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Criticism of Routine Lithotomy Position from an Unusual Source

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By Jill Arnold

Filed under NFW (Hint: The “N” is for “no” and the “W” is for “way”): Satirical website Cracked.com issued a smackdown on routinely forcing women into the lithotomy position to give birth. 

Obviously, giving birth to a smaller human might take a lot more effort than breathing. But when you realize that even the idiot deer that tried to jump in front of your car last month has probably managed to produce young, you would hope that we smart modern humans are getting it really right. Not so. Today, the majority of women in America are still directed to give birth in the “lithotomy” position, an odd pose that consists of lying flat on your back with your feet and legs raised, sometimes in stirrups.

In fact, short of actually duct-taping your legs together, this is pretty much the worst position imaginable to give birth in. And that’s not the opinion of a bunch of hippies who think that childbirth should involve dolphins and mood lighting: The World Health Organization has called use of the lithotomy position “clearly harmful,” and recommended that it be eliminated.

And when you think about it, it’s not hard to see their point: With the woman on her back, the baby is actually fighting gravity on its way into the world, and rest assured, that baby is in no hurry whatsoever to escape a world in which breathing and eating are already taken care of. The result: a more difficult labor and an increased rate of severe vaginal tearing. And as if that image was not utterly horrifying enough, directed pushing (those people who stand around the mother yelling “Push!”) has been shown to increase perineal damage and childbirth pain while also decreasing the amount of oxygen that gets to the fetus.


So how the hell are we meant to do it?

Basically, the head-down, legs-in-the-air position has become standard in modern medicine mainly because it gives doctors direct and unrestricted access to your hoo-hoo. The thing is, having babies is a lot like making babies — there’s no one position that suits every situation. The World Health Organization recommends giving women the opportunity to move around during labor and change their position according to what feels right.

But science can tell us that non-lying-down positions reduce tearing and that a squatting labor position usually opens up the pelvis by 10 percent. And as anyone who has ever got their head stuck in a drainpipe knows, a 10 percent increase in space can sometimes mean a lot. Basically, squatting should be given some sort of medal at this point.


Not known for extreme sensitivity, the Cracked writers miss that some women prefer being on their backs, which is not “wrong” as the title suggests. If extreme sensitivity is not your thing, do click over to view the whole article and the hilarious captioned pictures.


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Reader Comments (7)

Wow I had never heard of this site, and now am finding it quite hilarious. Thanks!

April 4, 2011 | Unregistered CommenterLilRedMommy

Lol. I love me some Cracked. They had a similar article a while back about common medical proceedures "that secretly aren't worth it," and they mentioned both cesareans and circumcision: http://www.cracked.com/article_18840_5-common-medical-procedures-that-secretly-arent-worth-it.html

April 4, 2011 | Unregistered CommenterAshley

I love Cracked! I can easily spend an afternoon clicking around those list articles.

Am excited to see that these truths are starting to reach a lay audience - especially one that doesn't necessarily spend a lot of time thinking about childbirth.

April 4, 2011 | Unregistered CommenterKate

Um "The "champagne cork" position" (gotta go to the link above) ROFLMAO!!!!

April 4, 2011 | Unregistered CommenterJennifer

I am still hoping we can get a Captain Morgan sponsorship for promotion of standing during labor! Maybe a contest where any mom who sends in a pic of laboring in that position gets a free bottle. Because nothing goes together like liquor and new motherhood, amirite?

April 4, 2011 | Unregistered Commenteremjaybee

The Unnecesarean... brought to you by Captain Morgan. Nothing strange about that at all. You must be some kind of ad wizard.

April 4, 2011 | Registered CommenterJill

bwahaha "as anyone who has ever had their head stuck up a drainpipe knows, 10% can mean a lot. ...basically, squatting should be given a medal at this point".

April 4, 2011 | Unregistered CommenterQoB
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