Vertical childbirth using the Ostrovskaya method

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If a pregnant woman is preparing for childbirth, studying, studying the issue, then she will definitely come to the moment of conscious choice of a doctor or maternity hospital. And one of the decisive factors in this choice will be the position of the doctor and the maternity hospital on the issues of free movement of the woman during contractions and the possibility of choosing a position for pushing.

In fact, some kind of regulation of the posture of the woman in childbirth came along with doctors to obstetric care. While childbirth was the work of midwives, each woman gave birth in the position that was most comfortable for her. And with the advent of court doctors, and then maternity hospitals, convenience for the doctor, and not for the woman, became decisive. Modern requests from women for vertical childbirth are a well-forgotten old experience!

No animal gives birth lying on its back. Not a single woman, unless she is forced to indicate a position, will lie on her back for pushing. She will give birth any way she wants: standing, sitting, on her knees, squatting, and even lying on her side, but definitely not on her back. Childbirth on the back, accepted in maternity hospitals, is the most unphysiological position that can be in childbirth.

And below I will explain why. As you can see, among the listed options for childbirth positions, most are vertical. Why did women always intuitively choose these poses? Yes, because childbirth in them is the most effective, comfortable, non-traumatic and least painful.

What is vertical birth

The birth of a child takes place in three stages, and the vertical method is no exception. But a woman’s behavior and postures during childbirth are radically different from those generally accepted.

First stage

This period begins with the onset of the first contractions. Of course, we are not talking about training contractions, but about birth contractions. This is the stage at which the cervix dilates. Here the woman is given absolute freedom of action. You just have to listen to your body and act as your intuition tells you. You can walk, sit on a special chair, jump on a birthing ball, even swim, if environmental conditions allow.

Those women who experienced vertical childbirth and left their reviews claimed that the process of opening was much softer and more painless than when passively waiting for the moment of delivery. This explains the fact that while a woman can choose her tactics during contractions, epidural anesthesia is used very rarely.

Second phase

During this period, the very moment the child is born occurs. This stage is the most physically difficult, because the woman must push the baby out and, accordingly, help him pass the birth canal.

There are several options for vertical childbirth:

• squatting;
• on the knees;
• standing;
• sitting on a special chair.

At the stage of preparation for childbirth, it is necessary to work out all possible positions in which it is possible to stay during pushing. However, it is impossible to decide in advance exactly how the process will take place; in this regard, it is better to be guided by intuition.

The main purpose of using a non-standard position is the soft and smooth movement of the fetus along the birth canal. And for each woman, the choice of body position and strength of pushing is strictly individual. It is worth taking into account only the health status of the mother, as well as the safety of the baby.

Third stage

After the baby is born, the placenta must be delivered. This period must also be spent in a sitting position. The woman puts the baby to her breast, and he begins to make sucking movements. This moment promotes uterine contraction, which helps to push out the placenta quickly and least traumaticly.

How active should a woman be in the first two stages?

In order for a vertical birth to be successful, in the first two stages the woman must be as active as possible, but all movements must be carried out under the constant supervision of medical staff. In some European-style clinics, there are even warm water pools in the delivery rooms. Immersion in warm water relieves pain symptoms, helping the expectant mother to relax after the next stage of contractions. That is, in this case it is allowed not only to move, but even to swim and sit in the water. If you are confident in the sterility of the room, as well as the pool itself, then this is a wonderful practice.

During not the most painful contractions and after them, a woman can walk, stretch her back, squat and stand up. Very good results can be achieved by moving on a special rubber ball. Psychologists advise trying to remain as calm as possible, not allowing fear or panic to even get one meter closer to your own consciousness. Excessive release of adrenaline has a detrimental effect on many systems. In addition, if you let a wave of fear approach you and give in to these emotions, it will be very difficult to calm down later.

A person in a state of panic begins to hear, understand, and perceive the world around him worse, and a woman giving birth must be very controllable. Ideally, completely comply with all the doctor’s requirements at the first word. A quick response and correct execution of the doctor’s commands is almost a guarantee that the birth will go as quickly, smoothly and perfectly as possible.

That is, during the first two stages of childbirth, a woman should not lie motionless - walking, squats, even a swimming pool or shower is allowed, but under the supervision of medical personnel.

And how it was before - why now almost everyone gives birth horizontally

In fact, horizontal childbirth is less natural and not so familiar to our body. This method began to spread only a few centuries ago from France. Few people know, but horizontal childbirth is popular only in European countries. In Asia, Africa, and the East, women give birth more vertically, unless, of course, there are special instructions.

Horizontal birth is more convenient for the obstetrician than for the woman in labor. The fact is that in this position it is easier for him to monitor the baby’s health and regulate the entire process.

