Why walking helps to hasten child delivery

A pregnant woman in labour Women in the course of giving birth in hospitals are usually told to stay in bed. Many health practitioners are of the opinion that such a posture is the best to ensure safe delivery of their babies. However, experts say that the simple act of walking around her bed helps in distracting her mind from the pains and reduce the length of labour time. Sade Oguntola reports.

Pain is a natural part of labor and every woman is unique in the level of pain she can tolerate. Women also have varying success with the kind of activities or interventions that can help decrease their labour pain and increase their comfort.

There are several effective approaches to pain relief that every woman would like to try throughout labour. One of such comfort measures include a calm environment, walking and using various positions such as sitting, kneeling and squatting and supporting with pillows if necessary.

What’s the best position for labour? There’s no best position. In fact, most women end up changing positions frequently during labour. A recent study analysed the research on this and recommended that women labour in whatever position they find most comfortable and so should not be required to lie down for a long period of time. The study found that the labour time of women who tended to walk or stay upright during early and active labour reduced by about an hour and that they were less likely to require pain relieve such as an epidural.

Though, the challenge of labour could be so overwhelming, but one position a woman in labour don’t ever want to maintain is to stay flat on her back. This may explain why some would prefer at the onset of labour to stand or walk. They like the sense of control they get from standing and walking during active labour. Some would however prefer swaying back and forth in rhythm with their breathing while standing or leaning on someone in a sort of slow dance, or by using a rocking chair if one is available.

Understandably, some find comfort staying on all fours on the bed. Research shows that being on your hands and knees may offer some relief from back pain before and during labour.

The choice of labour and birth positions has a huge impact on a mother’s comfort level during birth and how quickly and effectively her labour does or doesn’t progress. The more options she has, the more prepared she is to handle her birthing experience.

Effective positioning can speed labour and reduce discomfort by aligning the baby properly.

Many women giving birth in hospitals maintain the lying down positions of labour and this is the most prevalent posture in hospitals. However, lying down during the first stage of labor may slow the process, unlike other postures like the expectant mother sitting, standing or walking around, a new review of studies has found.

The analysis, published in April in The Cochrane Collaboration, combined data from 21 studies with a total of 3,706 women. Women, who lie flat, in a semi-reclined position or on their sides, were no more likely than those who sat upright or stood to have unexpected needs like a Caesarean section. And there was no discernible difference between the groups in maternal satisfaction or the amount of fetal distress.

The study found that those who sat up, stood or walked spent an average of one hour less in the first stage of labor (strong, regular contractions with three to 10 centimetres’ dilation of the cervix) than those who did not, and they were slightly less likely to require epidural anesthesia. The first stage is basically when the mouth of the womb (cervix) dilates and the contractions begin to build.

They advocated that when the expectant mother stood or walked during the first stage of labor, that gravity helps. The baby’s head pushing down on the mouth of the womb improves the regularity and intensity of contractions.

According to the experts, from the study, it was obvious that lying down isn’t safer in the first stage of labor. Rather women should be allowed to move around freely.

Dr. Jonathan Osamor, a consultant obstetrician and gyneacologist with the Oyo State Hospitals’ Management Board, said that the period of labour, the process which a pregnant woman goes through to deliver a healthy baby, varies from eight hours for those who have multiple births to as much as 18 hours for first timers.

Despite many old practices that women talk about in relation to labour, he said it was supposed to be as patient-friendly as possible. “Activities while in labour should be such that encourage the woman psychologically to bear the labour pain instead of sitting down in one place going through the throes of pain every three minutes when contractions come.

“There is no point restricting a woman to the bed if she can still walk around her bed without straying too far. This helps in distracting her mind from the pains she is going through every two minutes. Psychologically, it is not easy being on bed and you have to bear the pains.

Dr. Osamor however said such level of activity sometimes may later pose a problem considering that some pregnant women do not have good control on themselves when under stress. “We always have the problem with some. At the time, that some decisive actions need to be taken, she may not cooperate to lie down and position herself well. She may also have been exhausted. This may jeopardize the delivery of that baby and may injury the baby. . So we tend to apply a general rule that all pregnant women in labour should stay in bed and we manage them more proactively.

“By proactive management, this means we take charge of the labour from the point of admission and after the expected time if she had not delivered, you then may need to augment labour or use instruments to pull out the baby so as to save the baby from untimely death.

Dr. Toyin Oyelakin, a consultant obstetrician and gyneacologist also with the Oyo State Hospitals’ Management Board, said basically a pregnant woman in labour is allowed to attain any position in labour as long as it does not impede delivery in any way.

According to her, “There is no compulsion that she must lie on her back while in the first stage of labour. She can take the position that is most beneficial to her baby and her self, beneficial in the terms of the survival of both herself and her baby.

However, she said there is no scientific justification to say that taking such postures as standing or walking would hasten the first stage of labour. “If psychologically, she feels it has an effect, and then let her be, not that it has any association to the outcome of labour or that it hastens it,” she stated.

Dr. Oyelakin reacting to many old practices like asking a woman in labour to go and fetch water from the stream or pound yam to hasten labour, said all these are archaic midwife’s tales that have no scientific basis.

She said to help expectant mothers cope better with labour, they are usually asked to take light diet like pap so that they can have the needed energy for the delivery process. “We expect them to take some light diet so that even if they need surgical intervention, they can be sucked out and attended to, rather than ask them not to eat anything and when it comes to the time of delivery, they would have been so week.