One of the most common questions we get from our clients and our childbirth education class members is "Will I be confined to the bed when I'm hooked up to the monitors?".
The short answer? Not necessarily!
There are a lot of factors, but for the most part, when you're hooked up to the monitors, you will probably be able to move around at least a little. We are going to share our Top 5 labor positions to try when hooked up to the monitors!
EFM, Electronic Fetal Monitoring, are those two strips that you see going across women's bellies in the hospital while they're laboring. Each strip carries a monitor that transmits data to a computer for your nurses, midwife, and OB to read. One sensor reads your contractions, so that the care providers know how frequently you're getting contractions and how strong they are. The other reads your baby's heart rate, and the care providers use the heartbeat data before, during, and after a contraction to determine how well your baby is tolerating labor.
In some circumstances, it is necessary to be monitored 100% of the time while you're laboring. For instance, if you have certain medications or have received an epidural, your care providers will want to watch your baby's heart rate continuously. However, in the absence of certain medications or complications of pregnancy or labor, you can request "intermittent monitoring". Each hospital and/or care provider has different policies or procedures about exactly how long that can be. But, a common one in our area is "20 minutes on the monitors, then 60 minutes off." Occasionally your care provider may be okay with even less time, like simply monitoring baby's heart rate before during and after one contraction every 30 minutes with a doppler. You'll want to talk with your care provider during your pregnancy to find out their thoughts and routines so you know what you can expect.
Many of us know that movement in labor is not only helpful to achieving a more comfortable and often faster labor process, but it's also necessary for some women! Our bodies may be telling us to sit up, stand up, rock, sway, walk, kneel, squat, or anything in-between while we're laboring. Our best advice? Listen to your body! But, we recognize that it may be difficult when you're hooked up to a machine. So, since the bands around your belly will be holding sensors that are connected to a wire which is only a few feet long, we've come up with some pretty fantastic laboring positions to keep you upright while you're attached to them.
Sitting on the Ball While Leaning Over Bed
Ask your L&D unit if they have birthing balls. Most of the ones I've been to do have at least one. Or, you can always bring your own. If you sit on the birthing ball facing the bed, you can raise the bed so that your head and arms can rest on the bed. You'll be fully supported, you can rock your hips, bounce a bit, and most importantly, you're in a great position to rest between contractions. Lay your head down on that bed with a pillow. You can always have someone sit behind you to rub your back, rock with you, and keep you feeling stable and secure since you'll be on a round ball. If you stay on the side that the monitors are attached to, you'll have plenty of space!
Kneeling on Bed Leaning over Back
When you raise the back of the bed up to a sitting position, you can actually use that back as a place to lean. Kneel on the bed facing the back of the bed and lean your upper body up over the top. You can add pillows under your upper body or knees for extra support. You're still in the bed and attached to monitors, but you're upright, you have gravity on your side, and you can always adjust the bed if/when you get uncomfortable. Your back is still exposed so if you're cold, you can wrap up in a blanket or you can get counter pressure or a massage on your back if you're having back pain.
Standing With Arms Around Partner's Shoulders/Neck
Women who alternated between upright and laying down positions in labor have a labor that is 50% SHORTER than women who stay laying down the whole time. Can you believe this?! It's proven to work and many times, women who are laboring actually need to be upright. But sometimes your legs (and whole body) can become weak and tired from working so hard. So, the hugging position while standing is perfect. You're upright and letting gravity help you out. You're connecting with your partner (or doula/friend/mother/etc) and raising your oxytocin levels, which are crucial to a progressing labor. You can wrap your arms up around their neck and shoulders and let your knees relax a little. They can hold your body weight between contractions so you can rest. You can also turn around so that your back is to their front and rest/relax onto their body.
Squatting on Edge of Bed with Squat Bar
Most hospitals have a bar that attaches to the end of the hospital bed called a squat bar. If you squat at the edge of the bed, you can use the bar under your arms or with your hands to help hold your weight up in a squat. You're upright, your hips and pelvis are open, and you can be supported a little extra by your partner. Sometimes the bar can make your underarms a bit sore. Just wrap a towel and then a sheet over it and you should be fine. Because it's often instinctual to birth your baby in a squat position, you can talk to your care provider about using that squat bar during the pushing and birth phase, too!
Side Lying with Leg Propped (Peanut Ball or pillows)
The reality is, sometimes you will want to lay down. Either to rest, or because you simply feel more comfortable when you're lying down. If that's the case, that's okay! If your legs need a little break, laying down can give you a chance to regain some strength, take the pressure of baby's head off of your cervix for a bit, and give you a chance to relax and maybe nap in between contractions before getting back up. Laying down doesn't have to look like laying flat on your back, though! If you're laying in the bed with the head of the bed leaned back a bit (so, not sitting straight up), you can roll over to your side. You want to lay as far over as you can, so you're basically laying on the side of your big baby belly. Ask your nurses if they have a peanut ball. It's a large exercise ball that is in the shape of a peanut. You place it between your legs and your top leg kind of swings over your body and the ball to rest on top of the ball. If they don't have a peanut ball, you can use pillows between your legs or slide the little side table on wheels over and swing your leg over top of that, supported by pillows. You may need the support of a few extra pillows either in front of or behind you to keep you feeling stable. In this position, you can be still be attached to the monitors, rest a little, and still have your pelvis opened wide to give baby some space to continue doing his job and moving down!
Of course, one of the best things you can do for yourself before your birthing time is to hire a doula to join you. You don't want to have to think about all of these things when you're in labor and try to remember these positions! A great doula will be able to guide you to the most helpful and comfortable positions without disrupting the flow of your labor. Contact us if you have questions about these positions or the policies about monitoring of the hospital you're planning to deliver in!