After several days talking about possible routine interventions during a hospital delivery treating amnioscopy, enema and perineal shaving today we are going to talk about the mobility control of the woman who is going to give birth, that is, if they let her or not let her move once she arrives at the hospital.
At present, the protocols are changing and many women can already walk while they wait for the moment of expulsion or move if they are lying down, however surely there are still many centers where things are still done in the old way, that is, leaving women lying in bed waiting for labor to evolve.
The reason that the woman remains lying is basically that of facilitating the professional's attention (putting less difficulties). A woman is put on a monitor to listen to the baby's heartbeat, when the delivery is advanced, neuroaxial (epidural) anesthesia is applied and then a channel is channeled and a serum is given. So much connection can fail if the woman starts to move.
However, the need to have the mother more or less still so that the monitor does not whistle and so that everything stays in place goes somewhat unnatural, or in other words, against what is recommended for a favorable evolution. of childbirth, which is nothing more than saying to the woman: "get as you feel better".
Maybe there is some woman who says, "Well, I lie down, which is how I am better", maybe there is, but most usually require other positions, some of them of the most varied (resting on a table with one leg raised back, for example ...).
That need not to lie down responds to what has been said on several occasions in this blog: vertical positions and allowing ambulation could help shorten the duration of the first phase of labor and the freedom of movement allows women to adopt the positions that cause less pain, improving their control and granting a sense of prominence and process control.
What does the scientific evidence say about it?
The reality is that observing several studies there are no significant differences among the women who are asked to lie down and the women who are allowed to have freedom of movement. This lack of differences can be seen in the use of oxytocin and analgesics, in the type of delivery and in the results of the maternal and neonatal health tests (Apgar).
Similarly, it cannot be confirmed that the adoption of different positions shortens the first stage of labor or conclude, in view of the data that exists, that maternal comfort is greater.
Personal experience could say otherwise
However, personal experience could say otherwise. As I said above it is possible that some woman expresses her desire to be lying in bed, it seems more logical that a woman can adopt the position she wants at any moment, being this, normally, different from that of recumbency.
Here I ask for your opinion, because my wife suffered a lying birth in which she was very uncomfortable and in which she felt nothing protagonist and lived another birth with freedom of movement, three years later, very different in every way, especially in what to personal satisfaction is refers (it is not the same thing as letting them do it to you) and it makes me think and believe that all women would wish, despite the lack of evidence, to be able to stand, sit or as their body asked at each moment of childbirth .
Given all this, freedom is recommended
The lack of evidence that supports one or the other action means that from the Ministry of Health, the wonderful “do nothing” is finally recommended, where “do not do” is understood as a “do not lie down” if it is not the woman's desire. That is, since it cannot be demonstrated that leaving the woman lying down even when she is uncomfortable is beneficial for the woman, let her put herself on as she is best at all times, that It's not that it's better for the end result, but at least the woman doesn't feel totally controlled:
Women, including those using epidural analgesia, should be encouraged and helped to adopt whatever position they find comfortable throughout the period of dilation and to mobilize if they wish, after checking the motor and proprioceptive block.
