Birthing positions

[BETSRN]

I am just curious as to what birthing positions you all are encouraging. Do any of you still routinely use stirrups or have you gotten your practitioners away from that barbaric practice? We use the footplates if necessary and the squat bar makes an excellent footrest (especially if the lady has an epidural). We try and have our ladies sitting up, squatting or at least at a good tilt.

It's always fun to talk with others and find out what everyone is doing. In general, I think most places are trying to be mother friendly and NOT make birth a medicalized event.

How receptive are your docs to NOT performing routie episiotomies?

Let's ee what's going on around the country and the world.:chuckle

[mother/babyRN, RN]

We use as many positions as we can to facilitate pushing...Funny this topic came up because the other morning, with a patient sitting (squatting) on the stool, both the doc and I ( women in our 40s) were sitting on the floor coaching the girl, looking at a mirror strategically placed so we could see how she was doing, and when we elected to change positions to the bar with her pulling on a blanket, we both realized too late that we were really sore trying to get up and our knees cracked at the same time...Both the patient and her husband ( in their twenties) first were startled and then started laughing at the expense of us two "old" women....Poor girl used the stool, the bar, the bathtub and pushed for two hours with out an epidural ( some of that time with her foot on my shoulder to get her legs open wider) and THEN ended up with a section for CPD! I went home sore from head to toe, but felt ok about it knowing we had used just about every position known to OB before the poor girl had to "throw in the towel"....Orthopedically, I was hurtin for certain.....:)

[BETSRN]

Those of you out there still usuing stirrups and lithotomy positioning, come into the present. It's so much better WITHOUT all that stuff! I promise!

[BETSRN]

Women do NOT have to be flat after an epidural: in fact they should RARELY be flat ever. Women with epidurals can sit right up, squat, go on hands and knees: lots of things.

The squat bar is a bar that hooks into the foot plates on the birthing beds. We have the Hill-Rom beds. It is just a nice bar to hold on to when in a squatting position and also very good for supporting the feel when pushing. We,too, hook a sheet around it and use it for a pull towel (instead of using the handles).

Those of you who are in very old fashioned places owe yourselves a treat to go see what other hospitals are doing as far as positioning and being as ambulatiry as possible during labor and birth. Go and visit with some midwives,also. You'll learn a lot. I am completely convinced that the influence of midwifery is what changed things for the better at my facility.

[Bunte2000]

Well I had my son just 2 years ago & it was at the OHio State University in Columbus, Ohio. They would not let get out of bed AT ALL after they broke my water, no jacuzzi tub or anything. I let them know I was PISSED!!!! I was not allowed any position except on my back after my epidural. Then when it came time to deliver they draped my all over like I was some diseased creature!! I was very disappointed, I about strangled my nurse!! I made a promise to myself I WILL NEVER be a nurse like that!!!! But I tell you my next delivery will NOT be like that. I will insist on then following my wishes & I will be at a different hospital for sure!!!

[L&D_RN_OH]

Most deliveries are in semi-fowlers with support people holding the legs. Some of the docs break the bad, some don't. We only have one who uses stirrups and she is a FP doc so only rarely does a delivery. We also use the squat bar, jacuzzi and hands and knees.

I don't think we have any docs that do "routine" epis. But we have some that seem to do them more often than not.

[bagladyrn, RN]

I've worked with women pushing in every possible position. here are a couple to give you a good laugh: Pt. standing at bedside, squatting with every contraction, holding on to my shoulders, so of course, I was doing the deep Knee bends right along with her, midwife sitting crosslegged on the floor beside her. I think the pt' was in better shape after that delivery than I was!

Had a patient in side lying position, pushing with me supporting her upper leg. Somehow, in the midst of a push, she swung that leg, got it behind my head,clamped down, and pulled me in for a VERY close look at the situation! Worse, the midwife was laughing so hard she could barely help to get me loose! Glad no one had a video going of that one!

[mother/babyRN, RN]

YOU try to wrestle stirrips away from some OB people (docs)....And some people actually do seem to get into pushing better in that position. When they figure it out gravity is still the best answer..