Pushing stage: Why do 70% of women still give birth on their backs?

By Suzanne Swan

Why do 70% of women still give birth on their back when ACOG safer care recommendations say that for a spontaneous labour the low risk pregnant woman can:

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  1. Use position of choice when pushing and giving birth
  2. Rest and wait the urge to push after full dilation
  3. Push your preferred, most effective way

The benefits of being upright include a reduction in the length of pushing time as gravity can help bring the baby, there is better supply of oxygen to the baby, the baby can get in a better position and less pressure on the pelvic floor.  In the active birth classes we practice the positions that widen your pelvis.

Many caregivers still prefer non-upright positions even though current obstetric textbooks state that it is beneficial for first time mothers, to push in upright positions. Here are 4 reasons you may find yourself pushing in a semi-sitting position.

  1. Easier to monitor the fetal heart rate (EFM)
  2. How caregivers are trained influences their preferred method (the way Noelle, a popular birthing mannequin, is positioned in training is semi sitting)
  3. Epidurals contribute to higher use of back-lying positions
  4. Limited caregivers

What you can do!

Come along to our active birth workshops with your partner to learn the different upright positions that are possible in second stage. Your partner’s physical support will play a key role in whether you are able to hold upright positions to the duration of your pushing phase.  Educate your partner!