Alternative birthing positions

[PastaBaby2024]

I'm 20 weeks pregnant, first baby. Because I have a pretty severe hip cartilage tear, and now also issues with my tailbone pain and PGP, physio recommended I consider not give birth on my back as my hip could get injured further (women routinely get hip labral tears from birth anyway) leading to a lot of pain post partum. Injuring my hip further would guarantee I need hip surgery as well.

I need to speak to my OB GYN but I know she is generally supportive of different positions for birth.

My mum and a friend who has given birth recently however have said that birth plans tend to go out the window, especially if I have a long labour, and their experience was that midwives tend to manhandle you to do what you need to do to get the baby out anyway. And I won't care about post partum hip pain when I just need to get the baby out. So they think it's unrealistic, I'll likely end up on my back and injuring my hip anyway.

The alternative is C-section and I've heard so many horror stories about it, I'd like to avoid it. I don't know anyone in real life who has had a C section to talk about it. But AIBU to think I could give birth naturally in an alternative position? Or should I just accept I need a C-section?

DP is worried about my hip as I spent 8 months on codeine and intense physio after my hip injury to get me to a place where I could function again without too much daily pain.

FYI I'm not in the UK, I have an OB GYN who I am seeing throughout and she will be there at the birth. I'm seeing her next week but it would be useful to get some opinions before I go in.

I've had two c sections, the scary sort you mention and an elective.

Scary one involved me labouring with back to back baby for 36 hours, whimpering in pain, failed epidural, projectile vomiting, foetal distress crash section.

Now I later had someone talk me through my notes and what should have really happened is that when the nurse noted the back to back and how little I had dilated they should have offered me a section on the basis of how my body was coping. But they didn't. So I ended up having major surgery after two days of no sleep and agony. Sub optimal.

Second I went in, had a nice nurse shave my bush, put on a gown and some compression socks on and joined the morning conveyor belt of electives. I was third on the list and my baby was born just after 11. By the afternoon I was installed in my cubicle eating McNugs.

Have the c section.

Gently, yabu because everyone I know who has had an elective c section (including myself) would recommend it. If you want to avoid a horror story (your words) I think you have circumstances that would make a vaginal birth more horror story like

Cross posted with the comment above!

Can you contact Pelvic Partnership for advice and support?

https://pelvicpartnership.org.uk/get-support/get-help-and-support/]

Alternative view: I had a planned section and found it a really positive process, whereas I have heard a lot of horror stories about vaginal births. Given your issues, I would really give consideration to an elective section - you may find you end up having an emergency one anyway regardless of your health issues so it’s worth keeping an open mind about options.

I have a long-standing labral tear and mild hip dysplasia. My whole life I had groin pain and struggled to abduct my hip,.couldn't sit cross legged etc
Epidural after 48hrs labour, one of the midwives shoved my hip into a position it had never been in my life. Obviously it wasn't painful because of the epidural. Next day, quite a lot of bruising. 10 years later, never had another twinge and my hip moves much more freely!

I can’t comment on birth positions as I had 2 CSs. First was emergency and although not traumatic I was exhausted after as I’d been in labour a long time, the recovery was also longer. Second was planned section and no issues at all. I recovered very quickly.

I’ve done vaginal after induction with second degree tear and c section- technically an emergency but it wasn’t really - it was recommended as the best option several hours earlier so was very calm and the staff were great. There are pros and cons to both, but I healed very well from my cs and would have had no problem having another if we’d had more DC.

I imagine it must be harder recovering from a cs if you have a toddler- my eldest was almost 8, so no lifting of an older child needed.

