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A woman who gives birth in an upright position. How is vertical birth performed? Advantages and disadvantages

Vertical childbirth used to be common, but today many people view this type of birth process with a certain degree of concern. In the countries of Africa, Asia, and South America, they are still widespread, and the inhabitants of these countries are more likely to be surprised by the horizontal childbirth that is familiar to us.

In Rus', several centuries ago, midwives forbade women to be “lazy” during the birth process, requiring them to move, walk and perform various physical exercises, right up to the moment the child was born.

What is vertical childbirth? What are their advantages and disadvantages? Why do modern women increasingly choose them?

What is vertical birth?

Many people misunderstand this concept. Vertical childbirth does not imply a mandatory standing position for the woman in labor (this is quite uncomfortable), but rather has a free character. A woman can stand, sit in a special chair, kneeling or squatting and change the chosen position depending on her own needs.

The entire birth process takes place in the presence of medical personnel who are ready to help or give timely advice. If something goes wrong, it is never too late for a woman in labor to take a more familiar horizontal position.

Partner births are also very popular nowadays. This is a great way to relieve suffering.

General methodology

In essence, vertical childbirth is no different from traditional childbirth, with the exception of the position of the woman in labor. During childbirth in a horizontal position, the woman is constrained in her movements, and the birth process is almost completely subordinate to the obstetricians and doctors who supervise the birth.

The vertical position implies greater participation of the expectant mother in childbirth and the ability to take a position that is comfortable for her. Medical personnel necessarily monitor the process, but access to the woman in labor is a little complicated. If desired, a woman can use a special chair with armrests and a hole in the middle through which the obstetrician can deliver the baby. You can see what the chair looks like in the photo.

In cases where the labor process is delayed and the woman experiences a huge amount of painful and unpleasant sensations, obstetricians themselves often recommend taking a more comfortable position. The first stage of labor (contractions) is shortened on average by 2-3 hours if the woman in labor is active. Pushing is faster in a standing position, thanks to gravity and the ability to move the pelvis. Indications for vertical childbirth are varicose veins of the external genitalia or diseases of the retina (with the risk of detachment), including a high degree of myopia.

Contraindications to vertical childbirth

Women who have previously given birth are at risk of rapid labor, so they need to be especially careful - they can accidentally injure the baby. In addition, the expectant mother should think about whether she is ready for the absence of any anesthesia, since during vertical childbirth there is no anesthesia. Contraindications to vertical childbirth are diseases of the internal organs in a pregnant woman.

How to prepare properly?

After consulting an obstetrician-gynecologist and receiving permission from him for vertical birth, expectant mothers attend special preparatory courses to learn proper breathing. They are also taught to feel and control the birth process, to select the right position, which will be comfortable for the woman in labor and will not harm the baby.

You should not neglect gymnastics for pregnant women (the main set of exercises can be seen in the photo), it will prepare the body and muscular skeleton for childbirth and help you endure pain more easily. The psychological component is also important, so you need to monitor your mood, learn to manage your emotions and eliminate everything from life that can upset you. Another important factor is the participation of the spouse. It is better if the birth is partnered.

Positions of the woman in labor during the birth process

During the first contractions, when the uterus is just beginning to open, the woman in labor is advised to be active: walk, move, sit, lean back, or lean on her husband’s shoulders. At the pushing stage, when the labor process has already begun, the woman takes a position that is comfortable for herself - squats, kneels, holding onto a support, or sits on a special chair with a hole. Possible positions can be seen in the photo.

Often, a vertical birth is attended by a spouse or other relatives, who can also take part and help the woman give birth. The final stage (birth of the placenta) occurs faster due to more intense contraction of the uterine walls.

How to behave?

When choosing one or another method of the birth process, a woman should be confident in her decision, since comfort and psychological state play an important role in the birth process. If you choose a vertical position, movements will be free and practically unrestricted. However, it is necessary to listen to the advice of doctors and obstetricians who oversee the process. Do not forget that comfort and safety are not always equivalent. Proper breathing reduces pain during contractions and speeds up the birth process; this can be learned in courses for expectant mothers.

