Walking during labor...please bear with me

Specialties Ob/Gyn

Published

Specializes in NICU.

I always hear that wanting to walk during labor is a huge reason for not having an epidural, IV, EFM etc. I also know that it helps labor progress which makes sense.

So my question is and it might be dumb, if you've been walking a lot in your ~40 weeks of pregnancy and haven't "progressed" much, how walking in the last couple hours of labor going to make such a difference? Is being in bed for that time really going to make such a difference in speed of progression or optimizing position of the baby? Is it the walking with the addition of contractions? I'm a NICU nurse so I'm not a labor expert.

I progressed much faster after I had my epidural is partly why i ask. Am I just an anomaly?

Thanks!

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Specializes in 4 years peds, 7 years L and D.

I recall reading about recent studies that show walking really doesn't help labor progress...but it may help mom feel better then hanging out in a bed. Anyone know of these studies? I wish I could remember where I read them..??? It may have just been a parent magazine :uhoh3: I usually find epidurals help things go faster in most cases too.

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The latest studies I have read do not support the relationship between walking and length of labor.

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Specializes in Surgical Services.

We just did our rotation in L&D and was taught that it naturally helped with the gravitational pull and to get the fetus in the birth canal.

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Is it the walking with the addition of contractions?

Yes. ;) It seems to help more in early labor than active labor. Although, depending on who you ask, it doesn't help at all. IMO, movement is what helps, both for optimal positioning and for maternal comfort. If that means walking, rocking, dancing, squatting, kneeling, bouncing, ...... so be it.

Studies have shown epidurals have little effect on labor progress, unless given too early. Then they slightly lengthen labor, and create the need for more intervention. Some women who are well into active labor, and very tense, do seem to have "quicker" labors, once the epidural is in. It allows them to relax enough to let the contractions work, without them fighting against them.

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Specializes in OBS, OR, ER.

I have been in labor and delivery for 1 1/2 now and we often encourage the walking partly to help bring baby's head down with contractions. Another reason is to help moms cope during early labor with pain, it also can help relax and a relaxed mother dialtes more effictively. Some moms with epidural fail to prgress and it knocks out their conctractions, while others take a huge leap in dilation.

The thing about OBS nursing we do alot of trouble shooting and creative solutions. Sometimes they make a difference, sometimes it just puts the family at ease, and sometimes we think what action we took made a difference but maybe it was something else altogether.

All that being said I wouldn't discredit the benefits of walking but at the same time I would not necessarily discredit epidurals in exchange for the benefit of walking, plus apparently some hospitals have walking epidurals as well.

A trick I picked up a little while back if baby is too high and mom has a epidural sit them up in high fowlers and observe how the position is tolerated. She might have very numb legs after but hey if it averts a C/S all is good right

Hope that helps

:)

One last note often it takes a while to pass 1cm to 3cm, because the cervix is also very thick, but often if in good labor primip or multip dialte faster after around 4cm probably because the cervix is paper thin (at least in my experience)

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

I highly recommend:

The Labor Progress Handbook by Penny Simkin

Nurses and anyone caring for labor patients should all have this one....and there are plenty of "tricks of the trade" to help us care for laboring women and faciliate progress without numerous medical interventions. Walking and moving about are certainly better than laying in a bed, as are sitting on a labor ball or toilet. Worst thing we can do is having a laboring woman laying flat on a bed, or not moving for hours. Even with an epidural, a woman should be assisted to reposition frequently as this does enhance progress, esp if a baby is in the OP presentation.

9 years in OB have taught me well, that moving is so important to maternal and fetal wellbeing and progress in labor.

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Specializes in OBS, OR, ER.

hmm, looks like a great read...gotta get it :) been looking for something like this for a while

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Specializes in Specializes in L/D, newborn, GYN, LTC, Dialysis.

http://search.barnesandnoble.com/booksearch/isbnInquiry.asp?z=y&isbn=140512217X&itm=3

for your convenience. I love it.

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Specializes in OB, lactation.

I'm a really new nurse so I can't claim much experience, but if for no other reason it seems to make labor much more comfortable than lying down. At least it did for me and several people I've observed so far :)

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

Any movement, especially that of the pelvis, will aid the baby in navigating through the pelvic inlet/outlet. And if you're upright, then the gravity will help as well.

It also helps mom take her mind off things, which will aid in pain management.

I'm a big proponent of getting mom up and walking around if possible (also LOVE the labor ball, and squatting).

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