Vertical birth beds

My last post about the Borning Bed reminded me of a correspondence I had a few months ago with an assistant dean at a large state medical college. He wrote to me:

"I received a request from a public hospital in Peru for a vertical birthing bed. Might you direct me to manufacturers etc. who could help me?"

This was my reply:

I'd love to help out with this.

Two major birth bed manufacturers in the US are Hill-Rom and Stryker Adel. Neither of them are made specifically for vertical birth. However, both of them have squat bars that attach to the bed. If you raise the head of the bed all the way, the woman can kneel backwards, draping the top of her body over the back (see page 4 of the Adel brochure, for example). Still, these beds are mainly used for the typical on-the-back delivery positions. The Ave birthing bed is similar, but I've never seen it used here in the US. Again, it's mainly designed for on-the-back or reclined positions with the legs up, but can be adapted for squatting, hands and knees, or kneeling positions.

Frankly, a fancy bed isn't necessary--and in fact it's a bit of an oxymoron--for upright or vertical birth. The very point of birthing in upright positions is that you aren't lying in a bed. Instead of needing to buy specialized equipment for vertical birth, the hospital will only need to invest in inexpensive, simple devices that facilitate being upright (which can include hands & knees, kneeling, sitting on a birth stool, squatting, or standing). You can also use an existing bed in creative ways, as this handout illustrates. Some simple tools or equipment for upright birth might include:

• railings or bars mounted on the walls in various heights, to assist with squatting
• a high surface to lean the upper body on while standing up (such as a countertop, elevated bed, etc)
• birth balls (also known as exercise balls or yoga balls--large inflatable balls used for sitting on or leaning over when kneeling)
• a birth stool (such as the deBy birth stool designed by a Dutch midwife or this wooden birth stool with handles)
• mats or cushions for kneeling on
• knotted rope mounted from the ceiling, for the mother to hang onto while standing or kneeling
• large, deep tubs for laboring or birthing in. Some hospitals in the States have installed permanent labor/birth tubs; others use inflatable tubs such as the La Bassine or Birth Pool In A Box (these tubs can be reused if you purchase the disposable liners)

Training the hospital staff will be a much more important task than buying a special bed. The doctors, nurses, and midwives will need to know what upright birth looks like and how to encourage and support women giving birth in upright positions. I'd be happy to talk more with the hospital about this (if someone there speaks English--my only foreign language is French). I have personal experience supporting women as a doula and a midwife's assistant in both hospital and home settings, and most of those births have been upright. I also gave birth to both my children either kneeling or squatting.

I could also know physicians who are used to doing vertical/upright births even when women have epidurals. This takes some practice, since you have to know how to move all the wires and tubes the woman is connected to when she has an epidural, as well as how to support her when she has minimal or no use of her legs. Perhaps the hospital would be interested in talking with them?

Anyway, this has been a long answer to a short question! Let me know if I can be of any other assistance.

 I haven't heard anything back from him yet. I hope the information was useful for the hospital in Peru. Anything else you would suggest for a hospital wishing to implement vertical/upright birth?

ps--to see how vertical births look in one Peru hospital, watch the video and slidehow that accompany the article Peru embraces vertical births to save lives. It's definitely an intimidating, clinical environment in these images--but at the end of the day, all you need is a place to kneel down and something, or someone, to hold on to.