Disclaimer: The techniques mentioned in this post are not guaranteed to work for everyone every time. You know your body best. Always consult your trusted healthcare providers when taking on any sort of exercise or adjustments to your normal routine. Full disclaimer here.
There’s one major secret to laboring efficiently and expelling a child without surgery. Get it wrong, and your likelihood of ending up in the OR is through the roof. Get it right, and labor will be as short, easy, and painless as it can be. (I mean, let’s not be crazy, it’s still labor.) But nail this, and it’ll be much closer to the birth of your dreams.
That’s it. Sounds simple, but there’s a lot of factors around positioning to get that baby into the pelvis, through the birth canal, and out the door. Let’s break it down.
Contractions work to open up a cervix evenly, efficiently, and all the way if there is pressure on that cervix. Without the pressure, contractions make your cervix soft and your uterus super tired, and that's about it. Which is why a baby should be “engaged" well before the start of labor (we can help guide your babe there, so read on.)
Flexion is a major piece of the puzzle for the smoothest, easiest, and most efficient labor possible. Flexion= baby's chin to chest, crown of that baby’s perfectly flexed head sitting squarely on top of your cervix. Anything else on top of that cervix- feet, forehead, side of the head, head slightly cocked to one side or facing your belly or any number of other things that babe might do- means everything is harder, and might not work out without intervention.
Pelvic Ligaments, Joints, and Muscles.
A “perfectly applied head” (this ‘crown of perfectly flexed fetal-head-directly-over-cervix' situation)- often doesn’t happen on it’s own. Why? Because we live, we women, and as we do, the dozens of ligaments and muscles in our pelvis get (unevenly) wound tight. And the bones that they’re attached to get closer to one another than they should, and so the outlet (baby’s exit space) gets smaller than it naturally would be. If you’ve ever had a fall or car accident, been active in dance or sports, been injured, carry your bag on one shoulder, basically if you’ve lived- your pelvic ligaments and joints won’t be perfectly evenly loose and ready to let a baby through. They may be loose enough, but depending on your specific physiology the difficulty and length of labor will be more than it needs to be because babe can barely get through. Oftentimes a pelvis is locked up to the point where you can’t let a baby through, no matter how you try.
Unlike when your shoulders are tight and you can get a massage to loosen everything up and set things straight- there’s no reaching these muscles.
There are four distinct pelvic shapes, three of which are adequate for birthing, one of which is most likely to cause problems. Ultimately, doctors can’t tell which pelvic shape you’ve got, so while it affects birth dramatically, there's nothing you can do about it. Take heart though- most women have a more than adequate pelvic shape. More on that below.
The CPD Diagnosis
Cephalopelvic disproportion (when baby’s head is too large to fit into a mothers pelvis) is a real thing. BUT- few women have a pelvis too small for their child to fit through, and measuring the size of a baby by ultrasound is notoriously inaccurate (the later in pregnancy, the more inaccurate it is.) There is a way to actually measure the pelvis as compared to fetal size, the practice of which is called pelvimetry. Pelvimetry is effective in diagnosing CPD and in determining the shape of the pelvis, with one small caveat. Pelvimetry isn’t taught to doctors or most midwives these days, so it’s highly unlikely you’ll find a proficient practitioner.
The diagnosis of CPD through means other than pelvimetry is, essentially, a guess based on observation- baby won’t come out, belly is big, momma is small= CPD. This method is often inaccurate- small mommas can get big babies out, if they’ve got the right shape pelvis and aligned pelvic musculature. Misdiagnosis of CPD is common, and most often happens when the muscles and ligaments of the pelvis won’t allow the baby through, not because baby is too big.
But the main issue is...
Most birth professionals are also not skilled in identifying positioning beyond “head down” or “breech”. Some doctors can tell you where the baby’s back is by palpating your belly, but when it comes to identifying asynclitism- baby’s head being cocked to one side, not perfectly flexed over the cervix (aka your most important indicator of how birth will go)- no luck. Some midwives are able to tell exactly what’s happening by feeling the sutures of baby’s skull during an internal exam, but finding an in-hospital midwife who is skilled and willing to do this can be difficult.
Also no one’s talking about it….
You likely won’t hear about the specifics of your baby’s head position (flexed, extended, asynclitic, etc) from an in-hospital birth practitioner. And yet this is the most influential factor of a successful vaginal delivery, not only affecting whether or not you’ll need a cesarean, but how easily and quickly labor will go…or not.
Babies get into the best position for birth IF they are able to do so.
A baby will naturally find the easiest and quickest way out. When babies don’t, there’s a reason. It could be other things- short cord, cord wrap, disabilities; but far and away the most common cause of a babe not being properly aligned over your cervix is that the pelvis is too tight to get in there properly.
Bottom Line: an unprepared pelvis is the arch nemesis of easy birthing.
But- You can fix it.
There are exercises and movements you can do during pregnancy and labor that balance the muscles of the pelvis, loosen the joints and ligaments, and restore mobility and range of motion to make room for babe to get into the best possible position for birth.
Gail Tully of Spinning Babies.com has perfected the art of preparing the pregnant pelvis for birth, and in so doing has helped countless moms, doulas, and birth practitioners around the world have smoother, easier, and quicker births. In my work as a labor coach, I have had dozens of clients with incredible (and sometimes immediate) results from using Spinning Babies techniques in labor. Not only that, but I was able to vaginally deliver a baby who remained in an “undeliverable position” due to Gail’s wisdom and assistance in the birth of my second child. (It was no walk in the park, friends. But it was possible, and with Gail’s help, it got done.) Gail’s wisdom and intimate knowledge of birth physiology was the only reason I was able to naturally birth my second child.
The best part: all of this brilliant positioning information, pregnancy exercises, instructional videos, and situation-specific pregnancy and labor techniques are FREE on SpinningBabies.com. Pregnant momma, I could not recommend a more important preparation for birth. Forget the hospital bag checklist- if you want to get that baby out, you need these tools in your bag.
Full disclosure: I am NOT an affiliate or in any way a beneficiary of Spinningbabies.com. I just want you to have the easiest, fastest, and most beautiful birth possible, and so I’m giving you the most game-changing tools available to make that happen.
There are a few more practitioners who are doing groundbreaking work for pregnant and laboring mommas. I’ll be sharing their work in an upcoming post. Stay tuned!
Have you used Spinning Babies techniques to get a baby out?
Tell us about it in the comments below!