Thursday, April 16, 2009

More "news" we already knew: Don't lie on your back when you are in labor

Remaining active and mobile during labor can shorten the first stage and results in less discomfort for moms:
Women who walk, sit, kneel or otherwise avoid lying in bed during early labor can shorten the first stage of labor by about an hour, according to a new Cochrane evidence review.

Women who labored out of bed during the early stages were also 17 percent less likely to seek pain relief through epidural analgesia, the review found.
This is not only for physiological reasons, such as widening the pelvis and optimizing fetal position, but "[o]ther research has found that feeling in control and able to make choices reduces pain and psychological distress in general." If fact, lying on your back during labor can be dangerous:
[l]ying flat on one's back during labor can put a great deal of pressure on the blood vessels in the abdomen. "There is widely accepted physiological evidence that the supine position may be harmful in late pregnancy and labor," [lead review author Annemarie] Lawrence said.

According to the reviewers, the supine position puts the entire weight of the pregnant uterus on the blood vessels that supply oxygen to both mother and child, which could potentially lead to problems with heart functioning in the mother and reduced oxygen to the baby. These outcomes could be serious in extreme cases. Lying on one's side has no link with such problems, however.
So why do so many women labor in bed?

[Teri] Stone-Godena[, director of midwifery at the Yale School of Nursing,] said that despite all the attention given to empowering women to have the type of birth experience they prefer, medical professionals still pressure women into lying in bed during labor, because it is more convenient this way for nurses and doctors - and makes fetal monitoring easier.

"I think this research is very vindicating of women being allowed to assume positions of comfort," she said. "Listening to their bodies is what they need to do. Most of time when we limit people's activity, it isn't for reasons that are soundly based on evidence."

She added, "This clearly shows that there are no advantages in staying in bed unless that's where you want to be."

Generally speaking, if a particular labor position causes you increased pain or discomfort, it's not a good one to be in - for you or the baby. Pain is your body's way of letting you know you need to change what you are doing.

Link to article.

No comments: