Moving during labor

Amy at Lamaze’s Science and Sensibility is hosting the second Healthy Birth Blog Carnival. This one is about Lamaze’s Second Healthy Birth Practice: Walk, move around, and change positions throughout labor.

Amy did a great job explaining how natural birth advocates are constantly asked to prove that what is physiologically normal, like being free to move during labor, is better than an intervention, when it should be the other way around. Here’s a great quote from her anticipatory pre-carnival post:

Somehow, things have gotten turned around, and the normal condition is now the “experiment” and the intervention is the “control”. In addition to being irrational, this is a set-up to perpetuate conventional obstetric care, which imposes unhealthy and unfounded restrictions on women in labor. This is because in “intervention versus control” research, you have to show that the intervention performs significantly better, otherwise the control condition remains standard practice. While many of us believe that encouraging a laboring woman to move when and how she wants to is healthier and safer than making her stay in bed, waiting for evidence that it produces better health outcomes is putting a burden of proof on normal birth that has never been applied to routine intervention. Besides, lack of evidence of harm, less pain, and maternal satisfaction are valid and important outcomes in and of themselves, and provide the justification we need to reject routine policies and practices that restrict maternal movement.

I had a similar argument with a commenter on this post. Many elective cesarean advocates seem to want to present vaginal birth and cesarean birth as two equal options, not a physiologically normal event and an intervention.

So, since Amy already handled this angle well, I am going to talk about my own experience, and give a little advice at the end.

When I had my first child, I thought I was well informed. Hell, I had read every page in What to Expect When You’re Expecting. I read Mothering and Parenting magazines (both sides!), hired a midwife, took a childbirthing class, and thought I would have a “natural birth” as long as there wasn’t any unexpected emergencies.

Well, soon after I arrived at the hospital, I was told they didn’t have a birthing tub (I never thought to ask ahead of time, dangit) but I was told I could labor in the shower. After the shower, which was probably 20 minutes at the most, I was told I needed an IV with Pitocin. I had no idea what that was, but since my midwife recommended it, and everyone knows midwives always favor natural births over interventions, I didn’t even think of refusing. Well, I was told as soon as the Pitocin was started that I needed to be on continuous external fetal monitoring. Huh? Then, my midwife told me I had to stay in my bed(!!!), since the baby was showing signs of distress. I was not told before being administered the Pitocin that it would require being tethered to the machine, and I wasn’t told it may cause fetal distress, even after my fetus was apparently diagnosed with fetal distress. I wasn’t even told it may not be necessary, considering I had only been in active labor for about an hour when it was administered.

Fast forward several hours and I was flat on my back, pushing too soon, leading to a swollen cervix. No, no alternate positions were encouraged for my three hours of pushing, either.

So, my advice? Ask your practitioner(s), ahead of time, what their positions are on intermittent monitoring and movement in labor. Don’t just assume that what seems basic and normal will be encouraged or allowed.

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4 Comments

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4 responses to “Moving during labor

  1. I’m starting to wonder about the ableism inherent in all of the “walk around in labour” advocacy that I’ve seen. Is anyone writing about physiologic labour for women with disabilities? Is there any movement toward incorporating understandings of the wide spectrum of human abilities, as something other than tiny fineprint-asides (though they’re few and far between), into “mainstream” birth activism?

    • MomTFH

      I think all birth activism can be looked at through many lenses, including disablist activism. No, not everyone can walk during labor. Not everyone is even able bodied enough to labor. Not everyone can carry a pregnancy.

      Not everyone can breastfeed. I had a doula client with MS who wanted to go back on her meds immediately following her delivery, and she and her physician decided the meds were incompatible with breastfeeding. However, she was able to move during labor. In fact, I would not have known about her MS unless she told me.

      I think a lot of this post can apply to laboring patients with disabilities. Of course, it is my birth story, and I was able bodied during my first labor. I would hope that there are options for laboring people with disabilities to move as freely as possible, not be tethered to machines, and be given full informed consent. I would think there would be some room for using labor tubs.

      I have limited experience in this area. That would be a great idea for a blog carnival at FWD.

      I appreciate that you are speaking on disablist issues. I am not sure every post on my blog will include a disabled perspective, or a racial perspective, or a genderqueer perspective. I am not even sure they will all have a feminist perspective. I can try to be as aware as possible of these different facets of activism as possible, and I welcome comments, obviously.

  2. Pingback: Science & Sensibility » Healthy Birth Blog Carnival: Walk, move around, and change positions throughout labor

  3. Paige

    I wasn’t all that into the idea of walking around when I was laboring. In fact, walking was the last thing I wanted to do but there is NO way I could have made it through my contractions if I had been forced to lie on my back in a bed. Lying down was simply the most uncomfortable position for me. The tub was the best, the birthing ball a close second.

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