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.

@reallybadidea
It’s 0.5% if you aren’t induced. The OP said she would be an induction, hence the risk increases to 2%.

I might have missed it, but where does the OP says she is being induced?

I can assure you that shoddy equipment or not being placed properly are not the only reasons for belts slipping. It all depends on the anatomy of the woman. CTG belts are a crude tool. Ideally there would be some system for welding the transducers in place in the right position for labour. Until then we are stuck with what we have.

Hospital beds move. Sink it down low and push it to the side of the room and use it like a sofa? Maybe ‘they’ would be less keen to tie you to it then.

Wrongdissection So right about bloody CTG belts. Midwives should not be telling women "what to do" we can recommend and all our practice is and should be evidence based. VBAC women are offered CEFM for obvious reasons however after being advised of said reasons they can then make a choice what they consider is best for them and their baby. In our trust we offer telemetry but tbh it doesn't work properly half the time and you end up with a ctg which you cannot interpret which in a court of law should it go there you wouldn't have a leg to stand on.

As suggested applying an FSE to baby's head may help you as you can move around easier and you will also obtain a continuous trace of fetal heart which will show you if there are any problems developing or not.

Women do not labour well on their backs for obvious reasons, however to perform an abdominal palpation and vaginal examination properly it would take at most two minutes of lying down and in a semi recumbent position. Vaginal examinations aren't just about finding out how far dilated the cervix is you are checking for position of baby, if there is any moulding or caput present and how severe this is, the descent of the head and at what station it is at.

Good luck with you labour and birth. It doesn't need to be on your back. I assisted an amazing woman with an epidural insitu birth her baby kneeling over back of the bed had a beautiful normal birth no sutures required.

Don't know if anyone has said, but you should not be lying on your coccyx, as its moves and needs to be allowed to open fully to let baby through, but being propped up in the position that I've seen every woman on TV in, shuts it!

Hey OP - there is a fab website called evidencebasedbirth which has great information about all aspects of intervention and the statistics based on clinical studies. It is very helpful in informing you so you can make good choices for you when presented with different policies around birth in your chosen setting.

I found being upright essential in my labours and it just felt right & instinctive (not to sound too airy fairy!) & I think you’re right to do all you can to take control of your birth and have your choices respected. All the best for the birth xxx

Not being induced. Hopefully anyway!

In our trust we offer telemetry but tbh it doesn't work properly half the time

This is what worries me. The consultant said they do have a fair number of telemetry monitors and it "shouldn't be a problem" to use one. But if it doesn't work when it's on then, so much for that.

I wasn't aware of scalp electrode being an option. It sounds good if telemetry won't help but I worry it would hurt the baby - won't it distress the baby?

I don't object in principle to lying down for two minutes for an exam if it would give them useful information about progress. What scares me is the idea that it'll be suggested as "just two minutes" and then that's it, on my back for the whole rest of labour. Last birth I kept asking, please can I at least try standing up, or at least sitting/kneeling on the bed, and they kept saying yes absolutely, in a few minutes, let's just wait a little while first. Hours of that before I gave up and said "you aren't going to let me move so I want an epidural."

Midwife and consultant so far have both been very positive about my wishes to stay mobile or at least change positions and not lie down for birth, but this does not reassure me much as the midwives and consultant all said that last time as well until I was in labour suite! I don't think they were deliberately setting out to trick me or anything, I'm sure they were doing their best with the equipment and the situation they had, but all the same it was horrible and excruciatingly painful and I did feel tricked even if that's not what was happening, and it's left me really struggling to trust that I won't end up in exactly the same position this time, whatever they're telling me now.

(I would not rule out an epidural for this birth, but I had a couple of issues with the one I got last time so it's not my first preference now.)

Fetal scalp electrode would not be presented as an option if it caused distress. It’s a viable alternative. The electrode attaches under the skin, in a similar way to when you were a kid (or at least I was daft enough to do this) you could freak people out by putting a needle under the very top layer of skin on your finger and it wasn’t painful. Maybe just me and my mates who used to do that to freak folk out 😂

I hated this with my first. The pain was awful. With my second I had a home birth and I wasn't expected to lie down for monitoring as far as I can remember. Is it essential?

Telemetry shouldn't not work, I've used it for waterbirths without issue. You may need to lie/sit down to palpate and get it all on in the right place but I've had women walking up and down the corridor with it on!

As others have said a fetal scalp electrode may be a good option too, your waters would need to have broken to put it on is the only thing. It doesn't hurt the baby, but might be a bit of a longer examination to get it on and in the right place. This can connect to the telemetry too, so you're totally wireless.

Above all, remember it is YOUR birth and YOUR baby, you're in charge! You don't need to ask for permission to get up and move, if it feels like that option is being denied to you then don't just lie there in agony. Move as you need to, the monitoring can follow you around!

Loads of luck to you, I hope you have a successful VBAC and a more positive experience this time around! xxxx

Meant to add, if walking/moving particularly makes it hard then you can use the bed to your advantage! Use it to kneel over the back of the bed, be on all 4's, lean on while you stand.

