AIBU to refuse to lie down during labour?

[TooManyTerrapins]

Not actually in labour right now but due DC2 very soon.

With DC1 birth I was coping all right with contractions by moving/standing. As soon as I got into hospital they wanted me to lie down in triage for monitoring. It was agony but I went along with it. Then they weren't too happy with trace so wanted me to lie down a bit longer, ended up there for ages.

Got admitted to labour suite where midwives said they'd let me get up, move about, get on the ball etc even with monitoring. But then the monitoring belt kept slipping every time a contraction came (I physically couldn't stay still and kept squirming on bed), so it was lie down a bit longer... just a little bit longer... right the way through labour.

This time I really DON'T want to lie down, at all, not even in triage, not even 'just for a little while'. I know I'll be on CFM this time round too but hospital has telemetry monitoring now so that should make it easier to stand/move? I don't mind internal exams in principle but don't know if they can even be done w/out lying on back, so I would rather avoid altogether if that's the only way to do it.

AIBU? I know they can't MAKE me lie down if I outright refuse but I don't want to be pegged as difficult and pressured and eyerolled at, and I know from last time that I will have no energy to argue once in established labour.

I had a bloody good crack at a vbac and understood the first sign of the scar rupturing was maternal reporting, I was frequently asked if I felt everything was going well... As for the 1:50 statistic, is that actually the figure for how many ruptures caused health threatening issues? Or is it the result of the study by the man who did manual internal inspection of the uterus after women had given birth? I declined to lie down for the most part, but wasn't offered standing VA, wish I had been.

Same thing happened to me. I was determined to stand up, I was enjoying pacing up and down with the contractions. Then I had to lie down to have the monitor put on, everything was fine but they forgot about me for about five hours (middle of the night). I actually think it slowed my labour right back down, and I ended up having an emergency c section from lack of progression the following night.

I actually think the midwife did it because she was supervising a number of women, so easier to have as many as possible "tied" down being monitored (no disrespect to midwives - this particular midwife was really awful but my other midwife during labour was fantastic and never would have done it).

Make sure your birthing partner is clear on what you want and you can both stand your ground in a firm manner. Good luck!!

No YANBU, Hospital policy is simply that in a public hospital... hospital policy, it is not law and they cannot make you do anything, they can't make you even accept monitoring (they should have wireless by the way that you can also use in the shower).

Make sure to inform yourself of your rights prior to the birth and as above also take a strong birthing partner (or two) with you.

If it is a public hospital they cannot refuse you treatment even if you refuse certain aspects that they 'require' such as internal examinations, monitoring, confinement to bed while doing admitting procedures etc. It is your body and as long as you are making an informed decision you have every right to do so, as long as a birthing mother is of sound mind then no one has the best interests of themselves and the baby at heart more than her.

If your waters have broken there is also the option of using a scalp clip monitor which is more reliable than the wireless belly monitors so that might be worth looking in to as well.

If you can go on your side it is a better position so you’re not battling against gravity. I had similar for my first but they really tried to keep me mobile and upright but they just couldn’t get a good enough trace. They gave me the choice- lie down or they’d need to stick an electrode in the baby’s head. I went for the former. It wasn’t ideal but I’d do the same again if I had a similar choice.

I’ve had 2 vbac and another c-section. I too was not wanting to lie still for the first vbac I stayed home as long as comfortable and tried labouring on the bed on all 4s, the monitor was constantly on but I felt much more comfortable. I do remember leads being everywhere though! I had a very good chat with mw about trying to be as active as possible and of course would have listened if they ever told me they needed me on my back (in fact that one was ventouse and forceps so I did end up on back in the end, sometimes things don’t go to plan!). In the scheme of things I found the actual labour much more comfortable being active but by the time it comes to giving birth I think I would have done anything! Definitely have a good chat with midwife and put it on a birthplan (do people still write one of these?!). Good luck.

It's not a "pain in the arse" for midwives to monitor fh while mum is moving around. Sometimes it just doesn't work very well. I'm sure if it works then the majority of midwives are happy to do it......why wouldn't they be? If you're in less pain as you're mobile and the labour is quicker it makes their job easier. But they do need a good trace otherwise there's no point in doing it.