What's the advantage?

The birth process in a vertical position has many advantages:

The risk of rupture is significantly reduced, due to the fact that the baby passes through the birth canal more smoothly.
The mother's pain syndrome is noticeably lower - both during contractions and during pushing.
According to statistics, the risk of postpartum complications in babies is 30% lower than during traditional childbirth.
The woman in labor experiences less blood loss because the placenta is born faster.

Some obstetricians recommend putting the baby to the breast after birth (this stimulates the uterus) to speed up the birth of the placenta. Children born in an upright position are less likely to have neurological problems and gain weight faster.

Negative points

However, there are also negative sides. There is no need to be afraid; it will be much more useful to study them. The main difficulties faced by an expectant mother who decides to give birth vertically:

Today, not every maternity hospital has staff ready to accept vertical births, so you need to be prepared for refusals and continue to search for “your” maternity hospital;
a woman in labor who has neglected childbirth preparation courses may encounter difficulties in choosing a comfortable birth position, despite the fact that the choice is quite varied;
women sensitive to pain will not be able to receive anesthesia, while in traditional childbirth pain relief is not denied;
Due to the fact that the participation of doctors and the possibility of examining the mother during vertical birth are greatly reduced, situations may arise when assistance to the child is not provided in a timely manner.

Horizontal or vertical: which types to choose?

When thinking about the question of which birth to choose, you need to carefully study all the pros and cons, contraindications, consult with specialists, and analyze your own strengths and capabilities. There should be no hasty decisions in such a matter; the main task of a pregnant woman is to collect as much information as possible and realize all the responsibility that falls on her for the life of the child.

In addition, it is recommended to use all possible preparation methods: courses, video lessons, gymnastics classes, following the recommendations of doctors, communities, meeting mothers who gave birth in an upright position and those who plan to do so. All this will help you have a quick and painless birth, regardless of which birth was chosen.

Vertical childbirth is not an innovation, but a revival of the experience of previous generations. For more than two centuries, the main role was assigned to the doctor; for him, the horizontal position of the woman in labor is more convenient.

Model For vertical births
indications for its implementation: disability
milk “comes” How to restore

The more physiological, less traumatic and painful process of childbirth was forgotten. Now it is offered more and more often, if there are no contraindications, and the expectant mother expresses a similar desire.

How does this happen

Vertical childbirth is carried out, of course, not necessarily standing. The woman sits on a special chair, kneels, holding onto a support, or squats. The pose is chosen that will be more comfortable. Moreover, at any time you can abandon this position and lie on the obstetric bed. The doctor will advise you on the correct decision.

The process is the same as usual:

first period – contractions;
then pushing and the birth of the baby;
The final stage is the birth of the placenta.

During contractions, the cervix opens and the joints of the pelvic bones move apart. These processes themselves are relatively painless. Pain appears due to the resistance of the body's muscles to the changes that occur. The physical activity of the woman in labor helps to ease it.

Less traumatic process

Now this fact is taken into account not only during vertical, but also during horizontal childbirth. A woman is recommended to walk, sit on a fitball, making rotational movements with her pelvis, and “hang” on a support or the shoulders of an assistant. This way the muscles relax and the pain goes away.

At the same time, the cervix dilates faster. Thanks to the activity of the woman in labor, the first labor period is shortened by two to three hours. Moreover, the introduction of stimulants and painkillers is not required.

Pushing during childbirth in a standing position is aided by gravity. It is possible to move the pelvis more or less freely, making it easier for the baby to pass through the birth canal. Although this position is less convenient for the doctor, so in case of any complications, he can transfer the woman to the couch. Is it possible?

When giving birth in a sitting or standing position, the placenta is delivered faster. This is facilitated by the very position of the woman’s body, as well as the baby’s sucking of the breast. The blood loss that is inevitable during this process is also reduced.

All of the above is true only relatively. An individual approach is necessary, because what is good for many may turn out to be completely unacceptable for a particular woman in labor.

There are situations when vertical childbirth is not just suggested, but recommended:

the possibility of retinal detachment in a woman in labor;
cardiovascular diseases;
high myopia.

