By Shalini Wiseman, Chartered Physiotherapist in Women’s Health & Continence, Cork University Maternity Hospital in Ireland
As a physiotherapist in women’s health, my introduction to the Comfortable Upright Birth- Support (CUB-Support) was in the labour ward. No, not for myself, but for the purpose of updating the hospital guidelines on the management of pelvic girdle pain in labour.
This was during my trip to the down under (or labour ward, as the staff call it) with another colleague to review the new beds being used. This is a bi-annual opportunity for us to examine the beds and evaluate the range of movement required for the labouring hips, especially for antenatal women suffering from debilitating pelvic girdle pain.
In a corner-we spotted a cosy looking blue inflatable seating. The midwives raved about how useful it was during labour,’ working as a gym ball during labour with the comfort of being seated with support and safety’.
As curios physios do, we proceeded to take turns, sitting on it and adopting different positions- gravity-assisted positions for the first phase of labour of course!
It was surprisingly comfortable and felt more secure than a gym ball. CUB-Support provided the safety of being supported while sitting, with the ability to rotate and tilt your pelvis to alleviate any discomfort at the sacroiliac joints (SIJ). It also allows you to lean forward onto it in kneeling, or in a forward lean with the CUB-Support on a bed (Fig.1). From this position, you can rock back and forth with ease and safety, thereby easing any discomfort in the low back. This secure support is not felt with a gym ball unless a husband kindly obliges by holding it while you do different gravity-assisted dynamisms.
Small rocking movements at the lumbosacral joints have been utilised in many traditions to help ease labour pain, the Mexican Rebozza techniques being one such example. The CUB-Support allows for a bit more: working as a gym ball to alleviate restriction and aids movement at the SIJ and hips while allowing for the Rebozza techniques without the woman being restricted on a seat or her hands and knees. Additionally, the CUB-Support has a distinct sensation of while you rock your pelvis, a combination of mild vibrations, wobble and bounce with a definite sense of being supported and secure while doing so.
I am really taken by this! I needed to take this out of the down under and move it to the first floor (Physio department). In order to aid women in their second and third trimester in the self-management of pelvic girdle pain with safety, I decided to modify some of their gym ball exercises for use on the CUB-Support. This approach proved very beneficial.
Forward kneeling, upright positions and rocking have always been advised in the late trimester to allow the descent of the baby into the pelvis. CUB-Support allows 36 weekers to sit upright or adopt a supported kneeling position and leaning forward onto the CUB-Support to rock back and forth with secure support
The majority of the women loved the fact that with the CUB-Support they could experience the same benefits that the gym ball provided in the easing the SIJ discomfort while also experiencing the soothing affects of the wobbling motion that is peculiar to the CUB-Support. And all this with the added assurance of knowing they would not fall off it. The CUB-support is not just useful in labour. I have found it helpful in antenatal classes especially for women with debilitation pregnancy-related pelvic girdle pain who need the reassurance of safety while exercising.
The above information is a clinical opinion based on clinical experience. The CUB-Support has only been used with patients under supervision. There is no research supporting my claims, but this has been my anecdotal experience. However, there is the scope for utilising CUB-Support for pelvic girdle exercises in the third trimester by politely borrowing it from the labour ward.
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