Pelvic Health and Pelvic Floor-Friendly Positions
Doulas and midwives, armed with knowledge about the importance of pelvic floor health, can enhance a woman’s childbirth experience.
In previous blogs we have discussed the role and importance of pelvic floor physical therapists throughout the pregnancy and postpartum journey, Now, let's define who doulas and midwives are and the roles they play throughout the childbearing experience.
Midwives are trained medical professionals who provide medical care, including prenatal check-ups and delivering babies. This definition can be somewhat controversial, as most traditional midwives advocate for women taking radical responsibility, believing that a woman’s innate understanding is what guides the birth of the baby, thus challenging the conventional definition of “medical personnel.”
Doulas, in this context, are trained professionals who offer emotional and physical support, although are not medical personnel. Their role centers on providing guidance, knowledge, and holistic care to mothers during the stages preceding, during, and following childbirth. Doulas do not perform medical procedures but focus on empowering mothers through continuous labor support, comfort measures, advocacy, and emotional guidance. This collaborative approach ensures that women receive comprehensive support, preserving their choices and individuality while navigating the journey of pregnancy, labor, and postpartum from all aspects.
Now bringing it back to birthing positions- usually, midwives, doulas, AND pelvic floor therapists stand in resolute opposition to the lithotomy position during labor due to its adverse effects on the birthing process. The lithotomy position is where the mother lies on her back with her legs raised and separated. This may seem conventional, but can significantly hinder the natural progression of childbirth.
One of the key concerns surrounding the lithotomy position is its impact on the shape of the pelvis. This posture can reduce the pelvic outlet’s diameter, making it more challenging for the baby to descend through the birth canal. Consequently, this can lead to several complications, including prolonged labor, increased risk of shoulder dystocia, increased risk of episiotomies, and a higher likelihood of medical interventions such as forceps and vacuum extraction. Furthermore, the lithotomy position can result in decreased oxygen supply to the baby, affecting their well-being during the birthing process.
Recognizing these potential issues, midwives and doulas collaborate closely to guide the mother into positions that are more conducive to a smoother, less restrictive labor experience. They advocate for positions that open the pelvis, such as squatting, kneeling, or all-fours. These positions harness the forces of gravity and provide ample room for the baby’s descent, making labor progression more efficient and reducing the likelihood of complications.
By working together, midwives and doulas ensure that the mother has the support and knowledge necessary to navigate labor in a way that is less inhibiting and more empowering. This collaborative effort reflects their commitment to promoting a safe, comfortable, and fulfilling childbirth experience for both the mother and the baby, steering away from practices that may impede this natural process.
To learn more about the evidence on birthing positions, midwifery practices, pain relief, and protecting the perineum, visit:
https://evidencebasedbirth.com/evidence-birthing-positions/
https://evidencebasedbirth.com/positions-during-labor-and-their-effects-on-pain-relief/