In Rus', traditionally, childbirth took place not in hospitals, but at home. There was even a unique category of female midwives. In some areas they were called witches, that is, knowledgeable, knowledgeable mothers. They regulated the birth process as follows: the first two stages, or rather one and a half, because half of the first stage the midwife was just getting to the woman in labor, the birth often took place in a bathhouse. A bathhouse was heated for the woman, but not very hot. There they washed her, cleaned her, opened her pores with bath brooms, and, in general, cooked her. At the same time, the midwife forced the woman to move as much as possible, even sometimes lift moderately heavy objects if the birth process itself was delayed.

Sometimes the child’s immediate exit also took place in the bathhouse. Any presence or participation of the husband, the father of the child, or indeed any man in general was not allowed. Usually they just waited, listening intently, for the thin, long-awaited cry of the baby to be heard between the cries of their woman.

Of course, women giving birth back then were incomparably healthier than they are now, but help in critical situations was not as qualified then as it is today. But what is known for sure is that most women then, many centuries ago, gave birth not in a strict horizontal position, but in the way that was convenient for them. As for Africa, eastern countries, in particular Japan, women there often give birth in an upright position, because it is considered the safest for the expectant mother and her baby.

The advantage of vertical birth

In order to make a decision regarding the method of delivery, you need to know about all the advantages of each method. Therefore, after we have figured out what vertical childbirth is, let's look at its pros and cons.

Main advantages:

• The pressure created by the uterus on large vessels is significantly reduced. This can significantly reduce the risk of intrauterine fetal hypoxia.
• The first stage of labor passes much faster . This is due to the fact that the baby’s head puts increased pressure on the cervix from the inside, and accordingly shortens the period of dilatation. Statistically, in the control group, the time of contractions was reduced by several hours compared to “traditional” methods of delivery.
• Due to the fact that a woman can independently choose a comfortable position in the first and second periods of the birth of a baby, there is no moment of tightness and unnecessary tension . And accordingly, pain is mitigated.
• During pushing, the passage of the baby through the birth canal is smooth and gentle, and therefore the likelihood of birth injury is reduced. Despite a slight increase in the time of the second period, it is more beneficial for the baby and the woman.

• If we look at the statistics on complications, then with horizontal births the probability of birth injuries was 5%, and episiotomies - 25%. With the vertical method of delivery - 1% and 5%, respectively.
• Blood loss is reduced due to the rapid birth of the placenta.
• Reducing the likelihood of infection of the female genital organs.
• Reduced efforts during pushing and their greater efficiency, due to the additional influence of gravity on the fetus.
• Children born this way often have better Apgar scores, gain weight faster, and also have high levels of psychomotor development .
• There is virtually no need for additional stimulation of labor or pain relief. This minimizes the likelihood of toxic effects of medications on the baby.

There can only be one downside to this method of delivery. At the slightest disruption of the process and a threat to the child and the woman in labor arises, the process of vertical childbirth is stopped and the use of the “traditional” method begins on a special maternity chair.

Children who were born in this way develop very well, both physically and psychologically. About a third of the children from the control group were found to be significantly ahead of their peers.

St.

It is generally accepted that nature determined long ago how each new person should be born. Despite this, many methods of childbirth have been invented over the centuries. Some of them have remained unchanged, some, like fashion trends, appear and disappear.

One of these methods is the so-called. vertical childbirth - the story of this day's episode of the "Health" program is dedicated.

The chief physician of the Moscow maternity hospital No. 4, Doctor of Medical Sciences, Professor Olga Viktorovna Sharapova , the head of the Department of Hospital Pediatrics of the Russian State Medical University, Doctor of Medical Sciences, Professor Lidia Ivanovna Ilyenko and the head of the maternity ward of Maternity Hospital No. 4, a doctor of the highest category Nina Petrovna Kuznetsova .

Speaking about the possible pros and cons of this method of childbirth, first of all it is worth understanding that it is not some kind of invention of modern obstetricians. Enthusiasts of vertical childbirth (which include today’s guests of the program) note that it is precisely this method of birth of a person that is widespread throughout the world and has been known not even for centuries, but for millennia. Squatting birth is traditional for the peoples of the North, Central Asia, many countries in Africa, South America, Asia, Mexico, and China. As for Europe, childbirth in a vertical position was actively practiced in Holland and Germany. In particular, it is known that back in the early 19th century, the Dutch included a special chair intended for childbirth in the bride's dowry.

Therefore, no matter what ordinary people think, there is nothing unusual in the fact that this technique is also used in modern maternity hospitals (including European ones). Another thing is that people who present vertical childbirth as the pinnacle of obstetric art and call for choosing them as the best option for resolving the burden are also wrong: this method has both unconditional advantages and a number of contraindications.

