If for so many centuries we have given birth vertically, we can still do it

We started this week joining the celebration of the #WorldWorldBirthWeekend, and Nati told us that the process of applying the WHO recommendations on the use of technology during birth was being slow. We remembered then that "It is possible to take into account the preferences of women and reduce interventionism", to the benefit of both the mother and the baby.

A few days later, Valeria removed the blindfold with this reality: "women experience humiliation and depersonalization" in such an intimate, vulnerable and IMPORTANT moment, such as the delivery of her children. He pointed out the lithotomy position that many of us have seen ourselves in, and WE HAVE seen in the movies: lying on delivery tables that sometimes look like torture racks. It is not the only hospital protocol that can hinder the progress of a normal delivery, but the fact is that it is logical to think of the vertical position as a facilitator, since gravity favors the baby's push to follow naturally. If you want to know more, I am going to immerse myself more in this way of being born.

A brief note: we read in an entry in The delivery is ours that: "The delivery table has been invented for the comfort of accompanying healthcare professionals" (well, sometimes they rather condition) the delivery. And now I invite you to ask yourself why do you think that historically women have given birth in more or less vertical trunk positions? As it turns out, it shortens and widens the birth canal (by allowing greater opening of the joints), facilitates delivery with less effort, and allows the mother to contemplate the birth of the baby..

Thus, the modernization and instrumentalization of childbirth is not always positive for those who give birth (let us not forget that it is us); but in any case, Nati already said it: It is about being able to choose not only the position, but all the aspects related to that vital moment so decisive. From who accompanies us, to whether we want to eat or drink, or walk between contractions; going through shaving or the right to scream if we feel like doing it (and without anyone inhibiting us).

An upright position is considered to be squatting, sitting or semi-sitting (with the thighs on the abdomen)

If for so many centuries we have given birth vertically, we can still do it.

The Peruvian Ministry of Health, published in 2005 a technical standard for vertical delivery care. It is stated in the document that there was a disagreement between the personnel who attend deliveries (obstetricians, midwives) and the mothers, since the former had been trained to attend while the mother was in lithotomy, and the latter refused to be assisted in health establishments, preferring to give birth vertically.

The rule was intended to seek a balance between modern clinical care and the meaning of the act for mothers. In the Andean country they also existed 11 years ago (as in many western countries today) evidence that vertical delivery is physiological and facilitating.

Is it better to give birth vertically? In the next sub-section we will walk through the advantages of this position. The modernization of science, sometimes makes us believe that traditional practices are no longer valid, even when their effectiveness has been proven. But it is not a question of speaking in very technical terms either, because what is involved here is giving birth, something that women can and know how to do if we trust our bodies; And it is that with this type of articles (necessary, I do not say that not) we want to justify what should be justified by itself.

Engelman (in 1882), described in this documentHow the position adopted by the women we refer to as primitives allowed them to change when they wished; always avoiding being lying down; which had considerable advantages for labor.

The gallery below shows three images of vertical Parthians immortalized by sculptures or drawings of different civilizations. They have been obtained at The Well Rounded Mama.

The vertical posture is more natural.

La Guide of attention to normal delivery of our Ministry of Health, summarizes in this way the evidence associated with the verticality of delivery: "Vertical or lateral positions are associated (compared to lithotomy) with a shorter duration of the second stage of labor, fewer assisted births, lower rates of episiotomies, etc."

But in the West we want to demonstrate even the obvious, although we do not forget that this is due to the medicalization and instrumentalization of childbirth: there is still a way for the doctors who attend deliveries to renounce having control over what happens, to give in the prominence to mothers. Without prejudice that, taking advantage of the hospital facilities, any anomalous situation can be dealt with quickly.

Vertically, the woman's pelvic canal and her trunk are at a more flattering angle with respect to the horizontal plane.. The most common upright posture seems to be sitting (there are special chairs or stools) or semi-recumbent. And since the ideal would be that we could choose positions, there would be someone squatting, kneeling or standing.

The advantages.

The descent of the baby through the birth canal is favored by gravity; the uterus does not put pressure on the lungs helping the mother to relax. Labor may take less time, because as noted above, the canal shortens. Also, not as many episiotomies are necessary, and the tear rate is reduced. No less important are the feeling of freedom and control over the process that mothers have, which directly influences their satisfaction.

We do not have to learn to give birth, because we already know how to do it. Or not?

What has happened to us so that being designed to effectively play the leading role in the processes of pregnancy, childbirth and lactation, we are so far from our nature?

Some months ago I read this interview with the famous obstetrician Michel Odent, which we know both for his books ("The baby is a mammal", among others), and for claiming the biological need of mothers and babies to stay together after birth. As you can imagine (if you do not know him) he is an advocate of natural childbirth, and does not hesitate to point out the artificiality of the birth process, as the cause of possible traumatic situations in the woman and her baby.

In this interview, he said that he has a thesis: "medicine is neutralizing the laws of natural selection", because we interfere with the BASIC LAW that has allowed us to colonize the planet. This man is very wise, because he has more questions than answers (and the knowledge belongs to the questioner). The most difficult part to read is a phrase that refers to the loss of the ability to give birth and breastfeed children, due to excessive dependence on medicine.

And to end this brief review, Odent reminds us (as he has done dozens of times) that the mother should feel safe and protected during childbirth, needs darkness and silence; and that does not need support, referring with this last sentence to the justification of the masculinization of childbirth (and I understand that it refers both to the presence of a male partner and to the intervention of doctors). Phew! reading Odent is always a bit unsettling to me, he's so right.

The conclusion is that we mothers do not intend to shy away from medical advances rather, they allow us to ask for them when necessary; but also have more freedom about the way we want to START.