Many methods of natural labor pain relief refer to the preference of vertical labor over horizontal labor. To give birth in an upright position is recommended by the Lamaze method, most modern doctors in Europe, the USA and many other countries of the world. In Russia, vertical childbirth has not yet become widespread, but the ice has broken, and more and more women go to the maternity hospital with a preliminary agreement for just such a childbirth.
We will tell you about what it is and how such a baby is born in this article.
What it is?
As the name suggests, vertical childbirth differs from the traditional position of the mother's body in space. Childbirth occurs when a woman is in an upright position - standing, squatting, etc. In this case, the woman chooses the position of the body herself based on her own feelings and comfort.
In fact, there is nothing new in this method of delivery. This is how most mammals on the planet give birth. Among people, such births are widespread in Asia, Africa, South America.
In Europe, the fashion to give birth in a natural, natural position came from France. It was there that the first vertical childbirth began officially. Following the French, women from Holland and Germany tested the technique.
Few people know, but in Russia, professional midwives also forced the woman in labor to get up and walk in the bathhouse. Therefore, this way of giving birth has a very long and very deep tradition. It is believed that the vertical position is the most natural and physiological.
In Soviet maternity hospitals, women were forced to lie both during labor and during attempts on obstetric beds. Now all women in labor are encouraged to move during labor. But not all doctors agree to a vertical position in attempts.
It should be noted that for vertical childbirth, the presence of a partner is required. Either it must be the husband of the woman in labor, or another relative whom she completely trusts, or a health worker with whom an agreement has been reached on vertical birth. At the same time, the partner is by no means an observer. He is an active participant in the process, on which a woman can lean, on which she can hang, if it is convenient for her.
Managing an upright labor requires a separate skill from the obstetrician. If a specialist is trained in this, he must necessarily have an appropriate license. It is imperative to inquire about its presence when choosing a maternity hospital, if a woman has vertical childbirth as a priority.
Advantages and disadvantages
A supine delivery is more painful and carries an increased risk of the baby getting a birth injury. This is due to gravity - a heavy uterus with a fetus presses on the spine, compresses the aorta, the inferior vena cava. This increases the likelihood of developing hypoxia in the fetus, leading to a violation of the blood pressure level in the woman in labor. Vertical labor, again according to gravity, does not cause pinching of the blood vessels. Control with CTG in childbirth confirms that the state of the fetus in vertical delivery is always more successful than in classical back delivery.
Pain during childbirth in an upright position is reduced by reducing the gravitational load on the back. Therefore, the need for drug pain relief decreases. Even relatively gentle epidural anesthesia affects the fetus. Its use in vertical labor is not found. It is also rarely necessary to use stimulants - contractions in an upright position are rarely discoordinated or weakened.
The period of contractions in a classic birth, according to experts, lasts about three hours longer than in a vertical one. The opening of the cervix proceeds at a faster pace, again thanks to the gravitational fields and the pressure of the baby's head.
Attempts in an upright position are less painful, in the tilting stage of the birth process, the baby is pushed out not only by birth forces, but also by gravity. Babies get injuries less often, since the progress becomes softer and more delicate, because the woman feels well the muscles of the perineum and pelvic floor. The period of pushing itself increases by about half an hour, but the slower exit of the baby provides a low probability of injury.
The third stage of labor in vertically giving birth is usually faster - the placenta leaves more easily under the influence of gravity. This reduces blood loss by about 200 ml. Recovery after such childbirth proceeds faster, and not only in the postpartum woman, but also in the baby. The adaptive abilities of such children are assessed significantly higher than in children who appeared in the course of classical childbirth or as a result of a caesarean section.
If a woman has myopia, had a history of retinal detachment, or heart ailments, then before there was only one way out - a cesarean section, since such women are not recommended to push. Today, with such indications, vertical childbirth is quite successfully carried out without harm to the health of the mother and baby.
Despite all the advantages listed, this method of delivery also has disadvantages:
- it is more difficult for an obstetrician to monitor the condition of the fetus, do CTG when pushing, take the baby's heart rate;
- epidural anesthesia cannot be applied, since the lower part of the body will partially lose sensitivity, the woman will not be able to control her sensations;
- if the perineum has anatomical defects, the likelihood of rupture increases, while in the upright position obstetricians can do almost nothing to prevent injury to the mother;
- in an upright position, the likelihood of rapid childbirth increases, which can lead to fetal injury;
- under any unforeseen circumstances, difficulties, it is more difficult for an obstetrician to provide assistance to a woman who is in an upright position.