According to Professor Olga Sharapova , despite the fact that when going to a maternity hospital, where there is a possibility of choosing methods of childbirth, the decision is made by the expectant mother herself, the doctor’s opinion cannot be completely excluded.

“Of course, no one will specifically force you to have a vertical birth,” says Olga Viktorovna. – All this is carried out on the basis of medical indications. Moreover, they may not be in favor of both vertical and horizontal childbirth. Some women, in principle, can only give birth by cesarean section; some anatomical features do not allow them to use the vertical method, no matter how much they themselves would like it...

So everything is individual here.

On the other hand, there are quite convincing indications for the vertical position. For example, in cases where it is necessary to exclude or weaken attempts - that is, simultaneous contractions of the uterus and abdominal press. For example, an indication for this may be the presence of high myopia in a woman in labor or cardiovascular diseases in the compensation stage. With them, either a caesarean section is indicated, or, as in our case, a reduction in the load on the woman’s body - which is achieved in the process of vertical childbirth.

The fact is that, in our opinion, the “lying on your back” position is the least physiological and comfortable for both the woman and the fetus. It is only more convenient for an obstetrician... As for a woman, giving birth lying down is more uncomfortable and more painful than sitting or standing. When a woman in labor lies on her back, the uterus, which weighs up to six kilograms by the end of pregnancy, puts pressure on the blood vessels running along the spine, including the aorta, which disrupts normal blood flow and does not provide enough oxygen to the fetus. The longer labor lasts, the greater the likelihood of developing fetal hypoxia. In addition, with such a long and painful labor, the need to use stimulant and painkillers increases, which, in turn, affects the health of the child.

Finally, in a horizontal birth, the woman in labor is inactive, and the doctor or midwife plays an active role in the birth. During a vertical birth, a woman can do a lot herself.

According to Nina Petrovna Kuznetsova , if all other medical indications for a particular method of childbirth are observed, there must be additional grounds for the horizontal position of the woman in labor.

“In the traditional position, the midwife provides assistance to the woman in labor: she protects the perineum, touches the baby’s head, etc.,” says Nina Petrovna. – There is no need to do this with vertical labor: after all, in this case the child experiences only a normal physiological effect, emerging outside of the push. Although the latter process is considered purely physiological and uncontrollable, we try to restrain attempts until the last moment. The fact is that in an upright position the uterus expels the child not only due to muscular efforts, but also under the influence of gravity. The baby is born literally like a droplet, without causing injury to itself or the mother...

...It is worth emphasizing that both opponents and supporters of innovations in this delicate area draw attention to the fact that the “simplicity and physiology” of vertical childbirth does not mean that it is completely safe. The fact that our great-great-grandmothers gave birth in this way (let us remember that maternity hospitals as specialized medical institutions in Russia began to appear relatively recently - under Catherine II) does not mean that you can simply decide to give birth this way - and, moreover, not resorting to medical help. Protection of life and health of both mother and baby, not only during vertical, but also during any other types of childbirth, can only be ensured in a maternity hospital. And any doctor knows that no matter how you prepare a woman for childbirth, it is impossible to completely exclude the possibility of such a dangerous complication as obstetric hemorrhage. If a woman is lying down, she can be given any help, including surgery. If it stands, then the possibilities for “maneuver” are sharply narrowed...

True, according to Nina Petrovna Kuznetsova , the likelihood of such a turn of events during vertical childbirth is no higher than during normal birth. In addition, doctors always have the necessary drugs and equipment at hand - and the woman in labor, in principle, is still on Rakhmanov’s bed, although she is on her knees...

Moreover, the “commitment” of a particular doctor to vertical childbirth does not mean that he is an opponent of the more usual childbirth, in the “on the back” position. From a technical point of view, the woman is still in the maternity hospital, surrounded by professional specialists - so, if necessary, she will be provided with any other assistance, including a caesarean section.

According to the dean of the Moscow Faculty of the Russian State Medical University. N.I. Pirogova, Head of the Department of Hospital Pediatrics, Professor Lidia Ivanovna Ilyenko , vertical birth can rightfully be considered a friendly attitude towards the child.

“We have reliable statistical data that children born in this way develop and gain weight faster, which is especially noticeable in the first months of life,” says Professor Ilyenko.

...Indeed, there are a number of publications showing that, for example, there are fewer cases of injuries to newborns during vertical birth: despite their faster course, the number of complications in children is 3.5%, and during traditional childbirth - 35% ( mainly cephalohematomas). Children born vertically have higher Apgar scores, are more likely to regain weight loss after birth, and are less likely to develop various neurological syndromes. The normal dynamics of a child’s weight in an upright position was 60%, in the control group - 38%.