The thing midwives don't have time for is holding it in place for the duration of their shift. They will have other women to look after and even while in the room with you stuff to do. Plus it kills your fingers after about 20 mins. But if they're finding it difficult ask if your dh can try holding the transducer in place and see if that makes a difference.

Both mine were monitored during labour and I've stayed mobile each time. Had an epidural both times, catheter with my first, very long labours but midwives really supported me to keep moving.

With DD i has wireless monitoring didn't sit/lay down for 12 hours, it just wasn't comfortable. I was lucky as they only had two wireless sets and it was quiet when I went in. I wouldn't have been without the trace though, both mine were distressed by the end.

I had it in my birth plan that I wouldn’t labour on my back.
I was very clear that if they wanted to monitor me I was happy for them to but I wouldn’t be on my back.

I had a terrible 36 hour labour with a back to back baby. When I went into hospital after about 18 hours they basically made me lie down and everything was much more painful and I ended up in theatre with epidural then forceps and ventouse.

Had my second 2 weeks ago. Labour was 3.5 hours and while I wanted a water birth there simply wasn’t time! I got to the hospital just before 10pm, by the time we got into the delivery room and spoke to midwife it was clear things were progressing very quickly.

I ended up giving birth on my side as midwife suggested it would be helpful in getting him ‘round the corner’.

Had him just after midnight, second stage of labour is listed as 4 minutes 😱

That's really strange our hospital encourages you to go for walks, use the ball, can just do pretty much what you like until your fully dilated then you get the choice of bed, water birth etc.

The whole immobilising and then ignoring me in favour of the monitors (which turned out to be wrongly placed) was a key factor in having home births after the first. It led to a cascade of problems and interventions.

At home the midwives monitored me just as effectively without me having to lie on my back for labour or the births.

You can be monitored kneeling. The midwife CAN examine you kneeling or standing - some may be completely unfamiliar with this way of doing things since most women just end up lying down. If they aren't familiar have a foetal scalp monitor so you can move about. Every single shred of evidence supports that upright labours are safer and quicker. NICE guidelines do NOT advocate CFM for women with routine pregnancies and labours - if the hospital say "everyone has it for 20 minutes when they first come in" say fine, but we'll be doing it with me kneeling on the bed. Then take it off and start walking. Labour the way you want OP.

Yes, type II heart rate dips are the first signs of a variety of sometimes serious problems - thus lying down for labour and compressing the major blood vessels that supply oxygen to the uterus and thus to the baby actually makes no sense.

Lying on your side or back makes it more difficult for your baby to be born! You're not using gravity. That gravity helps apply the babies head to the cervix correctly helping with good, even dilation progress so yes, ending up on your back for 5 hours is definitely going to increase the chances of your labour slowing down. Plus the baby has to go up over the bottom of your tailbone which is actually designed to move back out of the way as the head is born - it can't do that if you're lying down.

I think women need to understand, as C8H has described, the potential cascade effect of the simple decision to 'just lie down' for x y or z. Lying down can increase the chance of Type II heart rate dips - then you've got yourself on the path to an episiotomy or caesarean - all just for lying down when you could have remained standing, walking, kneeling on the bed, sitting in a birthing ball.... If midwives can accommodate your needs during home births they can do it in hospital. When you enter hospital you enter a hierarchical organisation where 'this is what we always do' and 'everyone has z y or z done to them, it's our procedure' take precedence over 'does the woman actually have a clinical need for us to do this'?

@Ladykluck

Where are you getting those statistics from, as the RCOG states the risk of scar dehiscence as 0.5% or 1 in 200.

OP I agree with the suggestion of getting your birth partner to hold the monitor in place while you move around.

IF I have another, it would be a VBAC and I’d likely elect to have a fetal scalp electrode rather than trying to pick the FH up abdominally whilst moving around or consider not consenting to a CTG. Even with the telemetry it’s really tricky. It’s so annoying as a midwife when you desperately WANT a woman to be upright and active but then it’s near impossible to facilitate properly. And the telemetry is never bloody charged anyway.

