Stark Michael, Mynbaev Ospan, Malvasi Antonio, Tinelli Andrea
The New European Surgical Academy, Berlin, Germany.
Department of Obstetrics and Gynecology, Santa Maria Hospital G.V.M. Care & Research, Bari, Italy.
Int J Womens Health. 2023 Jul 14;15:1059-1061. doi: 10.2147/IJWH.S405077. eCollection 2023.
Throughout history, the upright position was the norm for most deliveries. However, due to cultural reasons, this practice was changed in the 17th century, and since then, the majority of deliveries have been conducted with the parturient lying on her back. The aim of this review article is to challenge the nowadays recumbent birth position and to emphasize the added value of gravity to the childbirth. Physiologically there is a strong argument for delivering in an upright position due to the significant role of gravity. The baby's presenting part does not move back between contractions as happens in today's recumbent position when due to the anatomy of the pelvis, the presenting part moves uphill. In this position, the second stage is shorter, and the signal for active pushing occurs spontaneously. It is recommended that any parturient should be informed about the risks and benefits of each birthing option to decide the birthing position that suits her.
纵观历史,大多数分娩采用直立姿势。然而,由于文化原因,这种做法在17世纪发生了改变,从那时起,大多数分娩都是产妇仰卧进行的。这篇综述文章的目的是对如今的仰卧分娩姿势提出质疑,并强调重力在分娩过程中的附加价值。从生理角度来看,由于重力的重要作用,有充分理由采用直立姿势分娩。与当今仰卧姿势不同,在仰卧姿势下,由于骨盆的解剖结构,先露部位会向上移动,而在直立姿势下,胎儿的先露部位在宫缩间隙不会向后移动。在这种姿势下,第二产程更短,主动用力的信号会自发出现。建议告知每位产妇每种分娩方式的风险和益处,以便她决定适合自己的分娩姿势。