'>If they tell you to think about childbirth, your mind probably runs to one classic image: the woman on her stomach, lying on the traditional delivery bed. Maybe we can add the figure of the partner next to holding her hand and the obstetrician and the gynecologist in front of her, over her baby bump, between her legs. But the lithotomy position (as it is called in obstetric jargon) is certainly not the only one that can be assumed at the time of birth: every mother should feel "mistress" to put herself as she prefers. “We inform our women - he says Sara amato, coordinator of midwives at the Arnas Civico in Palermo who, among other things, manage a very popular Facebook page, "Maternity ward, Civic hospital" - that lying down is the most common position, but that there are also other options: standing, sitting, squatting , on all fours, side by side ".
Dr. Sara Amato
The advice therefore is to try a different position from the supine one. What are the benefits?
“Let's start with the first. Clinical trials show that there is less recourse to episiotomy (the cut of the perineum which, in some cases, is practiced to facilitate the expulsion of the baby, ed), probably because they do not have a direct view of the perineum. Less. All alternative positions are not the responsibility of the obstetrician, but of the woman. If she feels freer to manage labor, she will certainly get up more often ”.
And then what?
“The alternative positions reduce the use of synthetic oxytocin because the contractions are more natural and favor the production of this substance by the body. In addition, the time of labor is reduced because the cervix dilates faster ”.
Let's see in more detail how a mother who is about to give birth can put herself ...
“Being on all fours is especially recommended when the presented part is only partially in the correct position. In this way, the children move. If, on the other hand, the dilation has been complete for more than two hours and there is a slowdown in the progression, the woman is invited to stand up to facilitate the descent of the baby. The position on one side, especially the left one, is recommended to avoid vaginal lacerations ".
To whom are alternative positions indicated?
“To women with a physiological birth, without particular complications and who want to manage their birth. They can also be taken if childbirth analgesia is used: the anesthetist who performs the epidural leaves the woman in labor the opportunity to walk ".
What is the role of the father?
“We make sure that it is always there because, from an emotional point of view, it is very important. It is good for the couple to contact the facility where to give birth before labor so as to know the operators and have more confidence in them. The result is better than those who arrive at the last moment. This is why the accompanying courses for childbirth and the outpatient clinic for full-term pregnancies are fundamental: pregnant women arrive in more serene psychological conditions ".
Mothers have practically always given birth stretched out. Are there any drawbacks?
“All the different positions involve a lower risk of assisted birth: the supine position only favors the work of the midwife and the doctor. Lying on your stomach causes more acute low back pain and cardiotocographic changes are also possible. While lying flat, the uterus squeezes the vena cava, which can reduce the blood supply to the baby. It may therefore be necessary to use the suction cup or commanded thrusts to speed up delivery. It is important not to force the thrusts: it serves to reduce the lacerations. The term obstetrician derives from 'ob stare', to stand and wait. We know how to respect physiology and that we only need the patience to wait for nature ”.
