Vertical childbirth: a return to ancient traditions

Just recently, the question of what position to give birth in did not arise for anyone. All women gave birth lying on their backs on a special bed. And there were no other ways. But about 30 years ago, vertical childbirth appeared in America and Europe, that is, childbirth in a standing position (on knees or all fours), half-sitting, squatting or sitting in a special chair. And now they give birth vertically in Russia.

Let's go back to history

Vertical births are not something new; they existed before, and even now such births are preserved in some countries in Asia, Africa, and South America. They also gave birth vertically in Europe: for example, in Holland, until the last century, the bride's dowry included a chair for childbirth. Until the 16th century, women in France gave birth mainly on all fours, and in Germany - on a chair. In Russia, women previously also gave birth, if not completely vertically, then certainly actively: midwives did not allow the woman in labor to remain in one position for a long time and the expectant mother often took a vertical position. For example, during contractions, a woman usually walked around the hut and leaned on the benches. According to popular beliefs, she had to unlock all the locks, untie all the knots and constantly step over all the thresholds, raising her legs high.

But over time, obstetrics became not a natural process, but a medical one, all kinds of obstetric manipulations began to be used during childbirth, and doctors appeared instead of midwives. It was then that the birth “moved to a horizontal position” - this made it easier for doctors to monitor the condition of the woman in labor, and in case of emergency it was more convenient to provide medical assistance. So, almost only in the last 200–300 years, women began to give birth lying down.

Postures for such delivery

Modern vertical childbirth involves various positions:

  1. Sitting or half-sitting. At the same time, the woman rests her hands and feet on a special device with a hole (chair, chair). She can also lean on her partner.
  2. Squatting (support is similarly possible). This position is most convenient for moving the baby along the birth canal, but it quickly tires the woman.
  3. Kneeling (again, on your own or with support).
  4. Standing on all fours (knee-elbow pose). This position allows you to rest during contractions and reduce pain.

    Vertical childbirth does not require a specific position - there are many of them

As labor progresses, the woman will intuitively understand which position will be most comfortable for her. Although you can try different options at home in advance.

Chair for vertical childbirth

As already mentioned, there is a special chair for vertical childbirth. It allows a woman to take a variety of poses and even lie down. The pelvis will always be suspended.

Since this chair is low, it is not very comfortable for the doctor. He will have to bend down or kneel all the time. Perhaps this is why obstetricians are not very fond of vertical birth.

The chair is comfortable for a woman, but not very comfortable for the doctor leading the delivery.

What is vertical childbirth?

Nowadays, if vertical childbirth has changed at all, it is very little.

When giving birth vertically, a woman, as before, can, at will, stand, walk, squat or half-sit on a special chair.

It turns out that the chair has become more modern.

Attempts also take place vertically: squatting, kneeling with your back to the obstetrician on a regular bed, standing or sitting in a special chair with a hole in the middle. The placenta is born when the mother is already sitting with the baby in her arms. The main difference between vertical labor and horizontal labor is that the woman in labor actively behaves in all periods. Medical personnel only monitor the process.

What are the advantages

It is not for nothing that vertical childbirth has become popular again - it has many advantages compared to childbirth in a horizontal position.

  • When a woman lies on her back for a long time, the large uterus presses on the inferior vena cava. Compression of the inferior vena cava is fraught with a decrease in the return of blood to the heart and stagnation of venous blood in the internal organs; As a result, blood supply deteriorates and the child may experience hypoxia (oxygen starvation). This condition does not always happen, but it is still better to avoid it. This, of course, does not happen with vertical birth. On the contrary, when a woman sits or stands on all fours, the pressure of the uterus on large vessels decreases, which improves uteroplacental circulation and prevents the development of hypoxia in the child both during contractions and when the head passes through the birth canal.
  • If during contractions a woman in labor does not just lie in bed, but moves and takes a position that is comfortable for herself, she is actively participating in the birth process. This behavior both physically and psychologically liberates the woman; she feels that she also influences the birth process, that something also depends on her. Well, also changing the position of the body distracts from pain and significantly makes it easier to experience contractions.
  • The baby emerges from the birth canal under the influence of pushing and contractions, but if you take a vertical position during childbirth, then the force of gravity will also act on it. This will speed up the first stage of labor (and it is usually the most painful) - the baby’s head from above puts pressure on the cervix and it opens better.
  • In some positions, for example, squatting or on all fours, the dimensions of the pelvic cavity and the birth canal expand, which also makes it easier for the baby to pass through the birth canal.
  • With vertical birth, the duration of the second period increases slightly compared to horizontal birth, but the child moves down more smoothly. This means that the risk of birth trauma in the baby is much less.
  • For many women, it is easier to push in a vertical position, since in this position several muscle groups work coherently - the abs, back, legs and, again, gravity helps.
  • The third stage of labor (birth of the placenta) with a vertical position passes faster than with a horizontal birth, still as a result of gravity. This means that blood loss during childbirth is also reduced.

