Accoucher sur le côté : Une position pudique, reposante… — Transcript

Explore the benefits and biomechanics of the lateral birthing position for mother and baby during delivery.

Key Takeaways

Lateral birthing position improves comfort and effectiveness of pushing for mother and baby.
It minimizes fetal head rotation and reduces delivery complications like shoulder dystocia.
Maternal pelvic and leg positioning plays a crucial role in facilitating birth mechanics.
Posterior fetal presentations should be managed by adapting maternal position rather than forced fetal rotation.
The lateral position is versatile and can be used with standard delivery equipment.

Summary

The lateral birthing position is restful, modest, and preferred by many women.
It facilitates the baby's descent without the need for turning or repositioning.
This position reduces the risk of shoulder dystocia and protects the mother from pelvic organ prolapse.
Optimal fetal positioning is typically occiput anterior left, but lateral positioning adapts to fetal presentation.
The mother’s leg positioning supports pelvic mechanics and effective pushing.
The baby exits along an oblique axis without head rotation, easing delivery.
Posterior fetal presentations benefit from maternal positioning adjustments rather than forced rotation.
The lateral position can be used on any delivery table and enhanced with tools like a peanut ball.
Maternal spontaneous position changes during pushing improve comfort and delivery outcomes.
Future videos will explore other maternal postures and their biomechanics.

Chapters

Full Transcript — Download SRT & Markdown

Speaker A

In this video, we will examine the lateral birthing position, which is a very restful and modest position that many women recommend and prefer, and we will observe how it facilitates the baby's descent axis, and how it is better for the baby, who does not need to turn, think, or reposition.

Speaker A

This also reduces the risk of shoulder dystocia, and the pushing effort helps protect the mother from pelvic organ prolapse.

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We observed in the video on pushing in the classic gynecological position everything a baby presenting in the optimal position for modern obstetrics, that is, back to the left anterior, must do.

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Occiput pubic. And here, one observes the extent to which the baby must do everything, as the woman does not move, the pelvis does not move, and, in front, the caregiver does not move.

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We have considered what becomes of this maternal-fetal mechanism. Are other positions preferable for the mother?

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And this is with Madame Lalose Paul, an osteopath specializing in newborns' skulls. We have studied and modeled it in relation to the maternal position.

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Therefore, we still have this perfect baby, head down, back to the left, well flexed, but we position the mother on her side.

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Since her baby is on the left, she is positioned on her left side. It is not every mother on the left side; it depends on the baby's position.

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However, there are considerably more babies positioned on the left side among first-time mothers. Therefore, many mothers are comfortable on their left side.

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If they are not well, it is necessary to go to the right. Therefore, this baby is positioned.

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One leg is extended, the other hip is flexed to avoid arching the back. The extended leg will provide support on the psoas muscle, a guide.

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We have just discovered the significance of the synoptic psoas muscle, except that in the gynecological position, it is not engaged, as it is in flexion.

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And there, on the extended leg, yes. Therefore, this baby always enters obliquely. The longest axis, well flexed, always push it.

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As the uterus is on the right, the baby on the left, it is very centered, pushing is very effective.

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When the baby reaches the ischial spines, it should not rotate. Simply, there will be a change in position at the mother's hip.

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She will undergo internal rotation instead of spreading her knees. And it will open in front of him...

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The sacroiliac joint and the rotation can occur with the pushing, and the baby will exit directly in the oblique axis; there is no reason for the head to turn, thus restoring a stretching of the transverse perineal muscle in the direction of the

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transverse fibers, which is muscle; therefore, there will be a mutatic reflex, an expulsive reflex.

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We will elaborate. And the coccyx can move backward normally. It exits precisely along the axis of engagement.

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It remains oblique. It often emerges in one piece. Because in reality, when the head is delivered, it emerges very quickly as a single unit.

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Without deviation, restore, without passing one shoulder and then the other. All at once. And this baby, it will move towards the back, which means it will need to be given to the mother.

