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"So, like, how does that work?": Explaining Out-of-Bed Birth

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A friend of mine was asking me about my birth experience at the birth center. She wasn’t really clear on how an out-of-bed birth works because it’s really not something that’s reinforced… anywhere. Popular literature for pregnant women provides plenty of sketches of different positions in which they can labor, but what happens when a woman is ready to push a baby out? The typical midwife goes to the woman and throws down a few Chux pads. The typical doctor tells the woman to get back up on the bed and assume the position if she happened to have left the bed in the first place.

I told her I labored on a physio ball for a few hours, then got in the tub, where I went from sitting during contractions to lying down between contractions, then felt like squatting and as the baby was crowning, my midwife asked my husband to help me stand up. I put one leg on the edge of the tub and felt the baby spin out. It was freaking glorious feeling. I wouldn’t trade those twenty or thirty ridonkulous transition contractions for anything in the world if it meant that I would have had been unable to feel that.

[And yes, I would have traded the feeling for any necessary intervention needed to save my life or my baby’s. Can we just assume that’s a given at this point and move on? I have.]

She listened and paused. I raised one bent leg as I was talking as a demo (because a reenactment of putting one leg up on a tub is necessary to avoid confusion, I guess).


She asked, “Like the guy on the Captain Morgan bottle?”


I laughed and exclaimed, “Exactly!”


My laughter was really hiding my embarrassment that I was also wearing that hat and nothing else.


Have a great weekend, everyone.

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Reader Comments (26)

Heather, I remember my eyes bugging out years ago when someone mentioned being on all fours with the baby's head out. She was trying to explain something about how she was in laborland and picked up on something random that someone was talking about. I couldn't even hear what she was talking about because I was so befuddled by giving birth on hand and knees.

I was clueless.

November 20, 2009 | Registered CommenterJill

HAHAHAHA!!!! You rock! And "Freaking glorious feeling," YES! Nothing - and I Mean NOTHING - compares to birthing your baby right.into.your.hands. Can't do that laying down...my arms aren't long enough. ;)

November 20, 2009 | Unregistered CommenterJill

Puts a whole new spin on the "Got a little Captain in you?" slogan!

Awesome educational moment there, Jill.

November 20, 2009 | Unregistered CommenterDou-la-la

I've been beaten to the "got a little captain in you" joke, but it's exactly what came to mind first. Absolutely hilarious reference!

November 20, 2009 | Unregistered CommenterMeredith

I always love the response I get when I tell people that I gave birth to my second child standing over the toliet (we actually had to lift him out of the bowl after he was born) AND that I caught his head and my husband caught his body. I actually had one guy ask me just how flexible I am LOL! It's amazing how much easier things can go when you are allowed to listen to your body and labor as you need to!

November 20, 2009 | Unregistered Commenterspingirl

I recently had another out of bed birth that was weird even for me. The mama is from another country and deaf, so communication is tricky - but luckily she's the type of laboring woman who is pretty sure of what she wants and she just gestured and pushed us around until we were doing what she wanted (mostly very hard counterpressure on her back - I'm assuming she had back labor.) Anyway, near the end, she got out of bed and knelt on the floor draped over the bed. I put a few chux pads underneath her and was waiting patiently, and then she started moving around more during contractions, kneeling to squatting, to leaning way back with hands on the ground and lifting hips in the air. Finally, she flopped down in her friend's lap, half on her side, have on her back, lifting her hips up, put one foot on the bed and the other on my thigh and started pushing - all while half turned over on top, with her arms wrapped around her friend's neck and shoulder. Then, she was pushing with her legs against me hard enough that she managed to push her self along the floor, as I'm trying to half crawl after her - it was quite a show. We had a new high school age aide in the room handing me stuff for the birth and she was absolutely flabbergasted - she'd seen one other birth (with an OB in lithotomy) and said "it was NOTHING like that!" This mama, though, was very comfortable to do what made her feel better, and just did it - and because of the communication barrier, there was no discussing or "allowing" we just followed her lead. She was just fine once the baby was out, and after a snuggle on the floor and the placenta being born there, she easily stood with her babe in arms and walked to the bed. Her poor friend, though, could hardly stand from her leg being asleep and needed 2 nurses to get her up!
Most of the births I attend out of bed are far more standard - kneeling, squatting, or standing, but not so much sliding across the floor with me crawling after! My favorites are always the bathroom births - especially one very short intense labor in which the mama screamed up at me with her eyes screwed up tight and the head half out on the toilet "How many more pushes?" and when I said "Just one!" she opened her eyes and said perfectly clearly and rationally "Oh, really?" and put her hands down and caught her daughter with the next push. Much better than hours of torturous pushing in lithotomy or semi-sitting.

November 20, 2009 | Unregistered Commenterdoctorjen

Jen, I love your comments so much.

The funny thing is that when I wrote "the typical doctor..." I was thinking of you (as in you would follow someone around with a Chux pad.) :)

November 20, 2009 | Registered CommenterJill

Good for you! I am a CNM presently (reluctantly) working in the hospital. I've only done two out of bed births so far, but it freaks the nurses out! One nurse's chart notes on a patient went like this (the woman was pushing when she arrived at the labor ward):

"Patient REFUSES to give urine sample. She is standing by the side of the bed. I have repeatedly told her to get up on the bed, but she refuses. She stated, 'Women have been giving birth standing up for thousands of years and SO CAN I! And then she pushed the baby out. I did put gloves on before the baby was born."

This client of mine was a VBAC client, by the way! I didn't make it in time for the birth, obviously. I've done one bathroom birth, with mom on hands and knees, and one side of the bed birth with mom standing. There is so much fear surrounding anything different from the cockroach position (flat on your back, legs in the air) that it makes me stressed.

Would love to see more women refuse to get into bed.

November 20, 2009 | Unregistered CommenterTheMidwifeNextDoor

Oh goodness, isn't it amazing how many women out there aren't aware of out-of-bed birth and how it works. It breaks my heart!

A friend of mine recently told me that a friend of hers had had four children, but it wasn't until the fourth that she got out of bed and moved around during labour, and this was her favourite birth and she caught her own baby. Apparently it was reading my birth story which made this mother aware that she was able to get out of the hospital bed and move however she liked! Amazing! And it makes all the hate mail I get for my birth stories and my naked birth photos online too ;)

November 21, 2009 | Unregistered CommenterSarah @ Ilithyia Inspired

I was familiar with many different labor positions before the birth of my first child but the only thing I had found on the 'all four' position was that "it is an unnatural and awkward position for a human to give birth in". I was in the birth tub in a squatting position, half held up by my husband, when the midwives said he was 'turtling' and they needed more access. I was terriffied that moving with the baby's head already crowing would hurt him (mature pelvic bones vs soft baby skull), and the position was horendously uncomfortable for me (bad hips, had been more comfortable earlier in labor just moving through a contraction but now with my hips splayed it was really bad) but it allowed, as my birth chart says "all four hands on the baby for manipulation" of a VERY stuck baby. I can't imagine, if 2 midwives with more than 500 births between them had that much trouble getting his shoulder unstuck after moving me into the best position for greater access and birth canal opening, what a doctor would have done if I'd been stuck on my back with my legs up in the air (which, with my hips, specifically closes my birth canal). It ended up being, ironically, an unnatural and awkward position for me to give birth in, but it, along with my wonderful midwives, saved my baby's life! 3 cheers for laboring in different psoitions!

November 21, 2009 | Unregistered CommenterJessica
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