Just to give my experience as not much mention of types of pain relief. I fully intended to stay mobile during labour, but had a diamorphine shot which was wonderful in terms of pain relief but I was high as a kite and couldn’t have stayed on my feet if you paid me!

I was monitored for dc 2 and 3, and I was very clear, I'm not lying down. dc2 was a bit harder (more real need to monitor) but the midwife was lovely and amazing and she said, you do what you need to do, I'll monitor the baby.
I mostly stood for all my labours, couldn't kneel/all fours anything, just standing, the midwife, bless her sat on the floor next to me holding the monitor in place.

dc3 was slightly easier, as they didn't need to continually monitor, but same thing, I stood, midwife worked round it.

I coudl NOT have laboured lying down. It actually upsets me that on OBEM they show them always lying down. There were even posters aroudn the unit telling people to stand and move aroudn during labour!

Sometimes monitoring isnt possible, but maybe address this with you OB.

With my second I was in hospital due to waters breaking but no contractions.

2 days later still in hospital (known to be good for high risk pregnancies), they were concerned about infection. I had bub within an hour with no monitoring as nurses didnt believe I was in active labour, hence I almost had him in the hallway when they decided to race me around to the birthing suite, all while I was telling them I needed to push.

Boy were the nurses shocked when they finally went to see how far along I was and there was the head.

OP I'm planning a VBAC too and have been reading this www.amazon.co.uk/Vaginal-Birth-After-Caesarean-Handbook/dp/1905177240?tag=mumsnetforum-21 which is helpful (if you have enough time before DC2!)

If you can afford it, using a doula should help with the feeling of being pushed around/nudged. They help ensure your wishes are respected and that you're not blindsided into anything.

With DC2 I stayed at home until I was 9cm and she was born half an hour after we arrived at hospital. If you can, try to Labour at home for as long as possible or if you think it’s safe, a home birth perhaps?

Birth is supposed to be a synergy between mothers movements in response to the babies; you don't hear often enough how much a baby moves in order to get itself born, it tries to wriggle and squirm and twist to navigate the pelvis and women, left alone, will move in similar ways during labour in response to baby, sometimes leaning, sometimes squatting, sometimes lifting a leg, standing upright to make their pelvis move to accommodate baby, its just doing what feels comfortable.

I had a wonderful VBAC on DS2 and I was able to labour on the ball, with the CFM on me. A doula explained it to me before hand, that I was ok as long as I was with the reach of the machine. I could not have laboured without that Ball! I loved that ball!! I got onto the bed for exams but got off again. I did actually deliver on the bed but that was because I was in the middle of an exam when he decided to make an appearance.Best of luck, VBAC was one of my most positive experiences ever.

I had CFM with my second birth which was a vbac and don’t lie down at all, they didn’t ask me to. I went on the ball and then on the bed on all fours, they should be able to examine you like that. I did refuse a cannula (in case) and was annoyed that I couldn’t go in the pool as they wanted to monitor me.
Good luck OP.

Had the belt with ds3, the useless pos couldn’t even stay put through a contraction, so MW put a clip on him. I did have to lie down for that but it took a second then I could move. :)

Dd1 did some serious damage to me on her exit that was a result of being up in blocks and laying down, if I had been mobile and in a different position it would definitely have been an easier ride for her and me.

Second time round I had a very detailed birth plan part written by my physio that stated very clearly that I was not allowed in the “traditional position” due to high risk of further injury (we’d considered csection but found the hospital supportive of my plan).

I had an amazing midwife and a mobile/cordless heart rate monitor. They exist in most labour wards but are a bit fiddly so they don’t like them! Ask if they have one and they can use that instead.

I need up on the bed but on it on all fours as the floor was killing my knees! So much easier!

Yanbu at all. Be polite, but firm. You do what you want. Your body is telling you the safest way to get your baby out. I sustained unnecessary damage with DC2 and she was blue when she was born, because I did as I was told and got on the bed. It was very much against my instincts and I couldn't give birth on a bed, they only let me get off when her heart was stopping with every contraction and I stood up and then had to push her out using all my force, as there was no time. I had a 3rd degree tear due to this and DD needn't have been starved of oxygen. It is a really dangerous practice.

The fact anyone has to ask this question says so much about our healthcare system and medical attitudes to birth! Everyone should have the right to do whatever they feel is best for them and their baby during labour. The Positive Birth Book by Milli Hill has so much great info on this. AIMS also have lots of info about your rights. This blog might help re: the vaginal exams... birthwithoutfearblog.com/2013/06/06/alternative-methods-of-checking-dilation-the-purple-line-and-more/

With my first baby I started in the birth pool at the MLU, felt great. They made me get out for monitoring and that's when it all went downhill. Was blue lighted to hospital and ended up with forceps and a haemorrhage. I genuinely believe if I'd just stayed in the pool I would have been fine. I just didn't fit their tick boxes for what happens at what time during labour. Second baby was born at home in the pool, no problems, despite their advice not to. Do what you feel is best for you!