Most of these cases involve a caesarean section. Delivery while sitting makes it possible to avoid this operation and its consequences for mother and baby.

However, this procedure has its pros and cons.

physiological body position;
pain decreases;
The cervix opens faster, the period of contractions is shortened;
pushing becomes easier;
blood vessels are not compressed, vertical birth prevents a lack of oxygen in the child;
the fetus moves more smoothly along the birth canal;
his head is less injured;
the woman in labor gets fewer breaks;
the placenta is born faster;
blood loss is reduced.

not everyone is comfortable with this situation;
It is more difficult for a doctor to control the birth process and perform obstetric manipulations;
epidural anesthesia is not possible;
It is better to use a special chair.

The chair used for upright childbirth is similar to a table with a hole or notch in the middle. There are footrests and hand rests. The woman sits on it, with the pelvis and vagina above the opening. Through it, the doctor admits the child.

How the baby comes out

Now there are couches of a special design on which you can give birth both lying and sitting. But for natural childbirth, the presence of such a device is not always necessary. The woman can kneel, then the doctor will accept the baby from behind. You can squat, but this is the least comfortable.

Comparison with horizontal ones and contraindications

When making a decision, you need to weigh the pros and cons. First of all, it is important to consult a doctor. Not everyone supports this idea, since the possibility of complete control over the process is lost.

But at the same time, more and more obstetricians and gynecologists support vertical birth. They have significant advantages over horizontal ones:

the position is more natural for both the woman and the fetus than horizontal;
the weight of the child and the uterus acts in the right direction - it makes the cervix open faster, speeds up the baby’s progress, while with horizontal ones it compresses the vessels passing under it, and the woman has to work herself;
It’s easier for a woman to watch their progress and participate more actively in the process under the supervision of a doctor.

Contraindications will be:

prematurity;
malposition;
narrow pelvis of a woman;
large fruit;
rapid labor activity;
placenta previa;
the presence of diseases of the internal organs in the woman giving birth.

How to prepare for this

It is better to prepare in the last months of pregnancy. Preparation for vertical childbirth is carried out in almost all courses for pregnant women. But the problem is that not all maternity hospitals are ready to provide such obstetric care.

There are several reasons for this. The presence of a special chair is far from the most important of them. In fact, many doctors, especially of the old school, do not support this “innovation” at all. But even if the medical staff has such experience, the maternity hospital must have a license to use it.

Therefore, the first step after deciding on a non-standard birth is choosing a maternity hospital. Then you need to consult a doctor; it is also useful to familiarize yourself with the poses in advance.

Postures during childbirth are as follows:

sitting on a special chair or half-sitting - you need support for your legs and arms, the pelvic area should sag over the hole;
squatting independently or with support - this position is considered the best for passing the baby, but can greatly tire the woman in labor;
kneeling with or without support - often used for vertical childbirth, can be seen in many photos;
on all fours – can be used to relax, relieve pain, and reduce the speed of the process.

It’s better not just to study the options, but to rehearse each of them. You can take preparatory courses. They should be conducted by a specialist, preferably on the recommendation of a doctor.

It is necessary to think through all positions during childbirth

When vertical birth begins, the woman will intuitively understand which way is more convenient for her. Sometimes it turns out that it is better to lie on your back - the doctor may also recommend this, even if there are no complications.

The right attitude, preparation, and consultation with a doctor ensure a good outcome for both mother and baby. This fact is confirmed by reviews.

Svetlana Lavrikova:

I practically didn’t feel the pregnancy, except that I went for tests, and then the baby started pushing. Long before I even became pregnant, I knew that I would have a vertical birth. I studied a lot of information on the Internet. I had to visit several maternity hospitals, and it turned out that they don’t do this everywhere. I found “my” doctor after going to her for consultations several times. Everything was explained to me in advance. I felt completely ready. Although it was painful from the very beginning. Thanks to the doctor and midwife, they supported me all the time. I gave birth very easily, except for pain, only two small tears. The very next day she was sitting calmly and upright. And the child is doing great, although he is large, 4100. The midwife said that if it weren’t for the vertical birth, he would have torn much more, and it’s not a fact that everything would have gone so quickly.