Why is this so?

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When experienced mothers talk about vertical birth, they usually note the relative painlessness of the process compared to lying down delivery. But this depends on the individual characteristics of the woman in labor, while a number of other advantages have already been recognized by experts:

  • In a lying position, the uterus puts a strong load on large vessels, this impairs blood supply in the body of the mother and child. With vertical birth, this cannot happen, which means the risk of hypoxia in the fetus is reduced.
  • It is believed that in an upright position the cervix opens faster and delivery is easier due to the even distribution of the load inside. The difference between the traditional and vertical methods is about three hours, which saves the woman’s energy for pushing.
  • Due to the fact that the baby comes out evenly, and also faster, thanks to gravity, the likelihood of him receiving a birth injury is significantly reduced. With this method, doctors almost never use forceps or vacuum to remove the baby.
  • Blood loss during childbirth while sitting is also reduced, and a woman in this position can see the process of the baby’s birth and even control it.
  • In addition, it is easier to push in an upright position, because not only the abdominal muscles are activated, but also the muscles of the entire body, legs and pelvis.
  • Attempts are more productive, softer and smoother, and this is the main advantage of such childbirth.
  • After the baby comes out, the new mother takes it and puts it to her breast. She gives birth to the afterbirth while sitting, with the baby in her arms. Due to this, the placenta leaves much faster, because when the baby sucks at the breast, the uterus contracts automatically.
  • Vertically born babies score higher on the Apgar scale.

There are also a number of disadvantages:

  • Vertical birth is more difficult for medical personnel, so for now they remain paid. It is difficult for doctors to control the process of the baby leaving the mother and to provide medical care.
  • Childbirth in this position makes it almost impossible to use anesthesia. Of course, an experienced doctor will be able to do an “epidural” so that pain is not felt and the legs obey, but it is unknown how such pain relief will affect the woman in labor.
  • Vertical birth is prohibited in case of complicated pregnancy, premature and repeated births (as they can be rapid).
  • Despite a pregnant woman's wishes, there is no guarantee that vertical birth will actually work for her. You can figure out whether such a position is comfortable during contractions and pushing in a particular case directly during childbirth.

Are there any disadvantages?

Let's just say that there are practically no disadvantages to vertical childbirth. There are some peculiarities.

When a woman gives birth vertically, it is more difficult for the doctor and midwife to monitor the progress of the baby through the birth canal (that is, conduct a vaginal examination). In addition, some obstetric manipulations (for example, an incision in the perineum when there is a threat of its rupture - episiotomy) are simply technically impossible to perform in an upright position. Of course, doctors who perform vertical births have already adapted to how they control such births, but the fact that if an episiotomy is necessary they will have to quickly take a horizontal position also needs to be taken into account.

As for anesthesia during vertical childbirth, this can also be done.

If epidural anesthesia is administered correctly and the dose of the medicine is correctly calculated, then the woman’s legs will not be taken away, she simply does not feel pain, but she feels her body below the belt. For example, a woman in labor can sit on a ball and even walk. Sometimes your legs feel weak at first, but this feeling quickly passes.


Gynecologists note the undoubted advantages of vertical delivery. These include:

  • the blood vessels of the pelvis are not compressed;
  • the child’s oxygen supply is not disrupted;
  • faster opening of the cervix due to constant pressure from the baby’s head;
  • childbirth is less painful for a woman;
  • a woman can actively behave during childbirth, choose a comfortable position;
  • the period of pushing is less long and painful;
  • the entire process of delivery proceeds faster than in a horizontal position;
  • the size of the pelvis increases;
  • the risk of injury to the child during passage through the birth canal is reduced;
  • the risk of complications for women is reduced;
  • very rapid passage of the placenta;
  • During childbirth, blood loss is reduced.

In obstetric practice, there are cases when vertical delivery is recommended. This applies to cases when a woman needs to eliminate or shorten the period of pushing.

Should I or should I not?

Vertical childbirth is officially accepted and allowed by medicine. There is no need to organize anything for them, no special equipment is required, the only thing needed is a doctor and midwife who know how to perform such births, the mother’s desire and the absence of contraindications to give birth vertically.

The first condition is that medical staff skilled in vertical childbirth techniques are not yet available in all maternity hospitals, but they can be found in large cities and modern medical centers.

The mother’s desire is also an important factor: the woman must be determined and mentally prepared for active childbirth, she needs to find out what positions she will need to take, it is advisable to even take special courses and even rehearse some positions during childbirth. By the way, during childbirth, a woman’s wishes may change; at some point she may want not to stand or walk, but, on the contrary, to lie down. And this is a completely normal desire.

If pregnancy and (or) childbirth occur with complications and medical assistance is required during the birth of the child, then vertical birth is either difficult or completely impossible.