Such indicators are quite understandable. For example, many problems in newborns arise from a lack of oxygen during childbirth, but during vertical birth it is believed that there is enough oxygen.

So, perhaps, the only serious argument against vertical birth is that in this case the work of the obstetrician is difficult. If a woman gives birth on her back, her perineum is both visually and physically accessible for any necessary actions by the doctor. He also delivers the baby, which, theoretically, reduces the risk of additional injury to the child.

In all other respects, vertical births are not much different from those that are considered “traditional.”

The decision as to how great the risk is in a particular case should be made only after talking with your doctor. And it is clear medical indications, and not the desire to follow fashion or the financial interest of a particular maternity hospital, that should form the basis of this decision.

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Assistants in vertical childbirth

The main point that is important to consider when choosing a method of childbirth is the choice of maternity hospital. This happens because not all medical institutions have the necessary equipment for non-standard methods of delivery.

In each period of vertical childbirth, a woman has her own “helpers” - special equipment with the help of which the process itself occurs.

During contractions, it is better to move around the room, or make gentle pulsating movements on a fitball. This will allow you to quickly and less painfully survive the period of cervical dilatation. Sitting on a special chair is also possible, but this option is less effective.

There are two types of devices for the period of pushing:

• Maternity chair - the seat resembles a toilet seat, which does not create the slightest obstacle for the baby to exit. During the process, you can focus on the armrests.

• A transforming bed is the best option. This is a special device that assumes that the choice of position is up to the pregnant woman, and she can find the most comfortable one. In this case, if necessary, the woman can be easily transferred to a lying position and the necessary examination or procedure can be performed.

Why are some doctors against it?

Many doctors are conservative people. And therefore, out of habit, they resist all innovations, even if they are for the good. Still, it is worth considering the arguments that are made against vertical childbirth.

One of the most important arguments is that control over the condition of the soft tissues of the perineum is insufficient, and accordingly, there is no way to prevent ruptures. It is worth clarifying that specific studies have not been conducted in this area, and therefore the remark is somewhat unfounded.

If it is necessary to use anesthesia, then it is necessary to use a horizontal method of delivery. This statement is absolutely true. After the injection, the woman in labor should no longer assume an upright position.

If serious complications occur, it is quite difficult to diagnose the need for intervention and provide the necessary assistance.

If a woman is not giving birth for the first time, then the risk of rapid labor is very high, and, accordingly, injury to the newborn is possible.

All of the above arguments are untenable for one reason. With the proper experience and qualifications of the doctor, the method of obstetrics does not play a special role. A specialist is able to predict all risks and possible complications, as well as stop the process of their occurrence in a timely manner.

Can everyone give birth vertically?

Of course, vertical birth has a number of contraindications that are very important to know. This is fraught not only with negative consequences for the woman, but also for her child.

Contraindications:

• breech presentation;
• large fruit and narrow pelvis;
• premature birth;
• the presence of serious chronic diseases in a pregnant woman;
• established pathologies of internal organs;
• direct indications for episiotomy and other types of surgery.

How the baby comes out

Of course, it is necessary to take into account that if something is good for one expectant mother, it will not necessarily have a positive effect on another. But still, in some cases there are even indications for vertical birth. These include: • serious vision problems, when retinal detachment is possible during normal childbirth; • diseases of the heart and blood vessels; • myopia greater than 6 diopters (meaning myopia).

For such pathologies, cesarean section is recommended. But it can be replaced by childbirth while sitting. This method of giving birth to a baby will allow the mother not only to avoid surgical intervention, but also the possible negative consequences of a cesarean section. But this procedure also has its drawbacks.

Video about vertical birth

Vertical birth, a video about which you can watch below, is an excellent opportunity to bring your baby into the world as naturally and comfortably as possible. An experienced gynecologist explains all the pitfalls of this method, and also suggests how to prepare for the process itself.

Share with us the stories of the birth of your babies. Why did you decide to choose this particular method? Have you ever experienced horizontal or vertical delivery in your life? Can you give preference to any one? Your honest advice can help a huge number of readers make a very important decision, on which their health and life may depend.

Vertical childbirth - for whom it is absolutely not suitable

Vertical childbirth is absolutely not suitable for those women who have a very difficult time tolerating pain. There is a category of organisms that are very sensitive to pain syndromes. Such mothers need epidural anesthesia, but with vertical birth it is impossible.

Vertical birth is not suitable for women with reproductive tract diseases. But most often this category is prescribed a cesarean section and the issue of horizontal and vertical births simply does not arise.

Vertical birth is impossible if there are pathologies in the fetus. But in such cases a caesarean section is also prescribed.

In case of any disturbances in the course of vertical labor, the woman is simply shifted to a horizontal position.