Instructions:
The Lunge: Hold a pelvic model in front of you. Gently open one ischium slightly outward in the direction that you lunge. Explain that the movement of the lunge to the side may pull open the pelvis just enough to allow a baby in the OP position to rotate to OA. If hips turn to the direction the knee points, the lunge does not open the pelvis. Watch students as they lunge to make sure their hips are facing forward while the knee points to the side. During labor, the woman may feel that lunging to one side feels better than the other. Lunging to this side may best facilitate fetal rotation.
Abdominal Lifting: The pregnant woman interlocks her fingers beneath her belly. Lifting her belly up and slightly inward helps to align the long axis of the baby with the axis of the pelvic inlet. With better alignment, the baby may be able to negotiate his way through the pelvis. Penny Simkin cautions that in rare cases, abdominal lifting during contractions might compress the umbilical cord. Therefore, abdominal lifting in labor should be done when there is a skilled person available to listen to fetal heart tones during the contractions. In pregnancy it may feel good to do abdominal lifting with the pelvic tilt to relieve pressure.
Hip Squeeze: Using a shawl or sheet to do the hip squeeze may ease discomfort caused by the stretching of the sacroiliac joints as the baby moves down in the pelvis. Practice with one person pulling on the rebozo; then try it with two people, one pulling each end of the crossed shawl. Knee press: The knee press relieves back pain by having the femur push into the hip joint to release the sacroiliac joints. The woman should be seated with her hips at the back of the chair and her knees level with her hips. She may need a book under her feet for proper height if her legs are short. Do not do this on a woman with knee problems.
Talking Points:
For most women, changing positions and moving around during labor increase comfort and facilitate the progress of labor. According to the Cochrane Library, upright positions may shorten the first stage of labor by about an hour.
Modifications:
Spiraling Positions into Each Class of a Series:
Class 1 – Demonstrate positions for sleeping and to relieve aches of pregnancy.
Class 2 – Add breathing awareness in various positions.
Class 3 – Add massage, touch, or stroking to each position. (note: assess based on the classes' comfort level)
Class 4 – Give rationale for positioning, in relation to position and descent of the baby.
Class 5 – Relate positions to other sensory stimulation (feet on cold floor, hands pressing on bedrail, etc.).
Class 6 – Discuss advantages of being able to move freely in labor to facilitate birth and to relieve pain.