Vertical childbirth: preparation, contraindications, pros and cons. Vertical birth

And at some point (this was somewhere in 1700) they agreed and laid the women in labor on their backs - this way it was more convenient for them to follow the process and meet the newborn. But sometimes (mostly, of course, for a lot of money) modern doctors allow women in labor to actively carry out contractions and give birth vertically. And here are the advantages of such births over horizontal ones, which became classic at the behest of obstetricians.

Vertical birth prevent the occurrence of hypoxia.If during contractions and the baby goes through birth canal the woman lies on her back, the fetus, uterus, placenta - all this puts pressure on the blood vessels running along the spine. Because of this, blood circulation deteriorates, and mother and baby do not receive much needed oxygen during childbirth. When the woman in labor is in vertical position(not necessarily standing - you can walk, sit on a fitball, stand on all fours), the pressure of the uterus on large vessels is reduced, uteroplacental blood flow improves and the risk of hypoxia is removed.

As a rule, vertical birth is less painful.Movement in the vertical plane during contractions helps the cervix to open faster, and simple walking or resting in the shower ease contractions that come from bottom to top. And in general, moving in space allows a woman in labor to feel not like a dying swan chained to a bed, but like a person who is about to have a big event. By the way, in many Russian maternity hospitals, active behavior during contractions is not prohibited, you just need to ask about it, because many doctors don’t say anything like that to their patients, and they lie helplessly on the couch, writhing in pain.

There is an opinion that lying on your back reduces the possibilities pelvic bones to dilatation during labor by approximately 30 percent, andtherefore, horizontal labor lasts longer than vertical labor.

Pushing is easier if the woman is not lying on her back.Horizontal birth requires more effort (the baby moves in fits and starts and the woman actually pushes him up, not down) compared to vertical births. Women who give birth while standing usually need to make one or two pushing movements, and then just tighten their stomach a little so that the baby comes out whole. Why? Because gravity helps.

During vertical pushing, the risk of spontaneous ruptures is reducedperineal tissue, and also minimizes the likelihood of interventions such as episiotomy or the use of forceps.

It is believed that six basic position positions and all their possible variations are well suited for vertical childbirth. : standing (you can rest your hands on the handrails, walls, hands of a partner), standing on all fours (or leaning your body forward, leaning on some surface with your elbows or palms), squatting (usually not practiced in Western culture and requires certain preparation - if you decide to give birth in this position, you need to train throughout pregnancy to give the body the opportunity to get used to this position), sitting with your legs wide apart (for this, in fashionable maternity hospitals there are special seats, the idea of which was not so has been greatly rethought since its existence ancient civilizations), sitting on your knees.

Modern clinics, including those in Russia, have everything necessary for vertical childbirth. There are special transforming beds that allow a woman to take the most comfortable vertical position for her. If necessary, a special “horizontal bar” is raised right in front of the woman in labor, on which she can lean so that pushing is as effective as possible.

However, one must understand that vertical childbirth is not always a good idea, and they are not shown to all women in labor. Firstly, you need to have enough stamina so that by the time you start pushing you don’t collapse on the couch from fatigue and send all supporters of nature and lovers of naturalness away. Secondly,any pathology of pregnancy is direct contraindication to vertical childbirth. In addition, the vertical position during contractions and pushing during premature birth, and also if the baby weighs significantly more than three kilograms, it is traumatic for both the child and the mother in labor.

Today, more and more pregnant women are striving to find the least painful and productive method of giving birth to a child. WHO specialists also support mothers in this regard, recommending the use of alternative “schemes” of childbirth. One of them is the vertical position of a pregnant woman during the birth of a baby, the so-called vertical birth.

But calling them an “alternative” and “new” method of childbirth is still not entirely correct - the tradition of giving birth this way existed in many countries until the 18th century. It was at this time - approximately three centuries ago - that it became fashionable to place the expectant mother in horizontal position King Louis XIV introduced the birth of a child, wanting to see the birth of his favorite. The tradition of giving birth in a horizontal position has survived to this day, although the idea is increasingly heard that a much more physiological and preferable way for a woman to give birth is the vertical position.

Vertical childbirth: pros and cons

Vertical childbirth is a technique according to which the woman in labor does not take a horizontal position at the moment of the onset of labor, but has the opportunity to move freely, look for the most comfortable position for herself, in which the least discomfort is felt.

