6 Ways to Assess Labour Without Laying on Your Back

We often see women in labour on TV, laying on their back ready to be assessed to see how dilated they are. This is great for healthcare professionals, but it’s not great for the labouring woman. Here are 3 reasons why laying on your back will make birth harder, longer and could mean intervention is introduced.

  1. Firstly, your baby will have to travel uphill to be born which makes birth harder and means it’s more likely intervention such a ventouse will be introduced.
  2. Your baby is also less likely to be in the optimal positioning for birth meaning that there is an increased chance of forceps and ventouse to help them be born.
  3. Lastly, your pelvis needs to be able to move, flex and open during labour and laying on your back inhibits the flexibility of your pelvis.

Why are women assessed on their backs?

woman laying on her back and giving birth

Women started to be assessed on their backs in the 17th century. During this time, people started to move into cities as the industrial revolution took off. They went from living with space around them to living in cramped conditions. Women started to go into hospitals to give birth which was due to the fact that home births were harder as there was less space.

When in hospital, women would be encouraged to lay on their backs as this gave the medical professional (a man who was in training) a better view. Put simply – it was much more comfortable for those not giving birth rather than the labouring woman. There was also very little understanding about the pelvis so we didn’t know that laying on your back would hinder the movement of the pelvis and make babies exit more tricky.

In our modern day however, it’s preferred by healthcare professionals that you lay on your back. They are trained to examine you in this way and so it is partly down to habit despite the fact there is evidence that proves birthing in this way is not best for the person in labour.

Laying on your back and experiencing a perennial tear

The other big point on laying on your back is that your legs could be up in stirrups and spread apart. This stretches your perennial muscles and increases the risks of experiencing a perennial tear. If you take your thumb and index finger and spread them apart you’ll see the skin is taught – now imagine that is your perennial muscles. If you close your thumb and index finger together then the skin will loosen. If you apply that to your perennial muscles – the floppier your skin the less chance you’ll tear because your skin has space to move.

It is your choice

Because we are so used to seeing women lay on their back to be assessed and give birth, it’s become normal practice and we expect it’s just part of the birth process. This is wrong and if you remember anything from this post I want it to be that you have a choice about whether you are assessed or not and it’s down to you to be in whichever position you’re most comfortable for birth.

Ways to be assessed without laying on your back

So, without further ado, here are 6 alternative ways for you to be assessed in labour.

  1. Through sounds – if you’re able to chat, you’re likely in early labour. If you need to concentrate, chances are you’re in active labour. If you’re experiencing self doubt, you’re likely in transition, and if you’re grunting, you’re probably in the second stage of labour. These stages will give midwives an indication of how far along your labour is.
  2. Through smell – an earthy, musky smell that is associated with birth.
  3. Through the amniotic sac bursting – by 6-8cm of dilation you could experience a gush of fluid as your waters break. It’s much more common for waters to break at the end of the first stage of labour rather than at the beginning.
  4. The purple line – a line that starts at the anus and goes up to the bum crack as labour progresses. The length of the line is equal to how dilated your cervix is!
  5. Physical signs – you may curl your toes up during contractions if you go over 6cm, or you could have goose bumps on your thighs.
  6. Finally, the height of the fundus – the space between the top of the bump and the breastbone decreases as your uterus pulls up and this is another indication of how dilated you are.

What is a CTG machine

woman laying on her back with CTG machine strapped around her pregnant belly

You may have seen women in labour, strapped to a machine so that baby’s heartrate can be assessed. By being strapped to a CTG (Continuous cardiotocography) you have less movement so it’s likely you’ll end up on a bed, laying on your back! If you want to be able to move, ensure staff know this and can work with you to not limit your movement.

CTG’s are used because they are an accurate way of measuring a baby’s heartrate but did you know they also make the working day more efficient? By being strapped to a machine, a midwife can leave you to be monitored while going off to complete other tasks. It’s important to state in your birth plan if you don’t want CTG monitoring as they may use a doppler instead.

How your pelvis moves during labour

The pelvis is not one structure, it is made up of many bones which move and flex to help your baby navigate it’s way down the birth canal. An important part of labour is when your sacrum moves out of the way. This is called ‘The Rhombus of Michaelis’ and it happens during the second stage of labour. It looks a bit like a kite shaped bone coming away from the base of the spine and it’s a completely normal part of labour.

If you’re laying on your back then this can’t happen and your baby will have a harder time with being born.

Another important point about the pelvis and stirrups is that if you have your legs apart then your pelvic outlet (the bones at the base of your pelvis) will close and make less room for your baby to be born. To overcome this, try keeping your knees together. A peanut ball can to wonders with helping you to open your pelvis.

How to make more room for your baby to be born

Making more room is quite simple. You want to be focussing on making sure your knees are below your hips so that in the first stage of labour, your baby can move into your pelvis. You may want to be on your hands and knees, straddling a peanut ball or leaning against a wall. This will enable your hips to open by an extra 28% and this will help your baby to make their exit.

For more information on how birth works be sure to check out our online hypnobirthing course. If you want to help your baby move into the optimal position and learn all about birth positions then check out ‘prepare my body’ over on the butterbean platform.

