Do women in the UK give birth differently than women in North America?

Factual Questions
1

I was watching The Lazarus Project on TNT. It is clearly a British TV show made by and for people across the pond. However, TNT bills it as an “Original” on their network. Yeah. Whatever.

Anyway, in one episode, a woman giving birth is an important plot point. In fact, being a show about time travel, this poor woman is made to endure the struggle and pain of childbirth a great many times. This leads to some problems for her.

When the act of childbirth is depicted. the woman is sitting upright and leaning forward against a bed/mattress. In other words, her chest is pressed against the sheets. She screams in pain as she pushes the baby out. The audience does not see any activity below the waist. From her posture, it appears that she is almost squatting as one might when (sorry to be indelicate) pooping in the woods. Basically, her torso is mostly vertical. She is supported by leaning against the bed/mattress, which is also vertical. I think that her boyfriend, nurses, whoever, also help support her with hands on her shoulders.

This is completely at odds with the way I have seen delivery depicted on American TV shows and movies. Invariably, the woman is lying on her back, often with her legs raised and perhaps supported by some sort of stirrups. Of course, the pushing, pain, etc. is part and parcel for the procedure. Even if the birth takes place outside a hospital – such as the back of a car – this is still the posture the woman takes.

In my own life, the only births I have directly witnessed were cesarian, so my experience has no bearing on this. The births I am talking about are vaginal births.

So, is there really a difference in the ways women on both sides of the Atlantic deliver babies? Is this just some convention that TV show producers employ that simply differ in Hollywood versus the UK? Why would this be different? Since women are the same animal all over the planet, it would seem to me that, with millennia of experience, the ideal position for childbirth would pretty much be the same whether in UK, the USA, or Burkina Faso. Are there really different approaches like this?

2

I recall one of those “fun facts” history articles that mentioned that birth in Europe before modern times was typicalli in the squatting position or a “birthing chair”, until some VIP (King of France?) back then had a weird obsession and wanted to see the show in technicolor. That led to it being done for a number of the court and servants on their backs, American style.

I have no idea how true this was. I have trouble imagining this changing how a continent does their thing…

3

AFAIK the delivery position of UK women giving birth varies according to how the baby is presenting. Both our children were born vaginally with my wife on her back, but I have seen births on TV (actual, not drama) in all kinds of positions. Many maternity units offer birthing pools these days as well.

4

If you think about it, squatting does seem more practical than lying on your back - do you lie on your back to poo? Gravity, baby!

Having said that, I have neither given birth or ever been a medical professional in the NHS, so decided to consult the UK’s largest childbirth charity, the NCT, who are generally right up there on latest trends.

They issue a handy pamphlet on your choices for birthing (under the general advice of ‘find what suits you’). I notice that not one of them involves lying on your back.

5

Also, I’ve just noticed a bullet point on the back of that leaflet stating ‘Make whatever you can of what you have to stay upright. Lying down slows down labour’.

I have also checked on the NHS website, and found this guidance. So I guess lying on your back is out!:

Your midwife will help you find a comfortable position to give birth in. You may want to sit, lie on your side, stand, kneel, or squat, although squatting may be difficult if you’re not used to it.

If you’ve had lots of backache while in labour, kneeling on all fours may help. It’s a good idea to try some of these positions before you go into labour. Talk to your birth partner so they know how they can help you.

6

My mom (an American) instinctively found the squatting position most natural, and repeatedly told the obstetrician as much (she, an avid gardener, described the position as “pulling carrots”). IIRC, she wasn’t able to get through to the doctor about this when my older sister was born, but when I was born, the doctor let her do it her way.

7

For various medical reasons both of our kids were born with my wife on her back but in the run-up to the event the generally preferred position was going to be something akin to what the OP suggests.

I’ve been out of the childbirth game for a while now but I wouldn’t be surprised if the upright/squatting varieties of position were now the majority. Anecdotally I hear that it is preferred by women.

8

Right, so squatting is IN in the UK. So the question now is… is this now the norm in the US too, and Hollywood is just way behind the curve?

9

I’ve seen footage of a woman in Japan giving birth in a similar posture, although I think she was on her knees rather than squatting the way most people poop in the woods. I also seem to recall hearing years ago that a women in India typically adopt a kneeling posture, although instead of supporting their upper body from below with a mattress or similar, they grab something that’s hanging from above.

If you go to YouTube and search for kneeling birth, you’ll find lots of examples, although this may not indicate anything meaningful about actual prevalence.

10

My experience in the US has been that expectant moms are encouraged to labor in whatever positions feel right and the L&D ward will have birthing beds that accommodate a range of birthing positions

11

For what it’s worth, I’ve watched a lot of episodes of the BBC drama Call the Midwife, which depicts a women’s clinic, run by Anglican nuns, in London’s East End in the 1950s and 1960s. Nearly every episode of the series depicts at least one childbirth.

Recognizing that it isn’t necessarily a documentary, though they do seem to try to be generally consistent with that era in other things…the show invariably depicts women in labor on a bed, on their backs.

12

The gynaecologist that ran our birthing classes here in the uk was a bit of a comedian. He said that the baby often comes out easier in the same position it was conceived. So the back seat of your fathers car works quite well!

13

We watch that series too. It’s based on the memoirs of Jennifer Worth.

They are shown to be pretty advanced for the times in how they work and while most births are with the mother on her back, they do turn them on to their sides and on hands and knees sometimes.

14

Wild ass guess as to why the lying down position might be used, is that it may be easier for the doctor. (insert misandronist comment).

15

I’d think the use of an epidural might necessitate lying on one’s back? So there may be a correlation (i.e. more drugs = less-upright posture).

Though my wife (UK) just had nitrous oxide, yet was on her back for the birth itself.

16

The antenatal classes I attended in the UK suggested trying out different positions when giving birth, and IIRC claimed that lying on your back is sub-optimal because it means the baby has to go slightly uphill to get over the tailbone. We were shown a video where a woman was giving birth on her back, and the midwife specifically said this was from an earlier time and that position is not recommended now.

I actually gave birth kneeling up, supporting my body against the raised top of the bed, which might have looked similar to the birth depicted in the TV show. I did try lying on my back, and although it was obviously less effort to maintain that position, it felt like it was significantly harder to push, However, mothers who get an epidural presumably have to give birth lying down, since it makes your legs numb.

I don’t know how much the advice and/or practices differ in present day America, though.

17

I expect that position is shown a lot in movies/TV because they can place the camera behind the mother’s head facing her feet, or high above facing down, and get good shots of the action, the actress, the doctor, all without showing any ‘indelicate’ shots during the scene.

18

In both cases where my wife gave vaginal birth, including an extremely difficult one that went on for hours and hours in a specialized medical center for children, they had her flat on her back.

I haven’t seen that many depictions of childbirth on Japanese TV shows, but I don’t believe I’ve seen anything other than the mother on her back.

However, google show that alternative approaches are readily available.

Here is a hospital showing various positions. The site is in Japanese, but it comes with pictures.

19

We have three children, born in US, Switzerland, and Canada* and my wife was lying on her back all three times. I witnessed the first and third. The Swiss doctor had done a residency in the US. I should mention that the youngest will turn 50 later this year, so things might be different now.

*I cannot leave this without mentioning that a border guard, hearing that the kids were born in three different countries, remarked, “You must be a professor.”

20

Misandrist.