Pros of vertical birth

It is believed that uninterrupted physical activity Even at the moment of contractions, it significantly alleviates the woman’s condition; it is not for nothing that in maternity hospitals, expectant mothers are directly recommended to walk and move around during contractions in order to cope with the pain.

At the time of the second stage of labor - pushing - during vertical birth, the woman, again, chooses the most optimal position for herself. For each woman giving birth, this position will be “her own”: squatting, half-sitting, on her knees, standing with a slight bend forward and with emphasis on the bed, standing in a special chair design. For vertical birth, no special equipment or specific qualifications of an obstetrician are required - unless the need to position the woman arises during the birth process itself.

However, experts say: as a rule, such situations practically do not arise. According to them, vertical birth can rightfully be called soft, it is less traumatic, accompanied by less blood loss, and ensures easier passage of the baby through the birth canal. Vertical birth, experts say, is much preferable for both mother and baby.

For a woman in labor - in the sense that it is easier to bear: the fetus, due to gravity, gradually and naturally puts pressure on the lower part and cervix; thus, the uterus opens gradually, and then the baby moves along the birth canal due to its own weight. Due to the fact that the woman is constantly in motion before pushing, the pain is felt less and is required less often. In addition, physical activity significantly shortens the stage of contractions - by 2-3 hours. And the fact that, having passed through the birth canal and “pushed” with its shoulders into the light, the baby continues to slide out more easily, reduces the risk of ruptures and the need to cut the mother’s perineum. There is data according to which, if during horizontal childbirth in 25% of cases the perineum has to be cut, then in the case of vertical childbirth this figure is only 5%. So, even if a fairly large child is born, with a vertical birth only small ruptures are possible, while serious interventions by an obstetrician are practically not required.

Vertical childbirth also has its advantages for a baby, if only because it completely eliminates the possibility of development. Thus, in the traditional position for childbirth - horizontal - the uterus of the expectant mother, which weighs about 6 kilograms, puts strong pressure on the internal organs and blood vessels. This causes decreased blood flow to the uterus and obstructed outflow venous blood from organs. As a result, circulatory disorders can affect oxygen starvation baby. And the process of childbirth in a horizontal position can slow down - due to the fact that in this case there is no uniform and constant pressure of the fetus on lower segment and the cervix. Often the way out of this situation is the use of stimulants and painkillers, which can be avoided during vertical birth.

The duration of the third stage of labor - the period of expulsion of the placenta - is also reduced by vertical birth. This happens for the reason that a woman gives birth to the placenta, already holding the baby in her arms and applying it to her breast. The placenta comes out faster not only due to the vertical position of the woman in labor, but also due to the fact that the uterus contracts simultaneously and due to the baby sucking at the breast.

Cons of vertical birth

Many women who have experienced all the benefits of vertical childbirth advise expectant mothers to choose this particular method of delivering a baby. However, obstetricians warn pregnant women: there are disadvantages to childbirth that you should also be aware of before making a final decision.

The biggest disadvantage is the inconvenience for the obstetricians themselves and their limitation in carrying out certain manipulations, because from this position of the woman in labor, the “field of view” is inaccessible to the doctor. In particular, monitoring the progress of the fetus along the birth canal, its heartbeat and other vital signs with the vertical method of delivery turns out to be somewhat difficult and problematic. But the inability to fully exercise control over the condition of the mother and child carries a certain risk.

Also future mom must understand and accept that the danger and likelihood of complications increases in the case of rapid labor, as well as in cases of disturbances in the structure of the perineum and genital tract. Since vertical birth involves the mother being on her feet (even if on all fours), the use of epidural anesthesia is impossible.

Well, another disadvantage of this type of delivery is the presence of some contraindications.

Contraindications

Vertical birth is contraindicated when we're talking about even about the slightest complications. They may be a large head of the child, hypoxia of the baby,. Also, you should not give birth vertically if there is a need to use obstetric forceps or the need for dissection of the perineum, there are diseases internal organs at the mother's. You should know that when delivering vertically in multiparous women, there is a high probability of a rapid progress of labor and the child receiving birth injuries.

In all other cases, vertical childbirth practically “from all sides” becomes a worthy and more gentle alternative to horizontal childbirth. Another thing is that most maternity hospitals rarely practice this technique, although at the stage of contractions, obstetricians usually advise women to always move more, and only when the uterus is dilated enough do they place them on the table.

