Let Birthing People Have Bodily Autonomy––Lying Down Isn't The Only Option

by Nikkya Hargrove
Malte Mueller/Getty

As women, we often find it challenging to listen to our bodies, to follow our intuition, to hear the call from deep in our bellies. When I was pregnant with my twin daughters, I wanted desperately to give birth vaginally, naturally, sans medication or interventions. I was stubborn about it up until my 30-week check-up, when I was diagnosed with preeclampsia and my life and that of my unborn twin daughters lay in the balance — depending on whether or not I would listen to the direction of doctors and rest, or continue to push myself to go, to do, to finish my tasks.

I was hospitalized for five days while my team of doctors and nurses worked to get my health in a safe place. After that experience, as disappointing as it was, I knew that a vaginal, unmedicated birth of my twins was not in the cards for me; mainly because of my fibroids, but also because birthing twins is also considered high risk.

So I made the choice that I knew was best for my babies and me — and that’s something that should be afforded to all birthing moms.

For centuries, our ability to understand, know and listen to our bodies have been questioned by doctors; specifically, men who have never given birth, yet are very vocal in how they think we should birth whole humans.

Every situation and every birth is different. According to the Center for Disease Control and Prevention, 700 women die each year during childbirth and from complications due to childbirth, as reported in the New York Times. And for us, as Black women, the risk of dying is much greater.

When we as women give over our right to birth our babies the way we need, and the way our bodies call us to do, and we turn that decision over to our doctors (often men) and willingly turn over the important decision of how we birth our babies to someone else — it takes away our rights. Throughout our pregnancies and birthing experiences, we have choices to make, and are usually trusted to make them.

But when labor starts and we have another choice to make — how to labor, how to bring our baby into the world — we’re expected to do it while lying on our backs. And it turns out that position may not be the best (or easiest) position for giving birth.

An article in the Journal of Perinatal Education says that historically, women are depicted giving birth in the squatting or kneeling position, where the natural pull of gravity can assist in moving the baby downward through the birth canal. But at some point around the 17th century, the standard birthing position changed to lying down, and no one’s sure exactly why.

Some scholars have theorized that it was due largely to the development and use of forceps during that time period. Others say that it was likely the influence of King Louis XIV, who fathered 17 children and reportedly enjoyed watching the birth process.

In the American Journal of Public Health, author Lauren Dundes, MHS writes, “Since Louis XIV reportedly enjoyed watching women women giving birth, he became frustrated by the obscured view of birth when it occurred on a birthing stool, and promoted the new reclining position.” Since people have been influenced by royal trendsetting since, well, forever, Dundes surmises that “Louis XIV’s purported demand for change did coincide with the changing of the position and may well have been a contributing influence.” Since the king cared more about how onlookers (namely himself) experienced the birth of a baby rather than how the baby (or his wife) experienced the birth, it became what people did back then.

Today, though anesthesia wasn’t a contributing factor in the original change in position since it wasn’t used back then, epidurals and other pain relief methods can make it harder for a mother to support her own weight in a squatting or kneeling position. (Anyone who’s experienced the jelly-legs feeling of an epidural can attest to this.) That may be a reason why we’re still giving birth on our backs.

But according to the Journal of Perinatal Education article, gravity isn’t the only benefit to giving birth in an alternate position. Squatting provides extra room in the pelvis for the baby to descend. And a side-lying position may be even better than squatting when it comes to reducing perineal tears.

Regardless of how it started, or why we keep doing it, the World Health Organization says that “It is important that any particular position is not forced on the woman and that she is encouraged and supported to adopt any position that she finds most comfortable.”

So basically, anyone who wants to tell us how we “should” be positioned while giving birth should GTFO.

We need to reclaim our right to birth our babies as safely as possible, and in the way we want to. As women, especially as Black women, it is time to advocate for ourselves and for our needs — especially when we are most vulnerable, like on our backs during childbirth. There are other positions we can try. We need to get to a place where we feel comfortable using our voices, not only to cry out in pain or yell out in exaltation when we see our baby’s face, but also to say what we need at that moment.

We are warriors, mamas, every step of the way.