Milena Elizarova:

The first time I gave birth was very difficult. I then recovered for more than a month. And six months later I found out that I was pregnant again. It became scary, but we decided to give birth. I didn’t even know what vertical childbirth was. The contractions went quickly and much easier than the first time. The attempts began, but the head did not come out. The doctor said, get up, kneel down, we will give birth standing up. I held onto the headboard and did what I was told. It felt like the baby was coming out and going downstairs on her own. The kind of effort that I made the first time was not necessary at all. Now I recommend vertical birth to everyone who wants to easily give birth to a healthy baby. Of course, if there are no complications.

: Borovikova Olga

gynecologist, ultrasound doctor, geneticist

Not every woman in labor knows what vertical birth is, but this method is more physiological for the birth of a child and convenient for the mother. A woman can take any position that is comfortable for her: sitting, standing or half-sitting. But vertical delivery also has disadvantages - it is much easier for the doctor to monitor the expectant mother and control the progress of the child through the birth canal if the woman in labor is in a supine position.

Stages of labor

There are three stages of vertical labor:

Stretching the cervix. The longest stage. The woman in labor should actively move so that the uterus contracts faster: do exercises on a fitball, walk or even swim. But in general, a woman can choose the position that seems most comfortable to her.
Pushing and expulsion of the fetus from the uterus. Uterine contractions become frequent and intense. The woman in labor takes a position that is comfortable for her, most often this is a squatting or kneeling position; sometimes childbirth can take place on a chair with a special hole for receiving the baby. In case of complications, the doctor can at any time transfer the woman in labor to a lying position in order to better control the entire birth process.
Birth of the placenta. The passage of the placenta occurs quite quickly due to the force of gravity when the mother is in an upright position. At this moment, the woman puts the baby to her breast for the first time.

What is vertical birth

Vertical birth is a method of delivery in which the woman in labor does not lie on a horizontal plane, but is located in the most comfortable position for her (standing or sitting).

This technique has always been common in Asia, Africa and South America. The horizontal position during childbirth appeared in France and after 200-300 years it became the main method of childbirth in Europe. But even in countries such as Holland and Germany, births are performed vertically - practice shows that this particular method is simpler and safer.

Vertical childbirth has become very popular lately.

During uterine contractions, the cervix stretches and the pelvic bones move apart, which is accompanied by severe pain. Physical activity helps to reduce pain at this moment - this is taken into account even in the case of horizontal delivery. The expectant mother can walk, go up and down stairs, jump on a fitball, swing her hips and even hang on her partner’s shoulders. This helps to relax muscles, reduce pain and dilate the cervix - thanks to the activity of the laboring woman, the first labor period can be shortened by 2-3 hours without the use of stimulants and analgesics.

Gravity helps push while standing. If possible, the expectant mother is recommended to make rocking movements with her pelvis to facilitate the movement of the baby through the birth canal.

Possible poses

During the pushing period, a pregnant woman can be in several positions:

Squatting, legs apart and lowering your pelvis as low as possible. This method helps speed up the process and expand the pelvic ring, but can lead to ruptures of the perineum and rapid leg fatigue.
Half sitting or standing. The position allows the woman in labor to rest and gain strength, however, if labor is weak, it is contraindicated.
On my knees. In this position, gravity works best, and the risk of perineal rupture is minimal. But it is possible only with a cephalic presentation of the fetus. If labor is rapid, kneeling is prohibited. The position is also indicated when there is a likelihood of ruptures and necessary cutting of the perineum, for example, during rapid labor or when the baby is breech.
Standing on all fours, your knees should be wide apart. The pose is comfortable for relaxation and pain reduction. The position is also effective in reducing the rate of labor activity.