 

 

woman being monitored by CTG machine

6 Ways to Assess Labour Without Laying on Your Back

woman being monitored by CTG machine

We often see women in labour on TV, laying on their back ready to be assessed to see how dilated they are. This is great for healthcare professionals, but it’s not great for the labouring woman. Here are 3 reasons why laying on your back will make birth harder, longer and could mean intervention is introduced.

  1. Firstly, your baby will have to travel uphill to be born which makes birth harder and means it’s more likely intervention such a ventouse will be introduced.
  2. Your baby is also less likely to be in the optimal positioning for birth meaning that there is an increased chance of forceps and ventouse to help them be born.
  3. Lastly, your pelvis needs to be able to move, flex and open during labour and laying on your back inhibits the flexibility of your pelvis.

Why are women assessed on their backs?

woman laying on her back and giving birth

Women started to be assessed on their backs in the 17th century. During this time, people started to move into cities as the industrial revolution took off. They went from living with space around them to living in cramped conditions. Women started to go into hospitals to give birth which was due to the fact that home births were harder as there was less space.

When in hospital, women would be encouraged to lay on their backs as this gave the medical professional (a man who was in training) a better view. Put simply – it was much more comfortable for those not giving birth rather than the labouring woman. There was also very little understanding about the pelvis so we didn’t know that laying on your back would hinder the movement of the pelvis and make babies exit more tricky.

In our modern day however, it’s preferred by healthcare professionals that you lay on your back. They are trained to examine you in this way and so it is partly down to habit despite the fact there is evidence that proves birthing in this way is not best for the person in labour.

Laying on your back and experiencing a perennial tear

The other big point on laying on your back is that your legs could be up in stirrups and spread apart. This stretches your perennial muscles and increases the risks of experiencing a perennial tear. If you take your thumb and index finger and spread them apart you’ll see the skin is taught – now imagine that is your perennial muscles. If you close your thumb and index finger together then the skin will loosen. If you apply that to your perennial muscles – the floppier your skin the less chance you’ll tear because your skin has space to move.

It is your choice

Because we are so used to seeing women lay on their back to be assessed and give birth, it’s become normal practice and we expect it’s just part of the birth process. This is wrong and if you remember anything from this post I want it to be that you have a choice about whether you are assessed or not and it’s down to you to be in whichever position you’re most comfortable for birth.

Ways to be assessed without laying on your back

So, without further ado, here are 6 alternative ways for you to be assessed in labour.

  1. Through sounds – if you’re able to chat, you’re likely in early labour. If you need to concentrate, chances are you’re in active labour. If you’re experiencing self doubt, you’re likely in transition, and if you’re grunting, you’re probably in the second stage of labour. These stages will give midwives an indication of how far along your labour is.
  2. Through smell – an earthy, musky smell that is associated with birth.
  3. Through the amniotic sac bursting – by 6-8cm of dilation you could experience a gush of fluid as your waters break. It’s much more common for waters to break at the end of the first stage of labour rather than at the beginning.
  4. The purple line – a line that starts at the anus and goes up to the bum crack as labour progresses. The length of the line is equal to how dilated your cervix is!
  5. Physical signs – you may curl your toes up during contractions if you go over 6cm, or you could have goose bumps on your thighs.
  6. Finally, the height of the fundus – the space between the top of the bump and the breastbone decreases as your uterus pulls up and this is another indication of how dilated you are.

What is a CTG machine

woman laying on her back with CTG machine strapped around her pregnant belly

You may have seen women in labour, strapped to a machine so that baby’s heartrate can be assessed. By being strapped to a CTG (Continuous cardiotocography) you have less movement so it’s likely you’ll end up on a bed, laying on your back! If you want to be able to move, ensure staff know this and can work with you to not limit your movement.

CTG’s are used because they are an accurate way of measuring a baby’s heartrate but did you know they also make the working day more efficient? By being strapped to a machine, a midwife can leave you to be monitored while going off to complete other tasks. It’s important to state in your birth plan if you don’t want CTG monitoring as they may use a doppler instead.

How your pelvis moves during labour

The pelvis is not one structure, it is made up of many bones which move and flex to help your baby navigate it’s way down the birth canal. An important part of labour is when your sacrum moves out of the way. This is called ‘The Rhombus of Michaelis’ and it happens during the second stage of labour. It looks a bit like a kite shaped bone coming away from the base of the spine and it’s a completely normal part of labour.

If you’re laying on your back then this can’t happen and your baby will have a harder time with being born.

Another important point about the pelvis and stirrups is that if you have your legs apart then your pelvic outlet (the bones at the base of your pelvis) will close and make less room for your baby to be born. To overcome this, try keeping your knees together. A peanut ball can to wonders with helping you to open your pelvis.

How to make more room for your baby to be born

Making more room is quite simple. You want to be focussing on making sure your knees are below your hips so that in the first stage of labour, your baby can move into your pelvis. You may want to be on your hands and knees, straddling a peanut ball or leaning against a wall. This will enable your hips to open by an extra 28% and this will help your baby to make their exit.

For more information on how birth works be sure to check out our online hypnobirthing course. If you want to help your baby move into the optimal position and learn all about birth positions then check out ‘prepare my body’ over on the butterbean platform.