Lying down, squatting or standing up? Birth positions help the baby find the easiest way into the world:
midwives know the appropriate birthing positions for each situation or. Birth postures. Children turn life upside down and, before birth, already turn themselves upside down: 94 out of 100 babies position themselves head down in the uterus, thus choosing the optimal "pole position" for a vaginal birth.
The few who are bum first present their parents with the task of getting detailed advice on whether a vaginal birth is possible or a cesarean section is advisable. Only about every 100. The child lies completely transversely and thus makes a clear statement against natural birth.
Phases of birth and birth positions – fontanelles show the way
During birth, the baby must move through the pelvis and birth canal with twisting and bending movements. In most cases, the baby’s head leads the way and must adapt optimally to the birth canal. For this reason, it is not yet ossified at birth and the bones of the baby’s head can push over each other. This is made possible by connective tissue connections, the so-called cranial sutures.
Midwives use these sutures and the two fontanelles (gaps in the bones created by the meeting of the cranial sutures) as a guide for vaginal palpation. They provide information about how the child’s head has adapted to the pelvis and how it is positioned which birth position should ideally be taken on the basis of the given situation in order to determine the to make birth easier.
In the Opening period the cervix opens centimeter by centimeter. Gravity acts more strongly on the baby’s body in a bent-forward position. The baby’s head is thus better levered into the sacral cavity and is at the right angle to the pelvic inlet.
In the Transition period the cervix is opened, the baby must now turn through the pelvis and enter deeper into the birth canal. Meanwhile, in the knee-elbow position, gravity no longer acts on the cervix. This can become significant – namely, when the little head has not yet assumed the optimal position or a remainder of the cervix still prevents birth.
In the Discharge period, In the last phase of birth, the leading pressure of the head is usually felt more clearly and sometimes triggers the need to push a little. Concentrating on the breathing and the active pushing help the tissue to stretch slowly. The midwife’s verbal and nonverbal guidance, and sometimes her hands, accompany the baby during the final stage of labor and protect the perineum (the region between the anus and the posterior angle of the pubic symphysis) as the baby gently glides into life.
About the mode of birth, the different birthing positions and the Possibilities of an active and moving birth Knowing about this helps to better understand the midwife’s guidance and support. However, birth mothers do not have to learn and remember all this by heart.
Because: During birth, the midwife is at the side of the woman giving birth and provides patient, empathetic and appreciative care. Midwives know soothing hand movements and integrate the partner into the birth process. You have a great knowledge of birth positions, birthing postures and their Beneficial effect in the different phases of birth. Massages, breathing instructions and a holistic view of the birth process are just as much a part of comprehensive midwifery care as watchful restraint at the right moment.
Intervening at the right time or holding back on action requires experience and confidence. "Skillful non-intervention is probably the greatest art in obstetrics!", experienced midwives know. Waiting, observing, giving time to the child and the birthing woman without intervening – all of this supports a natural birth process in a wonderful way.
Giving birth in motion – different birth positions
One of the most important laws of physics, gravity, can also be applied to birth. In addition, different birthing positions help the pelvis to widen an average of one to two centimeters, relieve back pain, provide active support, make breathing easier, improve oxygenation, and increase the release of "happy hormones" (endorphins).
Gravity acts more strongly on the baby’s body in a bent-forward position and the baby’s head is more easily lifted into the sacral cavity. In the transition period, when the cervix is already fully open, the baby must rotate through the pelvis and step deeper into the birth canal.
Good to know: Where the ischial spines protrude laterally into the bony pelvis is the narrowest point of the entire birth canal. To pass them well, asymmetrical positions are suitable. When you put one leg on an armchair or climb stairs, the small bony prominences are no longer exactly in one plane and the baby gets more space on its way through this neuralgic place.
Upright birth positions
With a stable position on the ground, not only birth becomes a self-determined experience, but also pelvic mobility becomes greater. The contractions are used more effectively and gravity does its part. In the free deep squat, squatting on the wall bars or with the support of a birthing stool, there is an increase in the diameter of the pelvic outlet. Whoever squats down for the birth optimizes the birth axis and shortens the birth path.
In the quadruped position, on the other hand, gravity has hardly any effect on the cervix. This can be important if the baby’s head has not yet assumed the optimal position or if a residual part of the cervix delays the birth.
Lateral and supine position
Of course, horizontal birth positions also have their place in obstetrics. They provide safe positioning after medication administration or in cases of weak circulation. Helping tired women to recover well during labor pauses. If used carefully, the rotation of the child’s head can be favorably influenced and a raised pelvis can be used to better deal with the premature urge to push.