Variants of postures during vertical childbirth

Optimal conditions

In order for vertical birth to be successful, optimal conditions for this must be created in the maternity hospital:

Natural childbirth. The risk of unforeseen situations should be minimized.
Trained medical personnel to provide the necessary assistance in a timely manner.
A special chair with a hole in the middle through which the doctor will receive the child.
Willingness to change position so that in emergency situations a woman in labor can easily take a lying position - even a few lost seconds can lead to serious health problems for mother and child

Main advantages

According to experts, vertical birth is less painful and proceeds faster

Vertical delivery has many advantages over traditional childbirth:

During the birth process, there is a companion nearby (mother or husband) who can help the woman in labor calm down, distract from unpleasant thoughts and pain, and hold her hand.
There is no uterine pressure on the hematopoietic vessels and internal organs, due to which there is no venous stagnation and blood supply disturbances, which reduces the risk of fetal hypoxia and reduces pain.
The expectant mother can choose a comfortable position herself, in which the pain is much easier to bear, and also change her body position.
With this method, painkillers are practically not used.
If a woman gives birth while sitting or semi-sitting, the passage of the baby through the birth canal occurs much softer and smoother, as a result of which there are practically no complications for the child and mother. During traditional childbirth, the perineum has to be cut in 25% of cases; with a vertical position, this figure is 5%.
The cervix dilates faster.
The physical activity of a woman in labor reduces the period of contractions by 2-3 hours. Pushing in a standing position is also much easier to bear.
With vertical delivery, the placenta is born faster - this is explained by the position of the laboring woman and the baby's breastfeeding. In this case, bleeding is significantly reduced, and the risk of infection of the uterus is reduced.
Newborns gain weight faster and are less likely to suffer from neurological diseases.

Important!With horizontal delivery, female injuries are observed in 5% of women in labor, with vertical delivery– only 1% of expectant mothers. During traditional childbirth, complications occur in 35% of babies, after vertical birth - only in 3.5%.

Main disadvantages

Vertical childbirth has not only advantages, but also disadvantages:

It is much more difficult for the doctor to monitor the birth and control the passage of the baby through the birth canal.
If complications arise, it will be more difficult for the obstetrician to provide medical care.
It is not possible to use epidural anesthesia and painkillers, as this affects the sensitivity of the lower extremities.
To carry out a vertical birth, the maternity hospital must have a special chair with a hole in the center, above which the pelvis and vagina are located when the woman sits on it. The device has a support for arms and a footrest, through the hole the doctor accepts the newborn.
In some cases, such positions turn out to be uncomfortable for the woman in labor.
If repeated births occur quickly, the child risks getting a birth injury.
The period of pushing is longer than with horizontal labor.

Important!In Russia, vertical childbirth is practiced quite rarely, so finding a suitable clinic with the necessary equipment and trained staff would be difficult.

There is a special chair for vertical childbirth.

Indications for vertical childbirth

If a woman is indicated for a cesarean section, but surgical intervention is contraindicated for some reason, the doctor may recommend a vertical birth. The main factors for this are:

Cardiovascular diseases.
High myopia.
Possibility of retinal detachment.

Contraindications

With a narrow pelvis, vertical birth is contraindicated

Vertical childbirth is prohibited if:

Childbirth occurs prematurely.
The fetus suffers from lack of oxygen.
The baby is large.
There is a need to cut the perineum.
Any complications during childbirth are observed, for example, incorrect position of the baby, placenta previa, or high risks of injury.
The woman has a narrow pelvis.
There is a need to use obstetric forceps.

Preparing for vertical birth

It is necessary to start preparing for childbirth 3-4 months before the baby is born. For the birth process to be successful, you must:

Choose a maternity hospital and a qualified doctor. Most clinics only practice horizontal childbirth, so it’s worth starting your search as early as possible.
Learn to properly relax your muscles and breathe. Pain during childbirth occurs due to overstrain of the muscle tissue that prepares the birth canal for the baby. Performing exercises on a special ball helps warm up muscles and relieve pain.
Study all possible positions that are used in this technique. It is recommended to attend special classes for pregnant women, where you can learn how the birth process will go and what you should pay attention to.
Choose a partner for childbirth - this should be a person who can calm and support the woman in labor at the most exciting moment - for example, a spouse, mother or best friend.