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She will have difficulty managing that on her own. There, she returns with the baby.

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That is an anterior, occipitopubic baby. Regarding a posterior presentation, which is considered obstetrically unfavorable, efforts will be made to rotate the baby, attempting to turn the head, and so forth.

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So that it arrives correctly, the occiput to the pubic bone, but in fact it would be much better to leave it in its axis of engagement and simply adapt the mother's position.

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Therefore, she is almost on her stomach, and the posterior presentations are very often on the right; she is almost on her stomach, which causes the mother's pelvis to rotate, it is a little less posterior, in fact.

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It always enters the same oblique axis, the pushing is always on the sacrum, and there it is the same thing, but it is the other iliac that moves like this, internal rotation of the femur for the firm, sacral nutation, there

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is space, retropulsion of the coccyx, and the posterior baby, the difference with the anterior one, is that it will go towards its mother.

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The baby will move forward here, and there is no need for the arms to be behind, as there is no extension.

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There remains a block, a single unit, and the mother can grasp it and move it here towards her.

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In fact, all mammals, the quadrupeds, the young are posterior, because if they were anterior, they would fall like that, but none of the mammalian mothers, rabbits, cows, etc.

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Do not lie on your back. Therefore, if the baby is posterior, certainly not on the back.

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However, is it necessary to rotate all babies to an anterior position to place them in the least favorable position?

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I believe it is preferable for the mother to choose the position, and it is considerably more comfortable for her.

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Her uterus is positioned; there is a track, and the pushing is significantly more effective.

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The lateral position is possible on any table; one will get onto the table on all fours, then move to the side, always bringing a thigh up to achieve a 90-degree angle. During labor, the peanut ball can be used, which is

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helpful for this. It is possible to move the sacroiliac joint asymmetrically. The baby always arrives obliquely.

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When the baby is approaching the ischial spines, the mother spontaneously changes position. It is positioned much more ventrally.

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We are going... To relieve the perineum and avoid excessive downward pressure, thereby minimizing the risk of edema and forceful pushing; the mother is essentially positioned almost on her stomach. An anterior-facing baby will exit along this axis, while a posterior-facing baby will move towards the mother.

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This is achievable in a lateral position, which can be accommodated on all delivery tables; the details of the setup will be provided.

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It is necessary for her to be able to have a diagonal of pushing, arms extended, providing support, always at an angle less than 90 degrees to avoid arching her back.

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If that were not the situation, it is quite evident that it would not proceed.

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And at the final moment, internal rotation of the femur, knee lower than the foot.

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There is a slight Limbourg-like feature, the pelvis is perineal above, and she may be pushing on the attendant.

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The support here, the diagonal, and the low pelvis. To open in front of the baby, at the moment the baby arrives there.

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By pushing, the asymmetrical iliac movement is emphasized. The anterior baby will exit directly along the psoas muscle, while the posterior baby will move towards its mother.

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In this video, we have examined the maternal-fetal biomechanics in relation to a maternal position.

Speaker A

In other videos, we shall examine other maternal postures and the same biomechanics so that each woman, at the time of delivery, may assume a position.

Speaker A

Subtitles, thank you.

Topics:lateral birthing positionmaternal biomechanicsfetal positioningshoulder dystocia preventionpelvic organ prolapseobstetric delivery positionsposterior fetal presentationpeanut ball laborbirth mechanicsmaternal comfort during labor

Frequently Asked Questions

What are the benefits of the lateral birthing position?

The lateral birthing position is restful and modest, reduces the need for fetal head rotation, lowers the risk of shoulder dystocia, and helps protect the mother from pelvic organ prolapse.

How does the baby's position affect the choice of maternal birthing position?

The baby's position, such as occiput anterior or posterior, influences which side the mother should lie on to facilitate an effective and comfortable birth without forcing fetal rotation.

Can the lateral birthing position be used with standard delivery equipment?

Yes, the lateral position can be used on any delivery table and can be supported with tools like the peanut ball to improve comfort and pelvic mechanics during labor.

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