Healthy Birth Practice 2

We are all told that moving during labor is good. It is even a Lamaze Healthy Birth Practice: #2: Walk, Move Around, and Change Positions Throughout Labor. Moving can help with the pain and it helps the baby move down safely through the pelvis. It does, but why?

Physiologic labor progress Physiologic labor is labor that is powered by our innate capacity of giving birth and being born. Yes, both! Physiologic labor is orchestrated by our hormones, and moving during labor is a safe and healthy coping strategy that supports normal biology.

When the normal biology of birth unfolds, our brain releases both more oxytocin in response to pain and endorphins to help cope with the intensity. More oxytocin creates more powerful labor surges that move our baby down, and labor is propelled by this hormonal feedback loop until our "cocktail glass" spills over with catecholamine for pushing. (The ending here is more spectacular!)

Catecholamine also helps our baby: It protects our baby's brain during pushing when their brain naturally receives less oxygen; it helps maintain glucose supply to the heart and brain, and it helps prepare their lungs for breathing.

Moving creates space

As labor progresses, what we feel can be our guide to moving a certain way or getting into a certain position. Most people say that moving helped them experience less pain.

It is helpful to remember that our pelvises are not fused. If you have experienced symphysis pubis dysfunction (SPD) or sciatica during your pregnancy, you know this. You also know that certain movements, exercises, balancing techniques, and bodywork can help alleviate the pain. Labor is no different. So what does moving do?

Inlet

Our pelvis is divided into three areas: the inlet, the mid-pelvis, and the outlet. A baby will begin its journey through the pelvis by engaging. The most space here, at the inlet of the pelvis, is from side to side. Instinctively, if we are having labor surges, we may walk, sway, stand –sometimes on tippy-toes which naturally flattens the low back creating more space, tuck our tailbone (posterior tilt), or sit with feet touching and knees out which makes the hip bones flare open.

Mid-pelvis

Being guided by our bones and our soft tissues, a baby will move deeper into the pelvis by tucking its chin and rotating. Having engaged in the pelvis in a sideways position, a baby will need to rotate to face our sacrum (ideally) to be born. To create space for this, we often intuitively resort to positions like standing or kneeling while moving, circling or swaying our hips, lying down with a pillow in between our knees or supported in a semi-prone position if we need to rest, or moving in an asymmetric fashion like putting one foot up on a stair or stool, walking up and down stairs, or doing lunging stretches.

Outlet

After the mid-pelvis rotation is complete, the head passes through the pelvis ending with the nape of the neck resting under the pubic bone before the head extends and starts to crown. The most space in the pelvis at this phase of labor is front to back. Most of us will naturally prefer to kneel, be on hands and knees, stand, hang, or get in a neutral squat. Some of us want to arch our backs and rotate our knees in and our feet out. The latter is more and more used as a "trick" to open the outlet when pushing is difficult but I have seen many people do this naturally. They are opening the outlet and their body knows this! More on that in part 5!

Moving can shorten labor

As you see, moving can be essential for the smooth progression of physiologic labor. Moving in response to pain signals our brain to release the hormones needed for optimal physiologic labor processes for us and our baby. Moving itself alleviates pain. Moving is also an innate response to what our body and our baby need for making space and allowing rotation. Lastly, moving during labor can lead to shorter labor, fewer interventions, and more satisfaction with the birth experience.

What about you? How did you move? What did you need? Leave me a comment!

Healthy Birth Practice #1: Let Labor Begin on its Own

References:

Healthy Birth Practice #2: Walk, Move Aroun d, and Change

Positions Throughout Labor

Michele Ondeck, RN, MEd, IBCLC, LCCE, FACCE

Spinning Babies