What are some good positions to give birth in to help reduce tearing and tailbone fracture?

Question

Staci Levine, DPT, OCS, PRPC · Answer

The question is, what are the best positions to give birth in to reduce tearing and tailbone fracture? When we give birth vaginally, the pelvic floor muscles have to expand like almost three times their length. What also needs to happen is there needs to be flexibility in the sacroiliac joint and in the sacral coccygeal joint, which is the joint between the sacrum and the tailbone. A lot of times, women give birth on their back with their knees up. And while this is a really good relaxation position for the pelvic floor, it also immobilizes your sacrum, your tailbone, and your SI joints because this lying flat on your back against the table, and they can't expand appropriately. Some positions that might be more optimal are actually in side lying, squatting, whether it's holding on to the bed or holding on to a thera ball also in the quadruped position on your hands and knees. And all of these positions allow more flexibility in the pelvic floor itself, but also in the associated joints that need to move around it.

Dr. Karlie Causey, DC, MS, CSCS · Answer

What are some good positions to give birth in to help reduce tearing and tailbone fracture? So there's lots of different ways to give birth, obviously. One thing to remember is that when you are in labor and giving birth, that fetal ejection reflex is moving the baby down the birth canal automatically. And so what we wanna do is we wanna make sure that we're breathing with the contraction, that we're not kind of trying to force or push the baby out. What that does is it allows us to allow the baby to descend slowly, which is going to cause less trauma to the pelvic floor. So really breathing during contractions is a really important part of this. As far as positions, there's a few that can be better as far as reducing tearing. One is going to be on hands and knees, so on all fours. Another one's going to be sideline. And the third one is going to be leaning forward, either supported, sitting, standing, or kneeling position. All these are going to allow the pelvic bowl to have more room as opposed to laying on your back with the feet up in the air. Another way that women sometimes give birth is squatting, but depending on how wide the knees are and how deep the squat is, it can stretch the pelvic floor, so sometimes that could lead to some tearing. But really what is most important is allowing your body and allowing yourself to birth in whatever position feels most comfortable for you. And so being allowed to move around, whether you're in warm water, whether you're on the bed, whatever that looks like, whatever feels most comfortable for you is going to be the best option.

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"What are some good positions to give birth in to help reduce tearing and tailbone fracture?"