Image via WikipediaMums who walk about during early labour have faster deliveries than those who lie down
by Eveline Gan
05:55 AM Jun 09, 2009
---------------
WHEN most women are about to deliver babies, they check into a hospital, where they are confined to a bed.But a recent report by Cochrane Library has found that mums who remained upright or walked around during the early stages of labour seemed to deliver their babies sooner than those who lay down.
Cochrane Library is an online journal that reviews research on the effectiveness and merit of medical treatments. The report was based on data from 21 studies, which covered 3,706 women from around the world.
According to Dr Watt Wing Fong, a specialist in obstetrics and gynaecology at Raffles Hospital, the early stage of labour can last many hours if the woman is "left alone", without medical intervention.
During this time, a woman's cervix gears up for childbirth by softening and dilating.
Women in labour are routinely asked to stay in bed so that the foetus' heartbeat and their uterine contractions can be monitored via a machine called a cardiotocograph, added Dr Watt.
GET OUT OF BED, DISTRACT YOURSELF
However, there is really no need for this during early-stage labour, said Dr Paul Tseng, a consultant obstetrician and gynaecologist at TLC Gynaecology Practice, and medical director of Centre for Assisted Reproduction (Care).
Dr Tseng's "personal practice" is to send mothers in early labour home. They are asked to return to the hospital only when their labour pains are more intense and regular.
"At home, they are encouraged to go about their normal chores, like gardening. These activities help distract them from their pain so they are able to cope until they are in a more advanced stage of labour," said Dr Tseng.
Mother of seven, Mrs Serene Lim, 39, can vouch from experience that distraction is helpful during early labour.
"Life goes on. And when you're not focused on the contractions, time does seem to pass faster," she said.
----------
RESERVE for post-natal recovery
----------
EARLY LABOUR CAN LAST A LONG TIME
For mothers going through early labour, going back to basics makes good sense, said doula Ginny Phang of Four Trimesters.
"Compared to lying flat down, walking around or simply being upright allows gravity to move the baby downward. This also places pressure on the cervix evenly, which helps it to dilate," said Ms Phang.
Confining mums in labour to bed too soon may also be counterproductive.
"The patient has nothing to distract her, and will just focus on the pain. (So, she will begin) to get tense and anxious," said Dr Tseng. Tension can cause the pelvic muscles to tighten up, prolonging labour.
For Mrs Lim, the pain of lying on her back is one reason she tries to delay going to the hospital for as long as possible.
"By the third trimester, I cannot lie flat on my back as it causes the baby to press on the spinal nerve. Also, I feel more in control when I am moving around instead of just lying there, all strapped up and waiting to give birth," said Mrs Lim.
On the other hand, lying in bed can help a tired mother get some rest, if her labour is already in the "established phase".
During this phase, the cervix is usually dilated to 3cm or more, and the mother experiences regular painful contractions, said Dr Watt.
She added: "It would be difficult for them to move around (during established labour), considering that contractions will be coming every two to three minutes, especially if they opt for an epidural."
"It also conserves the mother's energy for the big push later," Dr Tseng added.
Ms Phang said ultimately, women should be given the choice to deliver their babies in whatever position they want, whether upright, lying down, or even on all fours, after discussing their options with their doctors prenatally.
More than 95 per cent of Ms Phang's clients "birth in whatever positions they're comfortable with".
"It's about being educated on what your options are," she said.
"If you're thinking of less-traditional child-birthing methods, thinking through and writing out a birth plan with your doctor's approval can help."
What does "remaining upright" and "walking around" during early labour mean?
Don't take it literally by going on a marathon or walking long distances.
"Move around too much and you'll tire yourself out when you're in active labour, which can be extremely exhausting," said doula Ms Ginny Phang of Four Trimesters.
"Freedom of movement for labouring mums is encouraged," she added. Opt for light activities, such as preparing a meal.
From TODAY, Health – Tuesday, 09-Jun-2009
No comments:
Post a Comment