Dynamic Positions in Birth: A Fresh Look at How Women’’s Bodies Work in Labour

Most women give birth in hospitals, institutions modelled around the needs of the people who work there. The delivery room is designed around the obstetric bed which was designed for the benefit of the obstetrician rather than the woman giving birth. Despite research showing the benefit of upright positions in labour and birth, most women in the UK still give birth in the semi-reclined position, pushing their baby out against the forces of gravity. Jowitt argues that unnatural positions make labour and birth more painful and difficult for modern women than it was for their ancestors. How did we come to put the needs of care givers above those of the labouring woman? Is there anything that can be done?Starting with a short history of birth furniture, Dynamic Positions in Birth goes on to explore the anatomy and physiology of labour from an evolutionary perspective. This updated edition expands Jowitt’s new biomechanical model of how the uterus works first published in the British Journal of Obstetrics and Gynaecology in 2018 which has profound implications for giving mothers freedom of movement in labour and birth. It explores how rethinking positions for labour and birth could benefit mothers and their babies.Equally important is the need to change attitudes to birth so that women are encouraged to play a more active part in the birth of their babies instead of being subjected to clinical interventions designed to mitigate the adverse effects of labouring in a starkly unnatural environment. Jowitt argues that it is possible to give women labouring in hospital a better chance of giving birth naturally. The book concludes by calling for a fresh look at the environment for birth. Delivery rooms can be made more user friendly by introducing furniture designed around women’s need for physical support during labour as well as for the birth, and by hiding away the more alarming technology unless it is needed. Women need a less forbidding environment and more encouragement to move freely and adopt positions which will enhance their chance of achieving a normal birth.

Ever since the birth of her third child in 1991, Margaret Jowitt has been working towards making birth a safer and more rewarding experience for mothers and their babies. After a first degree in music and psychology, she gained a MPhil from Keele in 1998, researching into Mothers’ Experience of Birth at Home and in Hospital. Her first book, Childbirth Unmasked, looked at the the anatomy and physiology of birth, showing how stress hormones conflict with birth hormones. Since 1996 she has edited Midwifery Matters, the magazine of the Association of Radical Midwives. She considers that prevention is better than cure and believes that good midwifery care based on the needs of the individual woman is the key to safer childbirth.