You can learn more about vertical childbirth in courses for pregnant women

Summarizing

Vertical birth is the most physiological and comfortable for the woman in labor, since she can take any comfortable position in a sitting or lying position. The main disadvantage of vertical delivery is that the doctor will not be able to fully observe the progress of the birth process, as would be the case with traditional childbirth.

However, there is no need to worry; a pregnant woman should consult her doctor so that he can recommend the best option for her. Whatever method of delivery the expectant mother chooses, she should be positive and remember that a miracle will soon be born - her baby.

In many obstetric facilities, women giving birth vaginally must lie on their back while pushing. During such horizontal births, the mother herself is assigned a rather passive role. However, in modern obstetrics there is debate about how natural this position is for mother and fetus. Experts from the World Health Organization noted in their latest recommendations the need for alternative, gentle methods of delivery. When the situation allows, the woman in labor chooses a position that is comfortable for herself, which has a beneficial effect on the course and duration of labor and on the condition of the fetus. This also reduces the frequency of use of stimulation and analgesic agents.

Why is lying down uncomfortable?

Vertical births are those in which the woman spends all periods (contractions, pushing and birth of the placenta) in a vertical position. In the usual “horizontal” position during labor, the pregnant uterus puts pressure on the blood vessels. If a pregnant woman lies on her back, then the uterus, child, amniotic fluid (the total weight of which is on average about 6 kg) put pressure on the abdominal organs and large blood vessels - the aorta and the inferior genital vein. This leads to less blood flow to the uterus, and compression of the vein leads to difficult outflow of venous blood from the organs, a decrease in venous return of blood to the heart, which, in turn, leads to a deterioration in the blood supply to the uterus and fetus, and uteroplacental blood flow. In this case, there is also no uniform and intense pressure of the baby’s head and amniotic sac on the lower segment of the uterus and its cervix, which can lead to a slowdown in labor and the need to use stimulants and painkillers.

Vertical childbirth is one of the alternatives recognized by official medicine. 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 child from developing hypoxia (oxygen starvation) both during contractions and when the head passes through the birth canal. Intense pressure from the presenting part (usually the head) and the fetal bladder contributes to the effective and smooth opening of the uterine os. At the same time, the first stage of labor is reduced by an average of 2-3 hours. This is good for both the fetus (during each contraction the oxygen supply temporarily deteriorates) and for the woman.

In an upright position, the gravitational force of the earth helps the baby move through the birth canal. The risk of birth injuries for mother and child is reduced. The fetus moves through the birth canal slowly and smoothly. As a result, the muscle tension necessary for expulsion of the fetus is minimized due to the coordinated work of skeletal muscles and the force of gravity, and the pelvic floor muscles relax. The birth canal more easily adapts to the size of the fetal head and stretches. Ruptures and the need for dissection of the perineum (perineo- or episiotomy) in an upright position occur much less frequently. The presenting part (fetal head and membranes during birth in the occipital presentation, in which most births occur) increases the pressure inside the uterus by almost 35 mm Hg. Art. Uterine contractions become more effective and less painful.

When the woman in labor is squatting and sitting, the size of the pelvis increases slightly due to changes in the position of the pelvic bones. The woman actively participates in the birth process and sees the birth of her own child. Some studies have found that in an upright position, the production of stress hormones decreases, and the mother in labor feels less anxiety and tension. Since the placenta separates faster in a vertical position, blood loss during childbirth is 100-150 ml, which is below average. Thus, positive aspects are discovered and scientifically substantiated at each stage: in the first period (painful and long contractions frighten women most of all), in the second (to facilitate pushing) and in the third (when separating the placenta, when there is a high risk of bleeding and increased blood loss during childbirth).

What should you do if you want your birth to be vertical?

