jeevey
Rock n' Roll Doggie Band-aid
Standard practice in hospitals uses the 'semi lithotomy' position, which is sitting slightly reclined with the knees elevated in the same way they are for a pelvic exams. There are several reasons why this is not a great position to deliver. Your pelvic bones naturally have quite a bit of flex, mostly in the back around the tailbone. Sitting on the tailbone eliminates that flex and narrows the outlet. Moving to a forward leaning position actually allows the pelvic outlet to enlarge by something like 30%. Also semi lithotomy directs the weight of the baby's head on the perineum, increasing the incidence of tears. All those things tend to make babies slow descending and can contribute to interventions like episiotomy and vaccuum extractions, but hospitals like to use it because it's very easy for the doc to see, keeps the orientation looking the same as the medical textbook and all. It's very unusual for a woman to deliver in any other position in hospital. I know that I was bodily hoisted into it at my first birth.As for the topic at hand, I do have a bit of curiosity about something, not that I have any plans, mind you, but I do wonder about something. Maybe we could start a thread for birthing practices after all, but I digress, here's the question: These "water births", my only familiarity with them comes from the show King of the Hill, actually. While I'm sure the show was a fount of factual information, I had read an article on Cracked once (man, I am batting 1.000 on great sources here), that discussed the idea that the current practices for giving birth in hospitals (e.g. in the horizontal) are completely backwards from the way women should be giving birth.
Is that correct? Is it (scientifically speaking) better to give birth in a more....for lack of a better word...squatted position? And is that the idea behind water births?
Most women, if not directed otherwise, end up giving birth in some sort of upright or forward leaning posture. Hands and knees is a very common spontaneous position, which makes sense because it's the least amount of pressure for her. Sometimes if there is a really big baby with a very tight fit you end up with the woman in a very deep squat like on a stool or with a squat bar, but often you have to ask her to do it. That position puts a lot of pressure on the perineum and can increase tearing but gives the widest spread of the hip bones.
Water birth helps with those things in several ways. It's really, really relaxing so it helps with the pain a lot. It makes those forward leaning positions easier because of the lack of gravity. The warmth helps the soft tissue to stretch. For many women the privacy the water gives is a big deal- the woman is not totally exposed, and it encourages the docs to keep their hands off. Some medical staff get very handsy, often 'checking' a woman too often, sometimes without asking or even notifying her that they are going to, and some women find it impossible to focus and relax that way.
As for drugs, I think it would depend. Waterbirth and epidurals, spinal blocks or pudendal nerve blocks totally don't mix. I suppose you could have demerol/numbane if you were having a waterbirth in hospital, but most midwives or birth centers wouldn't offer it. But movement and the water (and touch) are really effective pain relief themselves, so it depends what you want.
That was really long, but if mods want to move this to a birth practices thread that's fine with me.