For example, if a woman has high blood pressure, she often needs to give birth in a horizontal position. Or if a child is born in a breech presentation, during such a birth he must be provided with certain obstetric assistance (take it differently than with a cephalic presentation), that is, the active assistance of a doctor and midwife is required. This can only be done if the woman is in a horizontal position. I am glad that there are not so many contraindications to vertical childbirth, these could be:

  • any pregnancy complication, such as increased blood pressure;
  • premature pregnancy;
  • rapid and rapid childbirth;
  • improper attachment, placenta previa;
  • hypoxia in a child;
  • breech presentation.

What does vertical birth look like?

During contractions (in the first stage of labor), a woman can take any position convenient for herself. You can stand, walk, lie down, half sit, get on all fours, sit on a fitball, hang on a wall bars or rope (if they are available in the maternity hospital). Many maternity hospitals have special transformable chairs in which you can also find a comfortable position. But even if there are no additional devices in the maternity hospital, you can still give birth vertically. Walking, standing and getting on all fours - you don’t need any equipment for this, but you can hang on the neck of your partner (usually your husband) or stand with your hands on a table or windowsill. In the second stage of labor, when the birth of the child is already taking place, it is necessary to take a special position: half-squatting, kneeling, standing or sitting in a specially designed chair. There is nothing complicated in these positions, this is the usual position of our body, you just need to choose the most suitable and comfortable one for the birth of a child. When giving birth to the placenta (third stage of labor), the woman again remains in an upright position. By the way, at this moment the mother can take the baby in her arms and put him to her chest.

In general, now in almost all Russian maternity hospitals traditional childbirth is not carried out as conservatively as before: in the first period, the woman takes the position that is comfortable for her, that is, during the period of contractions she can not lie passively on the bed, but move.

And this is not only not prohibited, but, on the contrary, is welcomed by doctors. Well, pushing and the birth of the placenta usually take place while lying on your back on a special chair-bed. It turns out that a woman spends most of her childbirth vertically.

If the expectant mother wants to give birth vertically “from beginning to end,” then it is better for her to find a maternity hospital where there are specialists who know the technique of performing such childbirth.

If a woman in labor spends a lot of time not lying down, but in an upright position, nature itself helps her and her child. The force of gravity gently “pulls” the baby down, it puts more pressure on the cervix, which opens more efficiently and more gently - childbirth proceeds more naturally and easier.

If no unforeseen complications arise during childbirth, it is better to carry it out freely, in movement and even in dance!

Now in Russia there are still few maternity hospitals where all periods of childbirth take place in an upright position. In some maternity hospitals, vertical childbirth is possible only with the conclusion of a contract - this, again, is due to the fact that in the maternity hospital there are only a few obstetricians-gynecologists who are proficient in the technique of performing such births.

How to prepare?

First of all, of course, consult your doctor to see if there are any contraindications for not giving birth horizontally. Next, find a maternity hospital that has everything necessary for vertical childbirth - from equipment to personnel. Experts also strongly recommend that the expectant mother study in advance all possible positions during vertical childbirth and do not settle on just one, since it is unknown what will actually be less painful and more comfortable during the delivery process. Let's consider different options:

  • Squatting. It is considered the ideal position for vertical childbirth: the perineal muscles are relaxed, the pelvic cavity is expanded, and even if it would be difficult for the baby to pass through the mother’s narrow pelvis in a horizontal position, then he has a better chance of passing vertically. This position relieves lower back pain in a woman giving birth and speeds up labor a little, because under the pressure of the baby’s head, the cervix opens faster and contractions become more intense. You should not take this position all the time in the first period, because your legs may get tired. But when the pushing begins, it’s time to squat down and push. In this case, it is better to spread your knees wide to the sides and rest your elbows on your legs. You can rest between attempts by standing on all fours.
  • Squat with a partner who will stand behind and support the woman in labor. To do this, he will need to lean against the wall, headboard or sit on a chair. Such assistance will allow a woman to reduce the load on her legs and become less tired during childbirth.
  • Squatting with the support of a partner. You need to spread your legs shoulder-width apart and hang onto your assistant, who will support the woman in labor from behind. At the same time, the stomach is relaxed, the legs hardly strain. Many women find it more convenient to sway a little to the sides; they say this reduces pain. This position makes the most of the force of gravity, and it is easier for the baby to pass through the relaxed birth canal.
  • Standing on one knee, the other leg stands as if in a squatting position. The legs can be changed periodically, due to which they will not get too tired. In this position it is very convenient to sway and move to other positions. It is believed that in this position labor can be somewhat slowed down.
  • Knee-elbow position. If you bend over in this position and lower your head below the level of your pelvis, the contractions will seem less painful and the desire to push will decrease.

Let us note once again that regardless of whether you chose horizontal or vertical labor, it is still better to spend the first period in motion, stopping only during contractions. This way you can be distracted, and it will be easier for the baby to move along the birth canal. Therefore, it is worth taking any position already when trying to directly give birth to the child and the placenta. The woman in labor can also take a semi-sitting position or lying on her side to make it more convenient for doctors to monitor the process. In this case, you can change the position to a vertical one at any time if it seems easier and more comfortable.

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