The “Reset Position” to Change the Contractions
Check out this picture carefully. This is NOT your old ‘Knee-Chest’ position! But it could save your next labor a great many hours. Do you see the incredible differences in the pelvis of this mother and father? It goes beyond just male and female pelvic shapes, mama’s is spread wider in part because her position is not leaning on her elbows. The mama in this candid photo had been in on-off strong prodromal (‘early’) labor for nearly 20 hours. And you won’t believe how fast the baby came after utilizing this ‘Reset Position.’
There are many ways to shift a labor pattern, some more effective than others, of course. And it depends on the situation, the mother and the baby, and any ‘whys’ that we can surmise. Is it the baby’s position? Too many ‘helpers’ and conversations diverting the focus in the birth room? Are both parents comfortable with where they are birthing? Has exhaustion derailed the effectiveness of the contractions? Midwives and doulas know it’s always great to have a few extra ideas to draw on in situations like these, and especially when prodromal labor comes and goes repeatedly, or drags on and on.
One of the differences in labors that are attended by midwives and those attended medically is how we might go about working with labor patterns. Everyone naturally uses the tools they are most familiar with. Since obstetrics is by definition a surgical medical specialty, their most commonly used tools tend to be meds and surgery. Midwives tend to work more intimately with the rhythms of labor and the individuals involved, and tend to be more comfortable with the varied timeline it may take for the physical process to work itself out.
The ‘Hands and Knees’ position is instinctively assumed by women in labor all the time. And sometimes it’s suggested that women go farther, into yoga’s ‘Child’s Pose.’ I’ve coined the term ‘Reset Position’ for the posture in the picture above. I thought I invented it (but really, who’s inventing anything new after 1000’s of years of birthing women?!) Then I found out that Sue Rusk, a tremendous midwife who did 2600+ births in Michigan’s Amish community, also figured out this pose and used it extensively.
The Reset Position can be done in any setting, repeatedly, and even when exhaustion has set in or epidurals used. Best results come with holding it 45 minutes. If mamas have the strength, it can be followed by going to the bottom of the stairs, and coming up the stairs two-at-a-time. This adds some asymmetry to the situation, we’ve had several babies at +2 forever born at the top of the stairs. Really.
Yes, this may be very uncomfortable, especially if she needs it very much. We have gotten creative to accommodate moms’ needs; like protecting a sore neck by having her at the edge of a bed with her forehead on a chair and pillow. Just recently we did this during labor with a mama who could only tolerate contractions in the water. We laid down a yoga mat in the walk-in shower, and dad in swim trunks used the hand-held water sprayer on her back while we kept her face clear of water at the edge and coached her up close.
This Reset Position opens the pelvis wide, and provides an opportunity for the baby to back OUT of the pelvis and REPOSITION itself. Gravity can help rotate baby’s back towards anterior (towards the floor in this case), and the extra space helps them line up their head. It has effectively repositioned asynclitic babies, posterior babies, and “I-wish-we-knew-what-was-going-on-with-you!” babies. And while of course sometimes not much happens, quite often things change rapidly.
Which is just what happened in this picture. Dad encouraged her while she went into a knee-chest position, and then was directed to take it more extreme…down lower and arms out behind. The mama in this picture held the Reset Position for 30 minutes. Towards the end, two good working contractions signaled the possible resumption of active labor. She went to the bathroom, and then things took off. Her baby was born 22 minutes later!!✨♥️✨♥️✨♥️.