Lithotomy Position and Childbirth

What is the lithotomy position?

In simple terms, this means lying flat on your back with your legs wide apart – usually in stirrups. This position is still the favored birth position for doctors and in hospital births. It is also referred as the supine position.

Why is this position favored?

Well, if you wanted to hear that it is favored because it has proven to be best for birthing moms…you will be disappointed.

The lithotomy position has in fact been proven to be best for medical personnel only. Do you have doubts about the validity of this statement? Here are some quotes:

  • “Except for being hanged by the feet, the supine position is the worst conceivable position for labor and delivery.” ~ Roberto Caldeyro-Barcia, former president of the International Federation of Obstetricians and Gynecologists


  • “The lithotomy position is the best. Here the patient lies with her legs in stirrups and her buttocks close to the lower edge of the table. The patient is in the ideal position for the attendant to deal with any complications which may arise.” ~ Human Labor and Birth’ by Oxorn and Foote


  • “This position, in other words, is the easiest for performing obstetric interventions, including maintaining sterility, monitoring fetal heart rate, administering anesthetics, and performing and repairing episiotomies.” ~ McKay and Mahan

Why is this position not good for labor and birth?

  • It places all your weight on your sacrum (tailbone area) which in turn narrows your pelvic outlet – your birth opening. The immediate consequences of this is that it increases the length of your labor as well as makes the pushing stage much harder. Case in point, try going to the bathroom while laying down flat on your back.
  • This position compresses your major blood vessels located in your back. This in turn will affect your blood pressure by lower it and having a cascade of other effects: lower blood pressure means less oxygen supply to your baby, which means your baby is likely to suffer from fetal distress. Some studies have shown as much as a 91% decrease in fetal transcutaneous oxygen saturation levels.
  • This position also shows to promote weaker, less frequent, and more irregular contractions which is not good news for you – the birthing mom. You have to work much harder at getting your baby out. It also increases your risks of tearing or of receiving an episiotomy.

Note: if you have an epidural, you will have few choices of birth positions.

Was the lithotomy position always the position of choice?

A resounding no! Most women around the world used to birth while in a squat – and for good reasons! Squatting opens your pelvis at least 30% more – yes 1/3!

Exodus 1:16 ~ Bible “When you help the Hebrew women in childbirth and observe them on the delivery stool, [squatting] ….”



Lithotomy Position



Advantages of Other Birth Positions Over the Lithotomy Position


“A review of the literature reveals that the influences of maternal position changes during labor and birth have been a continuing topic of interest and research over many years. Some of the outcome variables studied about the effects of maternal positioning in labor include:

1. decreased maternal pain

2. facilitation of maternal-fetal circulation

3. quality of uterine contractions

4. decreased length of labor

5. facilitation of fetal descent

6. decreased perineal trauma and fewer episiotomies”

Overcoming the Challenges: Maternal Movement and Positioning to Facilitate Labor Progress MCN, The American Journal of Maternal/Child Nursing, March/April 2010


So in conclusion, the lithotomy position is only good for medical personnel and having a natural birth gives you the choice between many birth positions which in turn increases the chances of a positive birth experience free of unnecessary interventions.

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