Vertical childbirth may look different in different maternity hospitals. In some institutions, the percentage of vertical births is quite large, and all periods of childbirth take place in a vertical position. There are a minority of such maternity hospitals - in Moscow, for example, there is one specialized maternity hospital - maternity hospital No. 4. In a number of medical institutions, the possibility of vertical birth is provided only when concluding a contract. In the vast majority of maternity hospitals, elements of vertical labor are used only during contractions. If you want all periods of your birth to pass in an upright position, then it is better to find out about this possibility in the chosen maternity hospital. In specialized maternity hospitals, women who want to give birth vertically are often recommended to take special training courses, although theoretically it is easier to give birth in a vertical position than in a horizontal one.

Progress of childbirth. How does vertical childbirth take place?

In the first period, while contractions are not too frequent, a woman can walk, stop during contractions, leaning on a table or windowsill, the edge of the bed. During this period, a woman has complete freedom of movement. Some women in labor sit on a large ball or ottoman to relax the perineum. Many women tend to get down on all fours, intuitively taking the most comfortable position for themselves. This “free” behavior during contractions is now practiced in all maternity hospitals. Statistically, pain relief during vertical birth is required less frequently.

The vertical position during pushing is possible in different versions: half-squatting, kneeling. The optimal position is when the woman in labor kneels on a regular bed during pushing, facing the headboard, slightly leaning forward. The doctor and midwife monitor the physiological course of labor, and only if obstetric intervention is necessary, the woman in labor is transferred to a supine position (she is placed on her back).

There is also a special chair: its design allows a woman to actively move during childbirth, lie down, stand, providing the most appropriate semi-sitting position for the course of childbirth. Chairs of this design can be found in specialized maternity hospitals, but vertical birth is also possible on a regular maternity chair. In this case, its back is placed in a vertical position, and the woman is on her knees; It is in this position that the baby is born.

During vertical birth, optimally convenient conditions are created for the comparison of the fetal head and the birth canal, which reduces birth trauma. Only if obstetric intervention is necessary, the doctor places the woman in labor on her back. In the last, third, period of labor, when the placenta separates and the placenta is born, the woman sits, holding the baby to her chest.

The sitting position promotes more efficient (gravity helps) contractions of the uterus, and the birth of the placenta occurs faster than with a “horizontal” birth. But if desired, a woman can give birth to the placenta lying down. Conducting childbirth in an upright position does not require special organizational efforts and does not require the presence of special expensive equipment. A woman can choose a position that is comfortable for her during the period of pushing (some women in labor prefer the position on their back; this may also be required during obstetric manipulations). Management of the first stage of labor in all maternity hospitals is carried out using vertical positions. Premature birth, breech presentation of the fetus, lack of oxygen in the fetus, the need for the use of obstetric forceps or dissection of the perineum exclude delivery in an upright position.

A little history

It turns out that women have only been giving birth in the “traditional position” for the last few centuries. Before this, childbirth was carried out either standing or squatting. In Central Africa, a woman, sensing the approach of the “decisive moment,” went into the forest. There, holding onto a pole, she squatted and stood up, and during the birth of the baby she squatted. Indian women gave birth while hanging on vines or tree branches. In Ancient Babylon there were special “birthing” chairs. In Holland, from ancient times until the century before last, the bride's dowry also included a special chair for childbirth (a chair with armrests and a deep cutout in the seat). Among the representatives of the ancient Aztec culture, the goddess of childbirth was depicted as a woman squatting with the head of a child born between her legs.

In Rus', midwives in bathhouses forced women giving birth to walk a lot and step over obstacles during contractions. This active behavior apparently contributed to stronger and more effective uterine contractions, preventing labor weakness and prolonged labor. Until the 16th-17th centuries, women in France gave birth in a squatting position, and in Germany - in a chair. According to historical literature, in the 17th century, Louis XIV broke a centuries-old tradition. The birth of an heir was supposed to become a state matter and the property of the nation - and for the first time the woman was laid on her back to make it easier to observe the birth process. The empress's birth became the basis for imitation. According to another version, over time, male doctors displaced female midwives, and the woman in labor had to lie down in order to conveniently perform medical procedures (for example, applying obstetric forceps). The use of the supine position during childbirth has become widespread. But over the past two decades, the issue of the optimal position of a woman during childbirth has become actively discussed in the world.

