Birth positions and control of your labour

Improving birth satisfaction and pelvic floor trauma risks

By Stacey Ly

Most women would admit that an impending labour brings about worry and concern. After all, pushing a baby out of such a small space in the pelvic region does really seem impossible! Research has shown that women who feel more in control during birth and delivery have a higher birth satisfaction. Giving a pregnant woman the chance to practice labour postures and to somewhat decrease the fears of labour can improve this control and outcomes come the big day that bub arrives.

Increasing control during labour consists of

• Understanding the use of pain control during labour
• Understanding the use of different positions to alleviate pain and assist labour and delivery
• Understanding your anatomy and how to contract and relax the abdominal and pelvic floor muscles during labour. This is called pelvic floor co-ordination an can make a huge difference to those final stages of labour when it is time to push.

Women's health physiotherapists specialise in exercise, pregnancy and the pelvic floor. This makes them the perfect health professional to give women this edge. They can provide pregnant mums-to-be an awareness, knowledge, practice an control all around labour and birthing.

Exercise for pelvic floor coordination for vaginal birth

Your pregnancy specialised physiotherapist can spend time training you, your pelvic floor and abdominals for pushing out baby in all birthing positions. This can get your ready for the big day. Your prior practice will not only reduce your fears and anxieties about the labour, but give you that control. You will know which labour positions work best for you (and not the midwife or doctor!), which positions allow for you to relax your pelvic floor muscles the best for baby's passage through the vagina with reduced pelvic floor tearing. You will feel more in control in a situation which can very quickly turn the other way.

If you are unable to visit your women's health physiotherapist for this labour training, here is an exercise you can try to master before labour to use when you are birthing and when it is time to push.

• Breathe in and imagine the tummy bulging or swelling (imagine you are ballooning your tummy outwards)
• As you do this, can you imagine you are also dropping your pelvic floor downwards? ( like the pebble we imagine dropping into a pond, or imagining we are about to start to wee)
• Breathe out and now tighten the muscles under your belly button in towards your spine. It is essential that you keep bulging the pelvic floor down as you push down through your vaginal muscles and your anal muscles ( like you are trying to empty your bowel)
  • Try to focus on your vaginal entrance and anus opening
  • Think of that moment just before you wee
  • Also think of widening the sit bones or try not to clench your buttocks
  • Repeat 5-10 times every night
  • See if you can practice this in common birthing positions such as on all 4's, on your back , in sitting, resting on a chair or leaning over a Swiss ball

  This practice of birth positioning will encourage you to be more mindful of the coordination of muscles working about in your pelvis. You need to focus on relaxing and not tightening the pelvic floor muscles as you activate your abdominals for the push.

  Along with birth positioning and pelvic floor coordination practice, there are other pre-labour things you can do to better the outcome of your birth.

  • Research has shown that perineal massage before and during labour can reduce the risk and severity of tearing during delivery.
  • Massage your perineum for 2-5 mins every night using oil such as coconut or olive oil.
  • Research also shows that the use of warm compresses on the perineum during pushing reduces 3^rd and 4^th degree tears. This can be simple as a warmed face washer applied directly to your vaginal and pelvic floor area.
  
  

  Birth preparation at The Fix Program

  At The Fix Program, we offer a birth preparation program with our specialised women's health physiotherapist. This includes a one- on- one and very private appointment to practice labour postures with the use of a feedback machine on your pelvic floor region. (NO.... it does not hurt a bit!!)

  • We will stick little electrodes on your pelvic floor to use an EMG, which is a machine that picks up muscular activity. On the external pelvic floor, you will learn how to co-ordinate your pelvic floor muscles during birth ( when we want them as relaxed or 'dropped' as possible)
    • This allows you to "hear'' when you are relaxing (or contracting) your pelvic floor.
    • It can teach you when to relax and contract during pushing in labour.
  • Practice of birth positions with the EMG- in sitting, standing, squatting, kneeling, on a Swiss ball so you learn to relax and co-ordinate your pelvic floor in these positions
  • Perineal massage techniques to the pelvic floor to reduce risk of tearing
  • Breathing techniques to help with relaxation
  Contact us for an appointment of if you have any questions