Labor Repose

Labor Repose
LaborPayne during her 6th homebirth (9th baby) at age 44

Thursday, May 14, 2009

I Support Perineums

I have been talking with a colleague about birth position. She has recently become very irritated about women being forced to give birth on their backs. I'm afraid her irritation was precipitated by a discussion we had about my homebirth, a couple of years ago. I told her why I choose not to give birth in a bed, and prefer instead a standing supported squat. (I also gave birth on all fours once and another side-lying.) Since my friend is planning a second pregnancy in the near future, she has been examining these issues closely. "Why do we submit to that?" she demanded to know. I suspect its mostly because we don't know any better. We assume that all the things we are asked to do is for our safety or our baby's safety (and a lot of the time that is true). However, this one is purely for the careprovider. I haven't seen any research on it, but my hypothesis is that we put our perineums in jeapordy with the lithotomy position. It gives physicians and nurses lots of nice access, but mainly for the purpose of casually abusing the tissue. It is my ethical stand that healthy muscle or tissue integrity should not be compromised (ie. cut or severed) without medical provocation. The muscles and tissue of the perineum are made to stretch to accomodate the birth of a baby. Yes, there are times when tissue manipulation is warranted, but mostly lying down to give birth makes as much sense as lying down to have a bowel movement.


Rachel @ Lautaret Bohemiet said...


I'm so glad there are those like you out there educating those who care to learn.

Good job!

Rebekah Costello said...

Haha, yes! I love that last line!

Rj said...

mostly lying down to give birth makes as much sense as lying down to have a bowel movement. Which is why it is also so hard to use a bed pan!

Anonymous said...

I knew better...something happens to our power in labor, at least speaking for myself this is the case. You know about my story, the nursie who had me on my back and baby had decels and I sat up. However, I continued to submit to pushing on my back. This was my 6th baby, what the heck was I doing. I would put our a whiny protest, but wouldn't change positions voluntarily. I just obeyed, and I felt violated. I kept thinking one more push and baby would be born and I could get this nurse outta my vagina and outta this room. What did happen was wasted pushing for over an hour as my baby was OP and the OB finally realized husband told me she came out ten minutes after he told the nurse to have me get off my back. My baby needed me to move so she could move, and I kept begging for it. I needed to just do it myself, but felt no power in laborland...with oppressive nursing.