I couldn't lie down either! A midwife actually shouted 'she's going to have to have an epi if she won't lie down'. I was furious and she was asked to leave. It shouldn't be a fight. My twins were born less than an hour later, a natural delivery on all fours. Do what works for you and make sure your birth partner knows how important this is for you. Good luck!

You're right, it shouldn't be a fight.

What I find a bit sad overall is that following on from the 70s British women rose up and called out all the crap that happened then and, thanks to their efforts, we don't have routine: pre-labour enemas, enforced pubic hair shaving, default lying down labours and births with feet in stirrups and scalp monitoring. It was pretty crap back then. Women fought to get things changed. Watching One Born Every Minute, we seem to have gone back in time.

Re lying down. There is one situation where if the midwife said to you "You've got to lie down and pull your knees back" and it would absolutely be the right thing to do, and that would be a shoulder dystocia. This is a known manouver to help get a stuck shoulder through the pelvis.

really I too wondered about this. The actual risk is pretty low I thought. The risk is more likely to play out in a future pregnancy because the egg can implant low and result in a low-lying placenta (and all the inherent difficulties (potential bleeding) that could come with that and also of placenta acreta where the placenta is morbidly adhered to the inside of the uterus (again, risk of severe bleeding) possibly along the scar line.

I gave birth to my third on my knees, kneeling on the bed with my elbows leaning on the top, raised portion. I was comfortable. The midwife managed perfectly well with her observations and monitoring - although I was well on the way when I arrived in the labour room and had the baby about an hour later.

Midwives should listen to you. Lying on your back is not an efficient labouring position.

They need to bring back labour chairs... Lying down is fucking ridiculous.

Second and third I was the same. Had to lie down for monitoring. 4th time I was able to walk around whilst monitored. Just limited in how far I could walk.
The midwives where fab that time. My waters had broken but weren't in labour and they let me go for a walk down the road. It was hours later I had to be attached to the monitor.

It depends if you need to move you need to move, I've also been at the stage where I could not move and needed to lie down. Just go with the flow.

I put “I do not want to asked to lie on my back” at the top of my birth plan and wrote a list of my preferred positions, for DC2 and 3. Being on my back really slowed labour with DC1 and resulted in a whole load of interventions.

Have a look at spinningbabies.com and think about positions you prefer, and try to stay out of hospital until you really need to be there. I found with DC2 and 3, arriving only an hour or two before they were born cut down on midwives telling me what to do and instead they just reacted (appropriately) assisting with what I was doing.

There's no reason for the belt slipping when not lying down other than shoddy equipment or not being put on properly. Had 2 DCs, one with continuous monitoring, and position was never a problem. Second one the midwife gave up because contractions went as soon as I saw the monitor.

Internal exams might be a bit trickier but there's no reason to have them either. Just refuse.

You'll be a lot more mentally there this time too, so just tell them you're not lying down. They can't make you.

I spent my last labour basically sitting down and it was great.

Ynbu wanting move about, but if they need to monitor then being still really does help them.

Hi TooManyTerrapins,
With my first i had to lie down with the monitor attached. It was awful, it took about 3 hours from first urge to push to birth as baby wouldn't budge, i was exhausted and ended up with a vacuum extract and episiotomy. For second i refused to lie down and went on hands and knees until baby was ready for the last big push. I suppose I just did what felt right for my body to get baby out and it only took 20 mins from first urge to push to birth, 10 mins of which involved me telling midwife, to her checking me, and then rushing me from the ward to the delivery suite.

The first stage of both labours were the same length of time but because i was mobile during the second labour, it was much quicker. And i was less fatigued, and able to eat throughout the day which also helped.
Long story short, do what feels right for you.

I made a damn fuss when they made me lie down for monitoring as it fucking hurt, so my birthing midwife allowed me to sit on a birthing ball next to the bed and stand by the bed with a monitor on. They then wanted to put a clip on my baby's head to give me an epidural then realised that my baby was about to enter the world.

Btw They may have mobile/Bluetooth monitors so ask.