Especially for- Tatyana Argamakova

Vertical childbirth is not an innovation, but a revival of experience previous generations. More than two centuries the main role was assigned to the doctor; for him, the horizontal position of the woman in labor is more convenient.

Model For vertical birth
indications for its implementation: disability
milk “comes” How to restore

The more physiological, less traumatic and painful process birth of a child. Now it is offered more and more often, if there are no contraindications, and the expectant mother expresses a similar desire.

How does this happen

Vertical childbirth is carried out, of course, not necessarily standing. The woman sits on a special chair, kneels, holding onto a support, or squats. The pose is chosen that will be more comfortable. Moreover, at any time you can abandon this position and lie on the obstetric bed. The doctor will advise you on the correct decision.

The process is the same as usual:

first period – contractions;
then pushing and the birth of the baby;
The final stage is the birth of the placenta.

During contractions, the cervix opens and the joints of the pelvic bones move apart. These processes themselves are relatively painless. Pain appears due to the resistance of the body's muscles to the changes that occur. The physical activity of the woman in labor helps to ease it.

Less traumatic process

Now this fact is taken into account not only during vertical, but also during horizontal childbirth. A woman is recommended to walk, sit on a fitball, making rotational movements with her pelvis, and “hang” on a support or the shoulders of an assistant. This way the muscles relax and the pain goes away.

At the same time, the cervix dilates faster. Thanks to the activity of the mother in labor, the first birth period reduced by two to three hours. Moreover, the introduction of stimulants and painkillers is not required.

Pushing during childbirth in a standing position is aided by gravity. It is possible to move the pelvis more or less freely, making it easier for the baby to pass through the birth canal. Although this position is less convenient for the doctor, so in case of any complications, he can transfer the woman to the couch. Is it possible?

When giving birth in a sitting or standing position, the placenta is delivered faster. This is facilitated by the very position of the woman’s body, as well as the baby’s sucking of the breast. The blood loss that is inevitable during this process is also reduced.

All of the above is true only relatively. An individual approach is necessary, because what is good for many may turn out to be completely unacceptable for a particular woman in labor.

There are situations when vertical childbirth is not just suggested, but recommended:

the possibility of retinal detachment in a woman in labor;
cardiovascular diseases;
high myopia.

Most of these cases involve a caesarean section. Delivery while sitting makes it possible to avoid this operation and its consequences for mother and baby.

However, this procedure has its pros and cons.

physiological body position;
pain decreases;
The cervix opens faster, the period of contractions is shortened;
pushing becomes easier;
blood vessels are not compressed, vertical birth prevents a lack of oxygen in the child;
the fetus moves more smoothly along the birth canal;
his head is less injured;
the woman in labor gets fewer breaks;
the placenta is born faster;
blood loss is reduced.

not everyone is comfortable with this situation;
It is more difficult for a doctor to control the birth process and perform obstetric manipulations;
epidural anesthesia is not possible;
It is better to use a special chair.

The chair used for upright childbirth is similar to a table with a hole or notch in the middle. There are footrests and hand rests. The woman sits on it, with the pelvis and vagina above the opening. Through it, the doctor admits the child.

How the baby comes out

Now there are couches of a special design on which you can give birth both lying and sitting. But for natural childbirth, the presence of such a device is not always necessary. The woman can kneel, then the doctor will accept the baby from behind. You can squat, but this is the least comfortable.

Comparison with horizontal ones and contraindications

When making a decision, you need to weigh the pros and cons. First of all, it is important to consult a doctor. Not everyone supports this idea, since the possibility of complete control over the process is lost.

But at the same time, more and more obstetricians and gynecologists support vertical birth. They have significant advantages over horizontal ones:

the position is more natural for both the woman and the fetus than horizontal;
the weight of the child and the uterus acts in the right direction - it makes the cervix open faster, speeds up the baby’s progress, while with horizontal ones it compresses the vessels passing under it, and the woman has to work herself;
It’s easier for a woman to watch their progress and participate more actively in the process under the supervision of a doctor.

Contraindications will be:

prematurity;
malposition;
narrow pelvis of a woman;
large fruit;
rapid labor activity;
placenta previa;
the presence of diseases of the internal organs in the woman giving birth.

How to prepare for this

It is better to prepare in the last months of pregnancy. Preparation for vertical childbirth is carried out in almost all courses for pregnant women. But the problem is that not all maternity hospitals are ready to provide such obstetric care.

