Childbirth Companion

Did you know that your baby’s position for birth may impact the length and ease of your labour as well as your success with a vaginal birth? This isn’t specific to just breech babies. Even those presenting with their heads down can influence labour and birth outcomes. The most common reason given for preforming a cesarean section is Failure to Progress (FTP) in labour. This is often a catch-all phrase that fails to specify what was really going on and more often than not would be better described as “failure to be patient”.

So, what would cause a labour to reach of point of apparent non-progression? Women are commonly led to believe that it is a fault in their own bodies or the size of the baby in proportion to the mother’s pelvis. However, there is much more related to this physiological process than a cursory glance may detect.

Of huge importance is a woman’s need to feel safe and comfortable with her environment and with those surrounding her during labour. If she is uneasy or fearful, she may produce too much adrenalin which can supress the birthing hormones, in turn affecting her labour progress.

The high rate of inductions is another contributing factor to a slow or dysfunctional labour. While induced labours may be prodded along faster than a spontaneous one, this speedy approach can force things to happen too quickly, not allowing the mother’s body or her baby enough time to adapt and maneuver adequately. In the end this can result in the cervix not opening completely or the baby not moving down through the birth canal.

Impatience can also play a large role in labour progress or, more accurately, the lack of progress. Some women and babies simply need more time than many policies and practitioners allow for.

What of the phenomenon that a woman’s pelvis can be too small and/or her baby too big? How does this explain the smaller or average size woman who gives birth to a large baby with apparent ease in contrast to a larger mother who ends up delivering her smaller or average size baby by cesarean for failure to progress? It is thought that our modern, often sedentary lifestyles may cause our pelvises to become compressed and misaligned. When we consider our counterparts of 50 – 100 years ago, the modern woman spends much more time at a desk, traveling in a vehicle, assuming semi-reclined positions, and, in general, being less active. Since babies will seek the path of least resistance, they may end up in a breech or posterior position or some other form of misalignment. So, we must look at ways to remain proactive in our prenatal health, in preparing our bodies for birth, and in encouraging our babies to assume an optimal position.

There are self-care recommendations that a woman may utilize to promote pelvic flexibility and the baby’s ideal position. These include self-administered round ligament massage, as directed by a chiropractor, activating certain acupressure points, taking quality prenatal supplements, getting regular exercise, and using techniques such as standing figure 8’s (i.e. belly dancing) to aid in good pelvic flexibility and alignment. Pregnant women should also avoid reclining chairs and cross-legged positions as well as prolonged, repetitive motions, and one-sided stances such as carrying a toddler on one hip or a bag on one shoulder.

Despite their best efforts, many women still encounter various discomforts in pregnancy and approach birth with a baby that is not in an ideal position. They are more likely to struggle through longer, more challenging, and more painful labours. This often results in a greater use of pain medication and medical interventions, including cesarean sections. While there are various techniques and procedures that are often tried, particularly for turning breech babies, many are awkward at a minimum or invasive and even painful. One such technique is the External Cephalic Version (ECV), a medical procedure which entails a doctor or midwife manually manipulating the baby to rotate. There is, however, a proactive chiropractic approach relative not only to optimal fetal positioning, but greater comfort in pregnancy, and shorter, easier births. This technique may also offer a greater rate of success than an ECV as indicated by the International Chiropractic Pediatric Association (see link 1 below).

The Webster Technique, requiring specialized certified training of a chiropractor, addresses imbalance in the pelvis and tension in the uterus. By righting the pelvic misalignments and releasing the uterine tension, the baby is freer to assume the best possible position for birth. While often associated with aiding a breech baby to turn, the Webster is recommended to any pregnant woman even if her baby is already in the optimal position. Many mothers who have received regular treatment report experiencing fewer of the discomforts commonly associated with the prenatal period. The technique may also decrease the potential for a long, complicated labour by providing the baby with an unhindered path through which to navigate.

Many misconceptions and myths abound regarding chiropractic care in pregnancy. It is important to note that a Webster-certified chiropractor does not palpate for the baby’s position or manually attempt to turn the baby. The technique also does not involve awkward contortions or intense manipulation. Pregnant women need not be afraid of the procedure inducing labour or that it will cause a baby already head down to turn into the breech position. Since babies will move themselves along the path of least resistance, a relaxed uterus and well-aligned pelvis will only encourage the optimally-positioned baby to remain in its ideal placement. In short, the Webster Technique does not turn babies but provides a more conducive environment for the baby to rotate itself.

With high intervention rates and about 30% of North American women giving birth by cesarean section, it stands to reason that a proactive approach to optimal positioning is essential. If the causes for labour failing to progress can be rectified through simple preventative measures, imagine the possible reduction in unnecessary interventions and cesareans. These reduced uses of medical procedures would correlate with better outcomes for moms and babies and even save in health care costs. It is then important for women to take charge of their bodies, their babies, and their births by learning about their options and making informed, proactive choices.

To find a Webster-certified chiropractor in your area, visit http://icpa4kids.org/Find-a-Chiropractor. Gravenhurst and Muskoka area residents may consult Dr. Kelly McIntosh at her Gravenhurst clinic or visit www.gravenhurstchiropractic.com.

See also:

1. http://icpa4kids.org/Wellness-Articles/for-many-pregnant-moms-webster-technique-is-the-key-to-a-safer-birth.html

2. http://icpa4kids.com/about/webster_technique.htm

3. http://www.youtube.com/watch?v=ry7rHUFrx5M&feature=related

©2012 Stephanie Hayes, CD(DONA), CE - Childbirth Companion