Who are contraindicated for?
Childbirth in an upright position of the body has a number of contraindications, and therefore may not be allowed for all pregnant women. So, you can not give birth vertically to ladies in the following situations:
- pronounced pathologies of pregnancy;
- labor began prematurely;
- the baby is in the pelvic, transverse or other pathological presentation;
- a woman has a clinically narrow pelvis;
- the child's head is large;
- the woman has chronic diseases of internal organs.
Even if vertical childbirth is allowed, at any time the decision can be changed and the woman will be transferred to the classic position if complications arise during labor, if doctors need to use forceps or other equipment.
How to Prepare?
It is necessary to prepare for childbirth in an upright position with special diligence. It is imperative to learn how to relax your muscles and breathe correctly during contractions and attempts. You will have to go to the courses with a partner. There will be shown exercises for two in acceptable postures and support, which it is advisable to rehearse at home. During vertical labor, a woman can use a fitball.
Preparation will require the collection of the necessary documents not only for the woman in labor, but also for her partner - without a list of test results and conclusions, the partner's doctors will simply not be admitted to the hospital. You also need to carefully familiarize yourself with the "assortment" of maternity hospitals and perinatal centers, find a doctor who is a supporter of vertical childbirth and sign an exchange card with the chief medical officer or chief physician of the chosen obstetric institution.
Poses and chair
There are no specific recommended positions for vertical labor. Their charm lies precisely in the fact that a woman in labor can choose any position of the body, as long as she is comfortable. Most often, women squat, stand on all fours, take a knee-elbow position, hang on a partner's neck. Poses should be studied in advance and rehearsed at home, but you should not choose the preferred ones in advance - childbirth will certainly make its own adjustments.
During the period of attempts, the squatting position is considered the most effective. During contractions, a woman can change positions arbitrarily as she likes. But almost all of them will require physical support from a partner, not only during the period of labor, but also during the period of labor.
There is a dedicated chair for vertical delivery. On it, a woman can take any position, but just not lie down. The pelvis is constantly suspended. Such equipment is quite simple, but so far not every maternity hospital has it.
The downside of the chair is its height. It is rather low, and it is not very convenient for the doctor - you have to sit in a hunched position or kneel. This variability in the required behavior makes vertical childbirth not the most popular among obstetricians and gynecologists.
Useful Tips
Today, with the development of paid medicine, there are many who want to make money on the couple's desire to give birth as they want. Not all maternity hospitals agree to accept vertical birth, this is still a fact. But more and more private clinics appear that offer such services for a lot of money. At the same time, the "specialists" of such clinics not only do not have a license to accept vertical childbirth, but sometimes do not have a medical education.
Often, such charlatans can be encountered in training courses for vertical childbirth. In a number of regions of Russia, there were conflict situations in which the organizers and teachers of schools of vertical birth did not have medical education and harmed their clients, who paid a lot of money for classes. When choosing courses and a maternity hospital, a woman and her partner should be careful. We are talking about the health of two - a mother and a baby. Be sure to make sure you have a license and ask about the doctor's qualifications.
Reviews of women
Reviews of vertical births are mostly positive. Especially valuable is the opinion of women who first gave birth in a classic position. They note that it is easier to give birth vertically, pain is much less pronounced.
The first stage of labor, according to reviews, can be quite tiring for a woman in labor: walking, standing and hanging with contractions quickly gets bored. But the benefits of the persistent period are appreciated by everyone, without exception. There are almost no reviews about injuries from the mother in such childbirth. There are also no reviews about birth trauma in an infant. Often women complain that doctors, even agreeing to vertical childbirth, did not give the woman in labor full freedom to choose a position, imposed a semi-sitting position, in which it is easier for them to work, regardless of the opinion of the woman in labor.
Is it possible to give birth vertically for free? You can, the reviews confirm this. True, for this, several conditions must coincide: the maternity hospital must support vertical childbirth, there must be such doctors, a separate birth, because the presence of a partner is assumed. In this case, a compulsory medical insurance policy is sufficient. In other cases, you will have to conclude an agreement for paid medical services and separately prescribe all the indicated points in the agreement.
For the pros and cons of vertical labor, see the following video.
