During the Talking Babies Hypnobirthing private class recently we were discussing ways to reduce the chance of tearing during childbirth. 😨A subject every woman wants to DELICATELY talk about!
One area we discussed was birth position. As we know through fantastic studies getting off your back and out of stirrups reduces your chance of tearing.
Well STANDING came up. I had a feeling that standing versus kneeling was at slightly greater risk, only really through my experience as a Midwife. Now, I like to be evidenced based with what I share and say. The whole purpose of setting up Antenatal classes that are Midwife-Led! So last night I was intrigued I did what I do best and did a bit of a search on standing during birth and the risk of tearing. I wanted to know, ‘Does standing increase the risk of tearing in comparison to kneeling?’
Unfortunately, I couldn’t find much that could adequately answer my question. The very popular Elvander et al (2015) OASIS study looks into birth positions of 113,000 women. Stating ‘standing’ as reducing the risk of tearing. However, when you look closer at ‘standing’ they have grouped kneeling and standing together. Far more mums kneel (You can see this easily from the study charts). Therefore, this study is unhelpful in answering my question.
Two more articles I explored, sadly both contradicting the other. One by The World Health Organisation and the other a Cochrane review. I’ve linked them and the OASIS one at the bottom if you want to read them.
I may not have found an answer to my question but, what I did find was very useful.
💜All Upright positions💜
Small reduction in pushing length
Fewer assisted deliveries
Fewer Episiotomies (✂️)
May or may not increase 2nd degree tears 😕
The positions that did definitely show an increase in the incidence of anal sphincter tears. (Rarer, deeper tears. Ouch!)
💙Birthing stool
💙Lithotomy
💙Squatting
I think it is essential to understand that forced positions are going to also increase your risk of tearing.
Birthing mothers you need to listen to your body. Some women NEED to birth their baby standing, squatting, kneeling, one leg up, bum in the air etc. What ever the position you birth your baby in make sure it is a position that YOU have chosen.
Please do not let this blog stop your natural instinct.