There are several reasons for this. The presence of a special chair is far from the most important of them. In fact, many doctors, especially old school, do not support this “innovation” at all. But even if the medical staff has such experience, the maternity hospital must have a license to use it.

Therefore, the first step after deciding on a non-standard birth is choosing a maternity hospital. Then you need to consult a doctor; it is also useful to familiarize yourself with the poses in advance.

Postures during childbirth are as follows:

sitting on a special chair or half-sitting - you need support for your legs and arms, the pelvic area should sag over the hole;
squatting independently or with support - this position is considered the best for passing the baby, but can greatly tire the woman in labor;
kneeling with or without support - often used for vertical childbirth, can be seen in many photos;
on all fours – can be used to relax, relieve pain, and reduce the speed of the process.

It’s better not just to study the options, but to rehearse each of them. You can take preparatory courses. They should be conducted by a specialist, preferably on the recommendation of a doctor.

It is necessary to think through all positions during childbirth

When vertical birth begins, the woman will intuitively understand which way is more convenient for her. Sometimes it turns out that it is better to lie on your back - the doctor may also recommend this, even if there are no complications.

The right attitude, preparation, and consultation with a doctor ensure a good outcome for both mother and baby. This fact is confirmed by reviews.

Svetlana Lavrikova:

I practically didn’t feel the pregnancy, except that I went for tests, and then the baby started pushing. Long before I even became pregnant, I knew that I would have a vertical birth. I studied a lot of information on the Internet. I had to visit several maternity hospitals, and it turned out that they don’t do this everywhere. I found “my” doctor after going to her for consultations several times. Everything was explained to me in advance. I felt completely ready. Although it was painful from the very beginning. Thanks to the doctor and midwife, they supported me all the time. I gave birth very easily, except for pain, only two small tears. The very next day she was sitting calmly and upright. And the child is doing great, although he is large, 4100. The midwife said that if it weren’t for the vertical birth, he would have torn much more, and it’s not a fact that everything would have gone so quickly.

Milena Elizarova:

The first time I gave birth was very difficult. I then recovered for more than a month. And six months later I found out that I was pregnant again. It became scary, but we decided to give birth. I didn’t even know what vertical childbirth was. The contractions went quickly and much easier than the first time. The attempts began, but the head did not come out. The doctor said, get up, kneel down, we will give birth standing up. I held onto the headboard and did what I was told. It felt like the baby was coming out and going downstairs on her own. The kind of effort that I made the first time was not necessary at all. Now I recommend vertical birth to everyone who wants to easily give birth to a healthy baby. Of course, if there are no complications.

Contents:

Increasingly popular in Lately vertical birth occurs when a woman does not lie down, but either stands or sits, while choosing the most comfortable position for herself. Like any innovation, this method of delivery has already acquired its ardent fans and malicious opponents.

It has its pros and cons, which should be assessed and weighed in advance before deciding whether to give birth this way. The more informed the couple is, the easier it will be for them to refuse or agree to vertical birth.

In Europe and Russia today there are ongoing debates about which childbirth is better: vertical or horizontal - and why suddenly everyone began to switch to new way delivery. In fact, it is not a discovery, since in the old days, and even in the countries of Asia and Africa, women gave birth standing (or, in extreme cases, sitting). So there is no need to talk about innovations and traditions. And yet, the transition to vertical childbirth is due to the following factors (which are their undeniable advantages).

No squeezing occurs blood vessels, the child is provided with oxygen, the risk is reduced to a minimum.
Vertical childbirth is always carried out with a partner, which makes the young mother’s condition easier: she can hold her husband’s (mother, friend) hand, talk, and take her mind off painful sensations.
The woman in labor chooses a position that is comfortable for her, which reduces the pain of contractions. She can change her body position whenever she wants.
According to statistics, vertical childbirth rarely ends with the administration of painkillers, which has a positive effect on the development of the baby.
The cervix opens quickly as the baby's head presses on it. As a result, a smooth and rapid opening of the uterine pharynx occurs.
Vertical childbirth is shorter by a couple of hours compared to horizontal labor.
Pushing is less painful as gravity helps the baby move down the birth canal.
It is easier to push while standing than lying down.
At the pushing stage, the muscles of the peritoneum, pelvis, legs, and back are involved, so the pushing is productive, smooth and soft.
The size of the pelvis and birth canal increases, which makes it easier for the child to travel.
The same statistics show that injuries to women in labor during horizontal births occur in 5% of cases, and during vertical births - in only 1%.
Ruptures with this method of delivery are very rare.
During vertical birth, the use of forceps to remove the baby from the womb is excluded.
The number of complications in babies after vertical birth is estimated at only 3.5%, and as a result of horizontal birth, this figure increases exactly 10 times and is 35% (most often it is a cephalohematoma - a tumor on the head due to the accumulation of blood).
The afterbirth comes off much faster.
Almost instantaneous birth of the placenta reduces blood loss down to 100-150 ml (instead of the usual 300-400).
The likelihood of infection of the uterus is very low.

