Childbirth positions on hands-and-knees are beneficial for many situations. They may not be pretty, but are effective at increasing the mother's comfort level and can prevent other complications.
The "crawl" position is performed exactly as it sounds, on all fours as if the mother were about to crawl. This position is also commonly used with pelvic rocking to increase the mother's comfort level. This position, while definitely not glamorous, is extremely beneficial for birthing a large baby. It allows the pelvis to expand to its largest dimensions and reduces the pressure on the perineum while giving the baby more room to maneuver if needed.
This position is also a natural alternative when umbilical cord prolapse is an issue. Cord prolapse occurs when the umbilical cord falls into the birth path before the baby. When this happens, the cord can become constricted, cutting off oxygen and blood to the baby. It's a potentially life-threatening situation.
If the waters have ruptured and the cord has potentially fallen into the birth path, moving into this position can prevent the cord from falling further. The baby is encouraged to move towards the top of the uterus, thus the cord has less risk of becoming constricted or may even retract on its own.
The "full moon" position is a modified version of a crawl position in which the mother rests her shoulders and forearms on the floor or other level surface, keeping them lower than her rear. This position is useful for turning a posterior baby. Gravity can assist in rotating a posterior baby to a more favorable anterior position. It is also helpful to have the mother widen her knees as far as is comfortable to open the pelvis as much as possible so the baby has the best chances of turning.
Some variations on these childbirth positions include having a birth companion placing a blanket or long scarf under the woman's belly and pull both ends. This supports some of the mother's weight and takes the pressure off her legs.
The birth companion can rub her lower back or apply hot/cold packs, a frozen water bottle, rice sock or other labor aids to increase her comfort level.
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Page Last Modified by Catherine Beier, MS, CBE
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