Learning to breathe correctly, relax muscles, and learn appropriate positions is the basis for making the birth of a baby much easier. Before choosing between horizontal birth or birth in a vertical position, you must consult with an obstetrician and choose a suitable maternity hospital. You should also study reviews about vertical birth to compare the experiences of women in labor who have already gone through this procedure. Various procedures are used for preparation:

Positions during vertical childbirth

In contrast to horizontal childbirth, with vertical childbirth much attention is paid to the woman’s intuitive feelings. To give permission, a woman is offered a special chair on which she can take various positions:

Squatting (independently and with the support of an assistant);
Standing (with support on the handrails);
Sitting;
In the knee-elbow position and its variations.

You can study all available positions and rehearse them at special courses for future parents or under the supervision of an obstetrician-gynecologist. Already in the process of resolution, the obstetrician delivering the baby may recommend a horizontal position if none of the positions alleviate the mother’s suffering.

Benefits of vertical birth

When choosing a method of delivery, every woman studies the pros and cons of vertical childbirth. The choice in favor of a vertical position is due to undeniable advantages compared to the classic method of childbirth for European women:

The circulatory system of the woman in labor is in a natural position, the vessels are not compressed, as during horizontal childbirth. This reduces the risk of suffocation of the baby when passing through the birth canal.
At birth in an upright position, women are allowed and recommended the presence of a loved one, a partner. This could be a spouse, relative or friend. The woman in labor will feel calmer and more confident, without feeling lonely.
The pain of contractions and pushing is reduced due to the ability to change the position to a more comfortable one. In addition, the muscles relax during movement, which reduces the body's resistance to the opening of the cervix and pelvis.
The uterine os opens faster, because The baby's head presses on the neck.
In a standing position, it is more convenient for a woman in labor to control her body and push.
Ruptures and injuries during vertical delivery occur in only 1% of women.
Children born in a vertical position are 10 times less likely to have birth injuries than horizontal newborns. Also, doctors do not have to use forceps and other instruments to help the baby pass through the birth canal. Thanks to this fact, the risk of infection of the woman’s genitourinary system and injury to the baby is reduced.
At the last stage of delivery, the placenta is delivered. As a result, the woman loses 2 times less blood, and the duration of the painful procedure is reduced.
For women in labor with heart disease, severe myopia and vascular pathologies, vertical delivery is prescribed by many obstetricians.

Disadvantages of vertical birth

Despite the impressive list of advantages, delivery on a special chair also has some disadvantages:

It is difficult for an obstetrician to fully control the birth process. With horizontal birth, control is complete.
Due to the lack of permanent monitoring of the newborn’s condition, the doctor may not notice dangerous pathologies, lack of heartbeat or breathing in time. This fact can be fatal for the baby.
Vertical delivery is based on a woman’s intuition and inner feelings. For this reason, this method of childbirth does not use anesthesia or any type of pain relief.
If a woman has an abnormal structure of the birth canal, complications are possible upon resolution.
Vertical birth is much faster. If the obstetrician has insufficient experience, injuries to the newborn may occur.

The risks of vertical delivery are associated with the experience of the gynecologist and the presence of certain types of pathologies in the woman. The occurrence of complications is very rare and the advantages of being born in an upright position outweigh the disadvantages.

About contraindications

In some cases, doctors prohibit vertical delivery if there are contraindications for the woman or fetus:

Any complications, pathologies of pregnancy;
Prematurity of the fetus;
Impossibility of natural childbirth due to the mother’s narrow pelvis and the need for a cesarean section;
The size and weight of the fetus is too large, forecasts for the need to use forceps;
The birth is carried out urgently due to hypoxia of the baby.
If the doctor suspects complications in the child or the mother, as well as in certain pathologies, vertical birth will be prohibited.

Vertical delivery is not the most common practice in Russia. If the obstetrician-gynecologist observing the expectant mother has experience in such births, and there is a maternity ward with the necessary equipment nearby, it’s worth a try. With vertical birth, the risk of injury is lower for both the fetus and the mother in labor. Birth is faster, less painful and with minimal intervention.