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  1. #1

    Strapping legs in stirrups during labor

    Hi,
    I gave birth to a girl almost two years ago. I am an Australian permanent resident, who is on a posting in a third world country and I gave birth in a nice private hospital here.
    While I had hoped for an unmedicated natural birth, things unfortunately went a bit different and I ended up with epidural and later on an emergency c-section, because (they claimed) that my daughter's cord was strapped around her shoulder and she was not going to come out. I was excited about the birth of my daughter and said immediately afterwards that I would be happy to repeat the delivery.

    Now I am pregnant with number two and I am starting to have my doubt whether my OB, who I trust (there are no midwifes here), should be the one to deliver my next baby. One thing that makes me doubt the OB is that I was not allowed to move after I arrived to the hospital, because my water had broken. So all I could do was lie in bed. I was not allowed to go to the bathroom or just move around gently - even when my contractions were measuring very strong. I chose to get the epidural, but I wonder if I could have gotten through it, if I had been allowed to move around and change position.
    Later on, when they decided that it was time to push, they took me to the delivery room. Here they strapped my legs to stirrups and I was so confused that I didn't object. I was however very uncomfortable to have contractions, when your legs are strapped in such an unusual position. Unfortunately, the labor didn't progress and my daughter's heart rate fell for every contractions (came back up again) and it ended in an emergency c-section.

    Now I am wondering: Is it common not to be allowed to move around once the water has broken? and how about the strapping of my legs? Is that not an old fashion way of managing things? Should I find another OB for my next delivery, who is more open to moving around and no strapping, or is it more common than I think?

    Thank you for reading my question. I look forward to the answer.

  2. #2
    Hello,

    Welcome to the Pregnancy, Birth and Beyond forum.

    I'm sorry to hear about some of the details of the birth of your daughter. No, it is not standard procedure to not move around once your waters have broken. What reason was given for this? There is no reason to not keep moving about once your waters break. Indeed, keeping active and upright in labour makes it far more likely that the labour will progress smoothly and quickly. There is a huge amount of research to support this. You may find these resources on active birth helpful.

    Similarly, stirrups are not best practice. If mum gets into a position she is comfortable in then, with gravity in her favour, she is likely to be able to push her baby out into the world naturally. Obviously, it is not possible to move into different positions if you have had an epidural.

    Having an epidural makes it more likely that you will have a cascade of medical interventions. Women who do not have an active labour are more likely to end up with an epidural and so a c-section.

    Did your waters break naturally or were they broken by your doctor?

    I agree with what you write above, it would be very difficult to have a natural labour if you were not allowed to move around freely. Indeed, many women find that birthing in water helps them to move freely and easily and to avoid medical interventions.

    Would you be hoping to have a VBAC (vaginal birth after a c-section) next time? Are there no midwives at all available? Would your current OB even be in favour of trying a VBAC?

    Warm wishes,
    LJ

  3. #3
    Hi LJ,

    Thank you so much for your response. You brought tears to my eyes with your response, as I have been wondering if it was just me suddenly overthinking my daughter's birth after 2 years.

    I have not yet discussed the delivery with the Dr, but I was thinking that I would be happy to attempt a VBAC if possible, but it would have to be an active birth, which may mean that I have to look for another Dr.

    My waters broke naturally at home and there was a nice progression to the labour (I thought). Their reasoning for not letting me move around was that there is an increased risk for the umbilical cord to get strapped around the baby's neck if you move around after the waters have broken. (There is a lot of superstition here! Another one is that if you take a deep breath during the pushing phase, you may suck the baby back up...)

    Midwifes are not used in the hospitals here, so it is the OB doing everything. At the check up after my daughter's birth my OB mentioned that I could try VBAC next time, if there was more than 2 years between the deliveries. I am just not sure I want a VBAC with the same inactive model as last time.

    I may have to ask other expats here for advise regarding OBs, who have supported them in an active delivery.

    Thank you again for your very understanding answer!

  4. #4
    Hello,

    It's good to read your reply. No, you are not overthinking the birth; you have a right to women-centered care and a positive birth experience.

    May I ask where you are living at the moment?

    I'm sorry to hear there are no midwives where you are. The statistics show that midwife-led care is more likely to lead to women-centered care with less medical interventions including c-sections.

    Being able to move around is key to having a smooth labour. There is no evidence there is any problem with moving around once the waters have broken.

    Over 75% of women who try for a VBAC will be successful in this. However, this would be more difficult if you did not have an active labour and you would be more likely to have a c-section if you were not moving. Also, the research shows that having a doctor or midwife who is supportive of VBAC has a significant impact as to whether it is successful or not. You could ask the doctors you are interested in about their VBAC success statistics.

    You may find these VBAC articles helpful.

    With warm wishes,
    LJ

  5. #5
    Hi Again,

    Thank you for confirming that there is nothing to suggest that a woman should be on her back once the water has broken.

    We are in the Philippines and it is very much the medical model that rules here. I have been offered lots of prescriptions for things, which in my eyes I shouldn't take medicine for. But luckily I use common sense and check things out before following recommendations here.

    I have asked advice from other expats and the best option here seems to find a doula and an OB, who will work with her. Then she can be the advocate on my behalf, now that there are no midwifes.
    I have found and OB, who is pro-midwifes and VBAC, which is not common here, so will meet with her for an interview to see if we are a match.

    Most women here end up with emergency c-sections and the percentage is scary high compared to most Western countries. Out of most of the mums I know, I can count on one hand the women, who have had a natural birth here.

    I was perhaps naive the first time and hadn't properly investigated the protocols here, but things like the strapping of my legs in the stirrups just went beyond my imagination and I don't think I could have prepared myself for that.

    Thank you for your advice. I now feel supported in requesting my needs from the OB.

    Warm regards,
    Audiomum

  6. #6
    Hello Audiomum,

    I certainly don't think you should feel guilty or think you were naive the first time round. You simply didn't know that was going to happen.

    Yes I was actually going to suggest a doula to you as well. I'm happy to hear that there are doulas available to you in the Philippines. I would highly recommend hiring a doula to any pregnant woman. A doula would be your advocate in labour. The evidence shows that women who use a doula are more likely to have a natural labour. Hiring a doula reduces your chance of medical interventions including having a c-section.

    I hope the interview with the OB you have found goes well.

    The World Health Organisation (WHO) state that the c-section rate should ideally be at 10-15%. The statistics I could see actually showed the Philippines to be around the 10% mark but I guess it may depend which part of the Philippines you are in. The country with the highest c-section rate is China at 50%.

    If you have any further questions then please don't hesitate to ask.

    With warm wishes,
    LJ

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