Is pushing on your back always a bad thing?
Pushing on your back has a bad rap for quite a few reasons. One, it’s the prime pushing position in the hospital setting, known for convenience for the doc as well as one of the only options you have if you get an epidural. It’s also known that if you’re pushing at a reclined 45 degree angle on your back, you are literally closing off your pelvis by putting pressure on the tailbone and sacrum.
But is there ever a time and a place for pushing on your back, and if so, what is the best way to get that tailbone out of the way?
When pushing phases are long and difficult, one of the positions we find the most success with, especially for first or malpositioned babies, is a position called McRoberts, which is….. gasp… flat on your back. Sometimes our clients get a little confused when we suggest they try getting onto their back, because they have heard you don’t want to push on your back and that is part of why they chose midwifery care! But the difference here to take note of is that in McRoberts, you are flat on your back with your knees pulled up, which swings your pelvis up off the bed, opening the back of the pelvic outlet completely. Imagine that you’re in a deep squat, but are laying on your back. The benefit of a squat is often that gravity is working with you, so what is the benefit of that deep squat on your back?
Often what we see is that the baby is having a hard time getting under the pubic bone and staying. Using the McRoberts position is often where we see a ton of quick progress where gravity helps the baby get under the pubic bone and stay there. So while this might not be the position you would have imagined birthing your baby in at home, and it’s absolutely not our first go to, sometimes it is a position we see make all the difference when your body or baby are requiring you to work really hard to get your baby out.
If you’re in the hospital setting giving birth and want to better facilitate the birth of your baby while you have an epidural in place, asking to be fully flat on your back can help provide more space for your baby at the back of the pelvis.
So if your home birth midwife ever says, can we try getting on your back to see if that helps you move your baby? We aren’t going hospital mode on you, and it’s definitely not for our convenience. It’s because this is a position that often works well in making some good progress to bring your baby into your arms when other positions aren’t working well.
Words by Jessica Morel @morelministries
The piercing pain of experiencing my 6th miscarriage has blasted through my body, ricocheting off all the tender parts of me. It has gutted me in a way that takes my breath away. My internal battle continues to rage on within as I process so much loss. Each one has been so different, yet equally devastating.
My first one was baby Pablo. I had no idea what to do. I had two little ones under the age of 3, a husband who worked nights, and besides my mom, a lacking support system to walk with me. Maybe because I was in my 20’s and not very many of my friends had experienced miscarriage…yet. My mom took me to the hospital. I bled out my baby in the waiting room toilet, while the local news blared on the TV. The care I received was as sterile as the exam room.
My next one was 13 years later. On my first ultrasound, the tech saw twins, we named them Luna and Sol. We told our four kiddos and I felt radically proud that my aging body still knew what to do. By my next appointment, they were not able to find heartbeats. My midwife, Lisette Pena, sat at my feet while I sat on the toilet, in my home, bleeding so heavily that its intensity matched my sorrow. Her experience knew that it was time to go to the hospital, something I hated to do, but I trusted her advice. COVID left me in an emergency room alone, bleeding out with a compassionate male nurse and a lazy physician. They released me a few hours later, despite my ongoing bleeding. They wheeled me to a bench outside the ER area and called my husband to pick me up. Within minutes, my body went limp. When I woke up, I was back in the ER room, with my husband demanding answers from the lazy physician on my condition. My body was still trying to release the pregnancy. Our bodies keep bleeding until all the tissue has been released. By design, bleeding is meant to protect us, but no one at the hospital wanted to fuss with all my blood. I was billed for two ER visits.
Then the fourth one, baby Alejandro, came the next year. Alejandro grew within me at an awesome time because my dearest friend was also pregnant. My mind raced with the joyous opportunity to raise our babies together. It all made sense and seemed so right. I was out of state for a work conference, in a hotel room with my husband and daughter. In the middle of the night, pangs woke me to what my heart did not want to accept. I passed a beautiful sac in the palm of my hand while crouched over the hotel toilet. My husband held my other hand as we both wept. I put Alejandro in a baggie, put him in the hotel freezer, and prayed the airport security would not confiscate him in my carry-on bag on my return flight home. My inner circle, which included our children, gathered around our mesquite tree in our backyard. We prayed and buried Alejandro under the waning moon.
Our fifth one, baby Febe, graced us with her love a year later. Hesitation and worry filled my every thought. Only 8 weeks in, the bleeding began. This sac looked different. I could not see anything inside this sacred sac. My two teen daughters assisted me, offering me their love. I chose to be open and transparent with my children about this unexplainable part of our life. Our fifth baby was buried at the base of our mesquite tree under a full moon.
Baby Hope graced us with her love in such a powerful way that I knew I was pregnant right away. She was bold and strong within me, and my body felt the daily advancements of her presence. Instead of hesitation and fear, as I experienced with baby Febe, I opted for an open heart, but only with my husband. I told no one. Not the kids, not my inner circle. No one. It was only in the quiet of the night that I drifted in and out of silent conversations with Hope within, praying with every being of my existence to hold this one in my arms. At my 9-week ultrasound, the sac was empty. A blighted ovum. Hope got started with her development and loved me so much, that she reabsorbed back into me. What a wonder. My body took 3 more weeks to recognize that Hope chose to stay within me. Once again, my midwives Lisette Pena and Alyssa Johns held space for me offering constant compassion. I woke up to a gush of my blood being released. My unwelcome experience of loss knew it was time. I had my special heart-shaped bowl ready in the bathroom. My husband ran a bath and asked what he could do. I asked him to make me some coffee. He held my hand as I sipped my coffee, watching the swirls of blood form in the water. Little by little, my body passed Hope’s temporary home within me. I gathered it up and put it in the heart-shaped bowl. My husband and I went back to the mesquite tree and buried Hope’s womb in the early morning before all our kids woke up. I couldn’t let them see me like this again.
I am still processing it all. Nothing makes sense. Rage boils within and then minutes later I experience love from babies I never held. Each baby has been so unique. Each passing equally different.
The pain is the same.