May 13, 2008

Get a Move On!

I was talking to one of the students yesterday about freedom of movement during labor. She was concerned that as soon as she arrived at the hospital she would be hooked up to the EFM and would not have the freedom to move about as she would like. She asked what I thought about that.

Well, if you are on full-time EFM, it is true that your movement options will be limited. This is because in certain positions, like on all-fours or sitting/leaning on the birth ball, the fetal heart rate isn’t as easily picked up by the monitor. As an alternative to full-time EFM, you can ask your doctor to do intermittent monitoring, which will allow you to walk the halls, take a shower or bath or what ever else you want to do, monitoring at times between these activities.

So why is it so important to be able to move around? First of all, it will be A LOT more comfortable to work through the contractions if you are not lying down and can move organically. Many of the laboring mothers whom I have assisted did NOT prefer a supine position. Most of them agreed that the contractions were a lot more intense and difficult to get through lying down. Secondly: “When you walk or move around in labor, your uterus, a muscle, works more efficiently. Changing position frequently moves the bones of the pelvis to help the baby find the best fit through your birth canal, while upright positions use gravity to help bring the baby down.”

A few years ago, I attended Monica’s first birth. Her baby was slightly posterior and her labor was not progressing very well. So, knowing that we needed to shift her baby in her pelvis, we turned on the salsa music and got her booty shaking! It was actually a lot of fun – her mom even joined us in dancing around the room! (The hospital staff didn’t quite know what to make of this spontaneous dance party.) And, the dancing and movement was quite effective. After many songs and different moves, her baby did shift into a better position and she was able to have a vaginal birth.

When I was at The Farm Midwifery Center this past fall, I remember Joanna, one of the legendary midwives, saying that moving during labor reduces the length of labor by 25%. What woman would not want those results? Ina May Gaskin, one of the founding members of The Farm, encourages women to “find their inner monkey” while birthing. A primate would not labor on her back in stillness. She would move. She would rock. She would sway. She would create mobility to allow her baby to descend and rotate deeper into her pelvis and work its way out of her body. So why not follow her example? Birth is birth!

There is so much evidence in support of open movement during labor. I encourage all pregnant women and those thinking about becoming pregnant to investigate this option with their care providers. If mom is ok and baby is ok, why not move and groove as your body and baby wants to?

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