There are even medical indications for vertical childbirth. In particular, this high degree myopia (myopia) and pathology of the heart or blood vessels. In this case, this method of delivery is an excellent alternative to cesarean section, which is undesirable. It seems that everything is perfect, but it was not so! To accept correct solution, you need to weigh the pros and cons: study reverse side medals, i.e. disadvantages of vertical childbirth.

Through the pages of history. According to ancient Russian sources, midwives forced women to give birth while standing, so the technique of vertical childbirth is as old as the world.

Flaws

There are far fewer disadvantages than advantages, but you should not rejoice at this fact. Ignoring each of the minuses threatens serious consequences for the health and even life of both mother and child. The disadvantages of vertical childbirth include:

poor-quality monitoring of the progress of the fetus along the birth canal by an obstetrician-gynecologist: he is simply inconvenient to do this;
Accordingly, there is no opportunity to constantly monitor the child’s heartbeat: if there are problems, help may simply not arrive in time;
inability to relieve pain;
if the structure of the perineum in a woman has pathologies, there is a high risk of deep ruptures, which could have been avoided if the woman in labor had been lying down;
repeated vertical births, which can lead to birth trauma for the baby.

Is the couple ready to take such a risk, preferring vertical childbirth? It is also worth thinking about the fact that most maternity hospitals are not equipped for this method of delivery. In particular, there is no specially designed chair, which is available in all hospitals abroad. Among other things, the disadvantages include a large number of contraindications.

That's how it is! Not long ago, a special chair for vertical childbirth was invented abroad. The smallest nuances are thought out in it: the woman is comfortable and comfortable on it, the born child falls into a special hole, which prevents him from getting injured. And yet there is a flaw: it is very inconvenient for a gynecologist to track the baby’s path and the condition of the female perineum with such equipment.

Contraindications

If a couple has decided to give birth vertically, the doctor may prohibit them from doing so if the woman in labor has contraindications to this method of delivery. These include:

complications of any kind (both for the young mother and the baby);
premature birth;
narrow pelvis (clinical or anatomical);
the need for obstetric forceps;
serious illnesses;
fetal hypoxia;
large size of the baby's head;
the need for dissection of the perineum.

Vertical birth after cesarean section also raises discussions: some consider this operation to be a contraindication to this method of giving birth to a second child. Among the reasons is the risk of seams coming apart. However, most doctors do not see caesarean section prohibition for a baby to be born as a result of such a procedure. One way or another, the decision is made by the future parents, and specialists (doctors) approve it or refuse it. If all doubts are behind you, you need to be able to properly prepare for such an important event.

Interesting fact. In Switzerland, a monument to a woman giving birth to a child vertically has long been erected.

Preparation stage

Preparation for vertical childbirth does not include anything supernatural. It is practically no different from the usual ones and boils down to the following activities:

Try a fitball, which will teach you how to relax your muscles.
Master the techniques.
Study all possible poses that are applicable within this technique (squatting alone; squatting with a partner; squatting with support; on all fours; on knees; knee-elbow birth position; half-sitting, sitting).
Decide who will be your birth partner.
Take special courses.
Find an equipped clinic and a doctor experienced in this matter.
Be under constant supervision by a gynecologist throughout pregnancy.

If the gynecologist observing the young mother already has experience in vertical childbirth and even advises her to give birth this way, it’s worth a try. If there is even the slightest doubt, it is better to refuse. In Russia there are still too few clinics equipped for this method of delivery, and maternity hospital staff are not yet prepared for them. Perhaps, after a very short time, this is how most babies will be born, but for now it is too far from a safe and painless practice.

