Category Archives: Optimal Foetal Positioning

Optimal birthing positions

Optimal position for birthing is upright and open or on all fours. Try not to lay on your back because it narrows the birth path and your body can’t birth as effectively. When you lay on your back you also have all the weight of your uterus, baby and placenta weighing down on your main artery causing your heart to work overtime and you’ll get tired fast.

Powerful position


Some of the options already in place at Cedars, or in the works, include walking epidurals (for real!), aromatherapy(for both vaginal and Cesarean birth), doulas for natural, epidural-assisted and even surgical births, immediate skin-to-skin contact. A new program called “Rock and Roll” encourages laboring women to change position every 20 minutes, and even try some labor positions (such as on a birthing ball or squatting), even if they have had an epidural.  The aim – to reduce the C-section rate (Cedars reports an 8% decrease) and the length of time in labor, which spokespeople say has gone down by 20%.

Penny Simkin has herself long been committed to reducing C-sections in this country. Simkin has been in practice more than 50 years, and has prepared nearly 11,000 women and families for labor and delivery.  She says the #1 reason for C-section is dystocia, or failure to progress, “and many other terms,” Simkin says, “that all mean the baby just isn’t coming out.” The problem with a C-section is that it almost always leads to another, second, or third, and so on.  She believes that there are small early steps that can be taken to prevent dystocia and the very first Cesarean.

“There are physical reasons for dystocia, including scarring, intense contractions (often brought on by induction and Pitocin), doctor-caused and man other physical causes,” but the most powerful types, she says, are emotional: fear, stress, suffering as opposed to pain — all can reduce blood flow to the cervix and interfere with dilation.

Part of the problem, Simkin says, “is allowing the clock to be our guide.“ Many providers will give up and resort toinduction when a woman’s cervix has not dilated more than 6 cm in a certain amount of time; Simkin calls for more patience.  “Let’s stop blaming the mother” for what might be going wrong, instead, “know that she is the key to the solution.”

Steps can be taken early, according to Simkin, that can improve the birth outcomes, including waiting full term (37 – 42 weeks), early movement when labor starts, acknowledgement that normal labor is strenuous physical work, sleep (even if induced with drugs). “Also, don’t tell women that because they have a big baby they will probably be induced, that scares them!”

Eating, drinking, distraction (Simkin suggests kneading bread), acupuncture. And support during the contractions that goes beyond the pain scale (1 – 10) and instead observes the level of suffering a woman is experiencing during her contractions. “Ask her, ‘What was going through your mind during that last contraction?’  Pain does not mean the inability to cope; suffering does.”

“When a woman is in pain, but not suffering,” explains Simpkin, “she can still practice her three Rs – She has the ability for relaxation, rhythm and ritual. If she’s suffering, she won’t be able to sway, rock, breathe in a pattern or even moan rhythmically. If she can’t stop crying even in between her contractions, if she says ‘I can’t do this,’ she is suffering, and she should probably have the C-section.”

Birthing positions are powerful and empowering tools: “It’s important to use gravity,” Simkin says, “not stay in a victim position lying flat in bed.” She showed slide of an all-fours, open-knee position; a squat with support; lap squatting, even an ingenious sling that allowed the woman to dangle, lengthening her trunk and allowing nothing to impinge her pelvis.

Penny Simkin continues to be optimistic, and feels we are moving forward to educate women about their options, and even more, attracting them to those options. And she believes much starts in medical school. “It’s so important that residents and students get exposed to midwives, that they get a chance to work with them and see that being with a women in labor is a privilege. Then, they grow up and become chiefs of staff, and will open doors to midwives and doulas.”


Rebozo techniques

Video Link

This video shows how a selendang, rebozo, shawl, or bedsheet can be used for sifting. This gentle movement relieves uterine ligament tension during pregnancy, and it can be used to facilitate fetal rotation and descent during labor. It can be used with or without an epidural. Produced by Katherine Parker Bryden, CD(DONA) and Jun-Nicole Matsushita, CD (CBI), HCHD.