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Moving for an easier birth - part one

Only use these positions and techniques in labour if malposition is suspected or diagnosed. Always be guided by your comfort, if uncomfortable or feeling pain, stop using that position. Check with your midwife if there are any reasons why you should not use these positions. Please read contraindications

Signs of malposition may include some of the following:

  • backache, pain above the pubic bone (often sharp).
  • Pain and discomfort in hips or groin and sometimes radiates down thighs.
  • Baby’s kicks and movements may be felt at the centre top of the abdomen or at the  front.
  • Sometimes pain location is described as ‘feels everywhere’.
  • During contractions may be unable to lie down especially during the early labour stage. 

Using the Rebozo

The Rebozo is a scarf that originates from Mexico. It is used in various ways in everyday life and women and midwives use it as an essential tool during pregnancy, labour and after the birth. It is specially woven fabric that offers a little elasticity or stretchiness so it can easily hug the body and abdomen.  While some of the rebozos have beautiful patterns please be aware that the open weave rebozos are easier to handle if using them for abdominal sifting (massage). Otherwise any scarf with similar dimensions and elasticity will work. Doesn’t everyone have a pashmina in the back of their wardrobe!

This video shows how to use the scarf for a gentle uterine massage. Gentle is the key word. Use a gentle rhythmic motion, can be fast or slow depending on individual preference. Remember, don’t do it if you don’t like it or if it causes discomfort. . In pregnancy use a rebozo, shawl or scarf to gently sift or jiggle the abdomen. This can be done daily. It can soften the broad ligament and increases the likelihood of successful optimal positioning of the baby. Particularly useful before using other positions to help balance the pelvis. Use in early labour and the first stage as above. This also provides comfort in labour and promotes relaxation. Sift in between contractions. Can be done for as long as the woman wants.

Caution: if the placenta is anterior, be gentle with no jerky movements. Please avoid if there is a history of bleeding in pregnancy. A one off incident in early pregnancy is not a contraindication but using with persistent bleeding in pregnancy is not advised

Find out more about rebozos and their use in labour in this article describing its culture, use and background. Sophie Messager has an online shop where she sells ethically and sustainably produced rebozos

Sidelying Release

This is a very easy position and can be used during pregnancy once or twice a week to improve and maintain pelvic balance and stability and it can be used during the birthing process. I’ve used the sidelying position for years in my work as a midwife. It is not guaranteed to resolve a problem caused by a biomechanical issue ie the baby’s position but I’ve found it to be over 90% effective so definitely worth a try. Using it helps stretch the muscles and ligaments attached to the sacrum and cross over or through the hip to the leg, giving the baby a little more space to get into an optimal position.

 

  • You may feel the hip stretch while practising the position - don’t worry if you don’t feel it or feel it in one hip only - it is still effective.
  • If there's pain or discomfort under the bump or down the side or back of the legs it means the stretch is not happening in the right place - a little tweak in the way you are lying will often correct this. 
  • Sidelying release can be used at any point in labour, early or active, where malposition is suspected or if you’re experiencing a lot of sharp pain above the pubic area, backache, or if labour is lasting a very long time. Use the position for 5-10 minutes each side or for three contractions. It is suitable to use with an with an epidural.
  • Repeat the position every 4 hours if necessary.
  • It’s very effective in the pushing (2nd) stage when there is slow progress despite good pushing effort or contractions space out.
  • It’s advisable to mobilise for several minutes following Sidelying Release, Always work both sides. Make sure you are safe as this position requires you to be close to the edge of the bed or sofa so the leg can hang freely. Either arrange furniture to hold on to or have your partner assist.