Natural delivery, including vertical birth. And for most women, this practice seems surprising and new, although in fact it is a well-forgotten old thing. But why similar births is it better than the usual lying position, is it comfortable for the woman and the staff, is this method of delivery suitable for all women? We will understand all the nuances and subtleties of this process.

Historical data

If you study books on history and ancient medicine, as well as evaluate the obstetric customs of many nations, then the birth of children in the position that is considered traditional today appeared only a few centuries ago. By the standards of human existence, this is a very short period of time. In ancient times, childbirth took place in a standing position, or women squatted, which was more convenient from the point of view of the physiology of the process. Thus, African women, as the birth approached, went further into the forests from people, holding on to tree branches or poles, they performed a series of successive squats and lifts while contractions were going on, and during pushing they squatted down, tensing their abdominal muscles.

In India, women often gave birth while hanging on tree branches, and ancient peoples even had special birthing chairs, chairs that had special armrests and a cutout in the seat area. Many ancient cultures imagine female goddesses squatting during childbirth, with the head of the emerging baby between their legs.

The modern version of childbirth, according to some data, appeared in France, at the birth of an heir Louis XIV. The women were placed in the traditional position for today's childbirth, so that His Majesty could witness the birth of the heir in all details. There is also evidence from sources that doctors at one time supplanted midwives and midwives by placing women on their backs; it became more convenient for them to carry out obstetric benefits(forceps, manual assistance).

note

Gradually, childbirth on the back, when the woman takes a horizontal position, became widespread. But more and more people can hear the opinion that this position during childbirth is not entirely optimal and natural.

Naturalness or convenience?

Most maternity institutions today at the birth of children naturally They use a traditional position - the expectant mother gives birth lying in a special (Rakhmanov) maternity chair. But it turns out that for a woman, if she is lying down, she no longer has such an active role throughout childbirth, and one can often hear arguments about how such a position is not so physiological for the child, not to mention how uncomfortable it is for the mother.

If the state of health and natural childbirth allow, the expectant mother can, as she feels, choose for herself the position, the pose that is most optimal for her, while they are walking. Such activity and movements around the delivery room contribute well to the opening of the cervical pharynx, accelerating the birth process. This also reduces the need to either induce labor with medication. When pushing, it is also worth taking a position in which it will be most comfortable to push, and the strength of pushing will be maximum for the speedy birth of the child.

Biomechanics of childbirth

If they talk about vertical birth , they mean a way of giving birth to children, which implies the position of the expectant mother with the pelvic axis perpendicular to the ground all the time from the beginning of contractions until the delivery of the placenta. That is, her pelvis is in a vertical position, she can stand or squat, or kneel. If this traditional childbirth When a woman in labor lies on her back, the large uterus with its weight presses on the vessels running along the spine. In this zone passes (collecting blood from the pelvis and legs) and abdominal aorta(carrying blood to the lower part of the body). In general, the uterus, if you calculate its weight by the end of gestation, adding amniotic fluid plus the mass of the baby, will average up to 7 kg, which significantly reduces the blood flow through the narrowed aorta to the pelvis, limbs and abdominal cavity. Accordingly, the blood flow in the area of the walls of the uterus, plus the vessels of the placenta, and therefore in the fetus during childbirth also suffers.

And a decrease in the lumen of the vein forms congestion in area lower limbs, as well as the venous plexuses of the pelvis. Venous return to the heart area is reduced, which worsens general circulation and creates disturbances in the placenta system, as well as the uterine walls and fetus.

In addition, there is no pronounced and uniform, constant pressure that the baby's head exerts on the lower part of the uterus (cervical area), and the effect of the amniotic sac as a hydraulic wedge is reduced. This can slow down the progress of labor and also creates the need to use pain relief and drugs that stimulate contractions. Vertical childbirth partially solves a number of these problems.

Doctors' opinions on vertical birth

Today, vertical birth, unlike many other options for obstetric care, is officially recognized by the medical community and is practiced in maternity hospitals (not all, only some). This is justified by their biomechanism. When the woman in labor gets to her feet, sits in a maternity chair with a recess, or squats, if she kneels, the pressure from the uterus on the area of large vascular trunks is reduced, and the uteroplacental blood flow is normalized. This reduces the risk of fetal hypoxia, not only during contractions, but as they turn into pushing, when the baby passes the area of the birth ring (bones and soft fabrics, components of the perineum).

