Alternative Therapies: The Squatting Position During Labor Alternative Birthing Presentation HH382.04, San Francisco State University

Introduction to Alternative Birth Options & the Squatting Position §“There is no single position for birth. Labor is a dynamic, interactive process... [and the] woman may want to assume various positions for childbirth, and she should be encouraged and assisted in attaining and maintaining the position of her choice (Lowdermilk & Perry, 2003).” §“Squatting is highly effective in facilitating the descent and birth of the fetus. It is considered to be the best position for the second stage [or pushing stage] of labor (Lowdermilk & Perry, 2003).”

Squatting Position: Advantages §Decreases the amount of time mother pushes during labor §Reduces the necessity for forceps use on infant §Lessens the use of episiotomy to aid in labor, due to “relax[ing] and stretch[ing] of the pelvic floor muscle” §“Shortens the depth of [mother’s] birth canal” §“Increases pelvic diameter by 10+%” §“Encourages and strengthens the intensity of contractions, while relieving back pressure”(Weiss, 2003) §Improves blood circulation of fetus §Improves health care practitioner’s access to mother’s perineum §“May increase pelvis diameter by as much as two centimeters” §“Uses gravity” to assist with birthing process(Perez, 2003)

Squatting Position: Disadvantages §Use of this position is exhausting to mother §The health care practitioner monitoring the infant may have difficulty hearing fetal heart tones §This position impairs the mother’s ability “to assist in delivery” (Perez, 2003)

Positioning of the Mother §“Women should assume a modified, supported squat until the fetal head is engaged, at which time a deep squat can be used (Lowdermilk & Perry, 2003).” §A firm surface is required for this position, and the woman will need side support (Lowdermilk & Perry, 2003).” §If the mother is interested in supporting herself, a squat bar can be attached to a birthing bed to allow for her to maintain the squatting position (Lowdermilk & Perry, 2003).

Use of the Squatting Position in Combination with the Birth Ball §“A birth ball can help a woman maintain the squatting position (Lowdermilk & Perry, 2003).” §“The fetus will be aligned with the birth canal, and pelvic... relaxation will be facilitated as she sits on the ball or holds it in front of her for support as she squats (Lowdermilk & Perry, 2003).”

Other Alternative Positions & Tools to Aid During Birth §Standing Position: This position allows the mother to remain upright, increasing the diameter of her pelvis by approximately one centimeter due to the downward pressure on the mother’s pelvic region. §Birthing chair/stools: Birthing chairs/stools, such as rocking chairs, permit the mother to remain in a sitting position during birth, which “enhance[s] bearing down efforts during childbirth.” §Beanbag chairs or floor pillows: “mold around and support the mother in whatever position she selects” §Side-lying position: This position “is an effective position for the second stage, with the upper part of the woman’s leg held by the nurse or coach or placed on a pillow.” §Hands-and-knees position: This position “enhances placental perfusion, helps rotate the fetus from a posterior [or back] to an anterior [or front] position, and may facilitate the birth of the shoulders, especially if the fetus is large.” (Lowdermilk & Perry, 2003)

Conclusion §Alternative birthing practices provide additional options to all mothers who are currently pregnant or are planning a pregnancy in the future. §Discovering such options provides each mother with the necessary education to consider which choices best suits her ideal birth process. §Therefore, this choice is an individual and personal decision. §Use of the squatting position can be a beneficial alternative approach to delivery and is especially effective during the second stage of labor. (Lowdermilk & Perry, 2003)

References §Active Birth Centre (2003). Retrieved December 4, 2003, from §Lowdermilk, D. L. & Perry, S. E. (2003). Nursing Care During Labor and Birth. In K. A. Piotrowski (Ed.), Maternity Nursing (pp ). St. Louis, MO: Mosby. §McGrath, K. (2001). Childbirth Expert: Is squatting a dangerous exercise late in pregnancy?. Retrieved November 30, 2003, from §Mother’s Care Doula Services, Inc. (2003). Birthing Balls. Retrieved December 4, 2003, from §Perez, P. G. (Reviewed 2001). Birthing Positions. Retrieved November 30, 2003, from 1,00.html §Weiss, R. E. (2003). Pregnancy/Birth: Squatting for birth. Retrieved November 30, 2003, from