Mother’s Advocate supports a woman’s right to give birth upright, instead of in a flat-lying position, as it’s much easier and more healthy for both mom and her baby. This week, Jill Arnold, founder of TheUnnecesarean.com, invites us to learn from Latin American activism for women’s birth rights — the fight for “El Parto Vertical,”or vertical birth.
In recent years, a variety of organizations, coalitions and advocacy groups in Latin American countries — spanning from Mexico to Argentina — have worked to confront the rampant overuse of unnecessary and unwanted obstetric interventions, while improving labor conditions and accessibility for women.
In Venezuela, women are faced with 80 percent cesarean rates in private clinics or 30 percent in public hospitals. Women who are permitted to give birth vaginally often experience the routine use of a forced lithotomy or supine position (laying on the back with knees bent, positioned above the hips, and spread apart through the use of stirrups). In reaction, the Organic Law on the Right of Women to Be Free from Violence, enacted in Venezuela in 2007, includes forced supine position as “obstetric violence,” alongside episiotomies and unnecessary cesarean sections.
The demand for vertical births is also growing in neighboring Ecuador and Peru. Peruvian-based activists in the Sociedad Peruana de Estimulacion Prenatal y Postnatal (SPEPP) argue that allowing women to labor in the position of their choice is a human rights issue. Their Facebook page, A FAVOR DEL PARTO HUMANIZADO!! – PARTO VERTICAL!!, currently boasts more than 2,200 members. According to obstetrician Pedro Luna of Ecuador, “Horizontal birth is an occidental practice brought by the conquistadors with zero medical logic.”
Indeed, supine position is not native to Latin America, and indigenous women are often reluctant and feel violated by the hospital birth process. A recent video by UN in Action explains, “For indigenous peoples, giving birth is a private and intimate family ritual. Midwives and family members are always there to give support and comfort. Modern medicine is not only unfamiliar, but also frightening.” Marta Mendoza Parissi, the former director of the Instituto Veracruzano de las Mujeres in Mexico, calls for an end to this kind of obstetric violence — stating that failure to respect the customs and traditions of indigenous women to give birth in a vertical or squatting position is in violation of the 2007 General Law on Women’s Access to a Life Free of Violence (Spanish).
Hope for the Future
The Mexican Secretaría de Salud (Department of Health) created a department in 2002 to shift existing paradigms in health care with regards to traditional medicine, particularly among Mexico’s diverse mestizo and indigenous populations. The department’s director, Alejandro Almaguer González, was quoted in June 2010 touting the benefits of vertical birth, and praising a vertical midwifery practice in Coetzala, Puebla, which won a quality award in 2007 for its zero maternal mortality rate. Almaguer González claims that vertical birth in hospitals could help reduce maternal mortality, as 80 percent of maternal deaths occur in indigenous and rural populations, often as a result of resistance to medical care.
Whether established as an option to provide indigenous women with culturally-sensitive choices in a hospital, or because coerced positions for perceived obstetric benefit are considered to be an act of violence against women, “parto vertical” has become a rallying cry in recent years in two hemispheres – inspiring new ways of thinking about and advocating for upright birth.
Jill Arnold is the founder of TheUnnecesarean.com, a patient advocacy blog that focuses on the overuse of the cesarean section, informed consent and transparency in maternity care.
What position did you birth your baby in, and why? Did your care provider support your decision and pushing wishes?
What position did I birth my first in? Flat on my back. I was already strapped down with the fetal monitor. They asked me to put my feet in the stirrups, and I said, “I don’t want to be on my back.” My OB said, “What do you want to do?” I wanted to answer, “All fours” but just then a contraction hit and I couldn’t speak. By the time the contraction was over, they had pushed me into the stirrups and were holding my feet back so I couldn’t move. They enlisted my husband to hold me down “or she won’t be able to push the baby out and we’ll have to do a c-section.” I felt raped and I hated my husband for being part of it even though he was as scared as I was and felt he had no choice. It was horrible.
I’ve had two unassisted births since then and they were great. With my 2nd baby, I pushed her out in a half-squat while holding the handles on my birth pool. It took just a couple easy pushes and I didn’t tear at all. With my 3rd, I was in a full squat and pushed while holding my doula’s hands. It was far, far easier being upright!
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I had my first baby with a hospital midwife – she suggested I try a birthing stool and it was great. For my second birth, my home birth midwife asked me what position I felt like trying. I sat on a stool for a while and ended up birthing while in a full squat.
I’m a doula now and doctors are always telling my clients that on their back is the best way to birth in case the doctor needs to do something. It makes me really upset.
I wonder how we can get this movement going over in this country. I guess Mother’s Advocate is a great starting place ;-). Even with an epidural women can often birth in an upright position. (with the right birthing bed and supports) Its a shame that we don’t understand the beauty of birthing upright in our culture. Its basic common sense to me. I once worked with a MD who wanted the mother’s legs pulled ALLL the way back until she was almost tilting the woman upside down. She did this “to open her pelvis” What she was basically doing was simulating a squatting position with the mother on her back. It was RIDICULOUS!!! God forbid a doctor have to lean down, squat, or sit on the floor to catch a baby!!!
Women have been giving birth in traditional ways for forever. I think if there was a problem with the method it would have been changed. After all these methods have been working for a very long time. Much longer than current doctors have had to run trials.
These MD’s seem to think that just because they’ve been to med school they are better than traditional midwives who have done just as many births often with less technology and lower c-section rates. If they try to force me to give birth their way, i’ll tell them where they can stick their medical degree.