Due to the intense pressure exerted by the presenting part (for vertical birth it must be the head), as well as due to the fetal bladder, which forms a hydraulic wedge, a smoother and more active opening of the cervix occurs with the formation of the birth canal. This helps shorten the first period and relieves pain during contractions. Reducing labor time is always a positive thing for children and female body , because each contraction is a temporary depletion of oxygen uterine wall with the placenta, which means temporary.

Pros of vertical birth

According to experts, the vertical position allows you to use the forces of earth's gravity so that the fetus moves faster and easier inside the birth canal. This reduces the risk of injury to the fetal head during childbirth, as well as the mother’s soft tissues due to the slow and smooth advancement of its head. During the pushing period muscle tension, which is necessary in order to expel the fetus from the uterus, will be minimal. This occurs because it works well together skeletal muscles and the force of gravitational attraction acts, and the muscles on the pelvic floor relax at this moment. With this influence, the birth canal can more easily adapt to the size of the fetal head; they stretch and seem to flow around the fetus. The need for incisions in the perineum or its ruptures when practicing vertical delivery, according to statistics, occurs less frequently.

note

The pressure of the presenting part (which includes the fetal voice and the anterior zone of the amniotic sac) against the background of labor with an occipital presentation can help increase intrauterine pressure with each push. This helps the uterus contract more efficiently and reduces pain.

The woman in labor taking a position on the crusts or sitting in the birthing chair helps to increase the size of the pelvis due to the fact that the location of the pelvic bones changes. Plus, the woman actively participates in the birth of the baby; she herself sees the birth of her baby. According to separate studies, an upright body position has been shown to reduce the release of stress hormones, which reduces the feeling of fear and anxiety in the mother. Due to the vertical position of the woman’s body, the placenta comes out faster, the total blood loss during childbirth is also reduced, amounting to about 150 ml, compared to the usual up to 400 ml.

The positive aspects of vertical childbirth are identified and scientifically substantiated throughout the entire birth experience: during contractions they become easier painful sensation and the duration of the opening stage, during the attempts the passage of the baby through the birth ring is facilitated, in the third - the placenta leaves faster and less risk blood loss and complications with retained placenta.

Indications for vertical childbirth

It is important to understand that the indications for vertical childbirth are strictly individual: what is good for one expectant mother may negatively affect the condition of another. However, there are situations in which vertical birth is recommended and shown as the most best option the birth of a child. This should include:

vision problems if normal birth probably
pathologies of blood vessels and heart without circulatory disorders
more than 6 diopters.

Vertical birth is prohibited if there is confirmed improper attachment of the placenta (partial or complete), as well as against the background of existing serious somatic pathologies. In each situation, if a woman expresses a desire to give birth in an upright position, the situation is assessed specifically. If there are no contraindications, then you need to select a maternity hospital based on whether such births are practiced there or not.

Choosing a maternity hospital

Today, vertical childbirth, although recognized official medicine, but they are not practiced in all maternity hospitals, especially free of charge. Moreover, in every maternity hospital they can go to different versions. Therefore, for each city it is worth finding out in advance which of the medical centers practices these births, how much they cost and whether they can be carried out within birth certificate. Some maternity hospitals are reluctant to do this even if they have a contract.

Most maternity hospitals practice elements of vertical childbirth only during contractions, and pushing is carried out in the classic position on the back in a chair. If childbirth is carried out vertically from beginning to end, the maternity hospital often offers special training courses before it.

How to prepare for childbirth?

If a doctor has cleared a woman for vertical childbirth, she must first undergo preparation for it, and this must be done as early as possible, not before the onset of labor, but in advance, at least three to four months in advance. This will help you study theoretical materials, watch videos of such births and mentally tune in and prepare. You need to practice preparing for childbirth as such in advance by attending preparation courses for future births in antenatal clinic or paid centers, at maternity hospitals and children's centers.

It is also important when preparing to make sure that the maternity hospital has a license for this type of practice and at the expected time of your birth it will not be closed for a scheduled “wash”, and your plans for childbirth in an upright position will not be disrupted. After concluding a contract for childbirth, it is worth once again discussing all the nuances with the doctor who will manage your childbirth, and he will help you become familiar with the positions that are practiced. It is important to know about all of them, because it is not known which of the selected ones will be most convenient during the birth of the baby, it is worth trying them all at home in advance.

Alena Paretskaya, pediatrician, medical columnist