if you haven't — which delivery position would you prefer? When you're in labor, comfort takes priority, and with so many different positions to choose from, it can be confusing to figure out why hospitals make you give birth on your back? Is it really better for mom and baby? Is it more comfortable or does it speed up the birthing process? Most hospitals prefer, if not require, this birthing position, even with other options out there. To find out why, I asked registered nurse and birthing doula Ashlyn Biedebach of By The Brook Birth Doula to break it down for us.
When it comes to birthing positions, there are plenty to choose from. In an email with Romper, Biedebach explains some of the most popular positions, such as on all fours (think cat pose in yoga). Biedebach says this particular position gives your baby plenty of room to maneuver. But it's not the only other option. There's also squatting, which allows for gravity to help do the work for you, and lunging is a position that can be difficult, but Biedebach says that it can offer a lot of room for your baby. Sitting semi-reclined can also help as gravity works with you in this position and you have the opportunity to rest (which is so important). You can even lay on your side while you give birth. With so many options, why is on-your-back the go-to position for hospitals?
"Most hospitals and providers prefer this position because of the ease of the doctor being able to sit at the feet of the woman, and the way in which hospital beds are designed to transform into a semi reclined or flat laying position," Biedebach explains. She also says that the preference for women to give birth on their back is fairly new. This position has become favorable by hospitals because of the drugs given during labor such as epidurals. For example, if a woman receives an epidural, it would make giving birth in other positions more difficult and possibly dangerous because she will be numb from the medication.
"When women are allowed to move and labor in ways that feel more comfortable, labor is usually shorter, pain coping mechanisms are easier to use, and mom and baby are in less distress," Biedebach adds. But she does note that "giving birth on your back is helpful to get baby under the pubic bone for sure." When asked about other back-birth-advantages, Biedebach says that doctors may be able to better support the baby's head as it begins to exit, as well as have better access for any emergency procedures that may need to be done. Also, back-birth doesn't require mom to support her own body weight during birthing.
But what about the cons to back-birth? Are there any? Biedebach says that if you lay on your back while you give birth, "you are working against gravity for most of the period in which you push." Also, birthing on your back may not create enough space for your baby "to move through the birth canal," as well as potentially add to mom's discomfort. So, is there a best position? According to Biedebach, "usually pushing in various positions is helpful as baby moves down and whatever feels comfortable for you in the moment is best." She advises moms that any positions that allow gravity to help with the birthing process is good, and mom's comfort should take priority (as well as baby's safety of course).
While back-birth definitely may be a great choice, it might not be what you want in the moment. If you prefer a little more freedom in your birthing experience, why not opt for a birthing center instead of the hospital? Or talk to the hospital you'll deliver at, along with your healthcare providers, to find out what your options are. I personally have no complaints when it comes to giving birth on my back, but everyone is different. Just make sure to choose a place that is accommodating to your personal birthing plan.