I would say in your circumstances an emergency section is more likely if you go for a Vaginal Birth (I had an EMCS and tbf I have no idea how it was really as I was put under). Personally I would choose an elective section as I wouldn’t want to risk it.

just to add my recovery was fine and I had no issues, I would say because you don’t personally know anyone who had a section then you won’t know anyone who had positive experiences

I had 2 of mine upright, on my knees, hanging on to DH. It wasn't an issue for the midwives. I did it because it felt easiest at the time.
I think your problem might be that you don't know what will happen on the day, it's not really predictable how you will feel or what might go wrong. So although in general I am a fan of natural births, in your case (that there is a natural birth could result in a serious injury) I think I would go for the c-section.

Hands and knees. So much easier than trying to push uphill!

I gave birth to my second baby on my hands and knees. The midwife did try to get me onto my back to try and get a better look at what was going on, as my baby's heart rate was dropping a bit, but (apparently!) I said "no no no, no fucking way" and then pushed the baby out in 3 minutes flat so she had no time to manhandle me 😅

However, I take everyone else's point that birth is very unpredictable and if you have pre existing hip problems, a planned c section might be your best shot at having the kind of birth that takes that into account.

I think an elective CS would be a better choice for you given your background history/hip issues. This is what I would go for, if I were in your position.

For what it's worth, I've had 2 elective CS births, both at 39 weeks, no complications for babies or me, straightforward recovery etc. I do absolutely realise this is not always the case.

Definitely push to discuss with consultant at some point, will prob be much later in the pregnancy

Personally I just think there are too many variables with your vaginal birth, needed to be in specific position etc

Good luck with decision making, just get as informed as possible

I’m not sure you’ll get helpful answers on a UK forum as this can be very cultural. For a ‘normal’ birth in the UK it’s not unusual to birth in different positions. In say, Japan, however it’s practically forbidden to give birth in any other position than with stirrups on your back and so your experience might be very different depending on where you are.

I had an emergency c-section but in contrast to pp it wasn't after being in labour so I guess the recovery was much more like a elective section. I had no issues at all- some pain obviously but was moving fairly freely within a week as long as I didn't overdo it. Pain manageable with paracetamol within 2 days.
I would definitely go for an elective section if pregnant again.

I’ve had a planned c-section and it was wonderful. Recovery was straightforward for me. EMCS was not so great, recovery wasn’t too bad but I was absolutely exhausted from labour beforehand, and I wasn’t manhandled during labour, but due to monitoring they did keep asking me to lie on my back which felt really uncomfortable. Given your hip issues I would go for an elective.

First I was knackered and ended up giving birth on my bag, legs in stirrups. Had a very long exhausting labour and needed an episiotomy.

Second I had a water birth so I was sat on my bottom with my legs akimbo and had him that way! Was a wonderful experience my water birth, no pain relief and I just trust my body! But part of that I suspect was that my body had done it all before!

You could put it in your birth plan and ask your birth partner to tell the midwives far in advance and then remind them at the end. Rolling you onto your side is no less convenient for them and doesn't require any effort from you when you're in that "I just can't" state. I think DS3 might have been born with me on my left side. I can't remember now.

I found the pain of contractions much worse on my back, so had my first in a sort of crouch position and my second two on my knees leaning over the side of the birthing pool. I didn’t have a birth plan as such, but midwives were very supportive of me through the process. I will say that somehow injured my coccyx in my last labour despite all of the above (and it bloody hurt!). I feel like you might be safer looking at a planned c-section rather than risk further injury.

I had all my babies on hands and knees.

Me too
There was no way i could have been on my back

I just don't think you can plan for what position you'd like to give birth in. Yes - in an uncomplicated vaginal delivery you can go with the flow but if assistance was required and delivery needs to be expedited leg supports will be needed. In theses instances a CS may not be the best option if baby is too far down in the pelvis.
An elective CS may be your best option.

I second this!!

Section section section!!!

Midwives will discourage you from birthing on your back anyway. Evidence shows that more upright positions in labour shorten the length of your labour and reduce your risk of severe tears.
Have you considered a pool birth? These encourage mobilisation during labour. I would discuss with your consultant if this is an option for you.