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16 Comments
Great to break down the biomechanics and impact on the pelvic bones in each of the different birthing positions shown. and the importance of asking what their birth position was – and if they are comfortable and remember – showing you. I really liked that.
What are your thoughts about the impact of a retroverted uterus to the pelvis ?
I wonder if it impacts the uterosacral ligaments?
Thanks for your attention.
It all depends on how the uterus is situated in there. I find the cervix location is indicative or what is going on with the uterus but the main impact is on the sacrum if the ligaments are attached there. I have found restrictions in the uterine mobility impact the pelvic position more than retroversion.
I often see the “splay” as well as weakness on the Right (and tension on left); many of my moms birth in supine/lithotomy, HOWEVER, thinking of the women who are told to “sleep on your left” and spend tons of time there….creating pelvic asymmetry in pregnancy as well. As well as nursing on side post-partum. Lots of questions to ask them…
This section was very interesting. I saw a patient who was pregnant in her third trimester with an upslip on her right side. She had no falls or injuries. She was not able to walk in the morning until traction was done on her right leg every morning. She would be fine for the rest day. So it was her sleeping position at night which could cause that. I don’t understand how it started?
I”m curious if she already has a kid and might she be holding the baby on that side with the hip thrusting? If not being pregnant causes us to be more flexible so the positions we sleep could be impacting her pelvis and muscles.
Love all of this! I’ve teach a lot of these things in my birth prep classes for how to help baby move and rotate in the birth canal, but so helpful to think of it in more detail from the postpartum side of things. I know these treatments are going to be so helpful for my mamas!
When I go back for a c-section, I always ask the doctor to tell me the position of the baby for this important information. I do assess the baby at birth so I get to see the shape of the head and sometimes there is a red pressure mark of where it was jammed up. When the doctor gives the position I’m able to verify what I am seeing on the baby outside of the womb.
If a patient is coming to you after multiple births, are you most interested in their last birth position, what birth they think their symptoms started, or just rely more heavily on physical assessment? So for example, a patient gave birth in 2019, 2020, 2023, and 2024. They gave birth in lithotomy for the first 3, but in kneeling for #4 but they had pain throughout their 4th pregnancy just never got services. Where does your detective brain put its focus?
Love this question Julia! Since they were having pain in their 4th pregnancy I would be looking for the effects of the lithotomy position and the open birthing pattern. Also the hands and knees position is less impactful on the pelvis as the earlier positions. I also like to ask if legs were supported by people or stirrups as people can make their legs more assymetrical which can cause more issues with the pelvis. However you always put this info aside and assess to see what you find and work with that.
Great to break down the biomechanics and impact on the pelvic bones in each of the different birthing positions shown. and the importance of asking what their birth position was – and if they are comfortable and remember – showing you. I really liked that.
What are your thoughts about the impact of a retroverted uterus to the pelvis ?
I wonder if it impacts the uterosacral ligaments?
Thanks for your attention.
It all depends on how the uterus is situated in there. I find the cervix location is indicative or what is going on with the uterus but the main impact is on the sacrum if the ligaments are attached there. I have found restrictions in the uterine mobility impact the pelvic position more than retroversion.
I often see the “splay” as well as weakness on the Right (and tension on left); many of my moms birth in supine/lithotomy, HOWEVER, thinking of the women who are told to “sleep on your left” and spend tons of time there….creating pelvic asymmetry in pregnancy as well. As well as nursing on side post-partum. Lots of questions to ask them…
YES! All those factors influence the pelvic bones during pregnancy when they are really susceptible to forces. Thanks for this comment.
This section was very interesting. I saw a patient who was pregnant in her third trimester with an upslip on her right side. She had no falls or injuries. She was not able to walk in the morning until traction was done on her right leg every morning. She would be fine for the rest day. So it was her sleeping position at night which could cause that. I don’t understand how it started?
I”m curious if she already has a kid and might she be holding the baby on that side with the hip thrusting? If not being pregnant causes us to be more flexible so the positions we sleep could be impacting her pelvis and muscles.
Great comment. Thanks
Thanks for sharing this!
that’s such an important point!
Love all of this! I’ve teach a lot of these things in my birth prep classes for how to help baby move and rotate in the birth canal, but so helpful to think of it in more detail from the postpartum side of things. I know these treatments are going to be so helpful for my mamas!
Josie, they are!!! Thanks for taking this course and sharing it with your moms!!
When I go back for a c-section, I always ask the doctor to tell me the position of the baby for this important information. I do assess the baby at birth so I get to see the shape of the head and sometimes there is a red pressure mark of where it was jammed up. When the doctor gives the position I’m able to verify what I am seeing on the baby outside of the womb.
Love this Marya!
If a patient is coming to you after multiple births, are you most interested in their last birth position, what birth they think their symptoms started, or just rely more heavily on physical assessment? So for example, a patient gave birth in 2019, 2020, 2023, and 2024. They gave birth in lithotomy for the first 3, but in kneeling for #4 but they had pain throughout their 4th pregnancy just never got services. Where does your detective brain put its focus?
Love this question Julia! Since they were having pain in their 4th pregnancy I would be looking for the effects of the lithotomy position and the open birthing pattern. Also the hands and knees position is less impactful on the pelvis as the earlier positions. I also like to ask if legs were supported by people or stirrups as people can make their legs more assymetrical which can cause more issues with the pelvis. However you always put this info aside and assess to see what you find and work with that.