Ep 145: Push It Real Good

If you’ve watched a movie or TV show where a woman is giving birth, most often, it’s in a hospital, she’s in a semi-reclined position, and she’s typically screaming at someone.  But…….your birth doesn’t have to look like that!

This conversation explores the importance of pushing positions during labor and childbirth. Dr. Shannon and Doula Rachael discuss the downsides of a single pushing position and emphasize the benefits of using gravity and changing positions. They highlight the importance of listening to your body's natural instincts, the role of comprehensive childbirth education, and the support of a doula in advocating for pushing positions in a hospital setting are also discussed.

The conversation concludes with a focus on upright pushing positions and the benefits of water birth. This conversation explores the importance of movement during labor and the limitations of medical interventions.  You'll learn the impact of epidurals on the pushing stage and how to maintain movement.

The conversation also highlights the role of chiropractic care and pelvic floor physical therapy in facilitating efficient pushing. It emphasizes the importance of advocating for one's desired pushing positions and staying curious throughout the birthing process.

Topics covered:

• Different pushing positions
• Why changing positions is beneficial during labor
• How chiropractic care can help with the pushing stage
• What pushing positions can look like with an epidural (also check out Episode 92: all about epidurals )
• How childbirth education courses can help you have an empowered birth experience and learn pushing positions (check out Episode 50: hospital based classes vs independent childbirth ed cla

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Transcript

Dr. Shannon (00:12.833)
Stula Rachel here, Dr. Shannon here. Yeah, we're here. But we got an intro.

Cause this is too good. Too inter -music today. At -bat music. The same, the same there.

Dr. Shannon (00:32.225)
Get up on this. We are talking about pushing positions. And that's why I needed salt and pepper. Salt and pepper here. That's my jam. Oh my God. We had a... This just came to us like two seconds ago to start with some intro music. We hope you enjoyed it as much as we just did. I don't even know where we're at right now. We're talking about pushing positions. And that's what we're talking about today.

Rachael Hutchins (00:52.76)
That was amazing. That was amazing.

Dr. Shannon (01:02.081)
Let me see some salt and pepper. So why are we talking about pushing positions? One goal that I had with this, again, Dr. Shannon here, Dula Rachel here, you got your regular host just in music form, rare form. No, we don't normally show this. Yeah. But Rachel, I started off and I was like, we should do, push it.

Rachael Hutchins (01:15.704)
Rare form. Maybe not rare form, just not shown on the podcast form.

Dr. Shannon (01:28.245)
Push it real good. She was like, please do that and I was like no I'm gonna get the music going but here we are we are talking about pushing positions today because I wanted to talk about That you don't only have to push on your back pushing on your back isn't always bad and that you can have interventions that can Limit or hinder how you push but it doesn't have to that's though that was

kind of the main goal of what I wanted to talk about today too. And then we'll get into a little bit of how chiropractic can help as well. So again, welcome to the show, Rachel. I know, I could have just kept going.

Rachael Hutchins (02:08.728)
Hi, Dr. Shannon. Amazing intro. I didn't want it to end, but we got a, you know, don't want to get copyright infringement or whatever. Giving credits on Peppa. Oh my gosh, that took me back. I won't say to what year or what stage of life I was in, but that was fantastic. So yeah, pushing, pushing position. This is definitely in both of our areas of work with I'm a virtual year chiropractor. Like,

Dr. Shannon (02:17.855)
That was Salt and Pepper. Push it. We love them. We love them.

Dr. Shannon (02:26.369)
Uhhh... Mm -hmm.

Rachael Hutchins (02:37.24)
It is definitely a conversation. Your clients are probably asking you about it. You know, and you're giving guidance and advice leading up to the birth for how to be, have efficient pushing stage, how to have a safe and healthy pushing stage. And then that's definitely part of childbirth education, birth, doula prep. We have these conversations come up a lot with our clients because they're kind of like, either they have this vision about how they want to push, or they have a lot of questions, concerns, and fears around pushing because they've heard bad stories or whatever.

Um, and so, you know, the pushing stage is the third stage of, or sorry, wrong, second stage of labor. Uh, first stage is everything zero to 10 centimeters. And then once you're complete and baby's nice and low, then you begin the second stage, which is the pushing stage. Third stage is the delivery of the placenta, just to give quick overview. Um, and the pushing stage is if you've only ever seen it, like in a movie, it.

Dr. Shannon (03:35.081)
Mm -hmm.

Rachael Hutchins (03:36.12)
appears to be this either horrible, like painful, you got maybe a screaming person with a purple face, sweaty. Um, and so you've got like that vision and then it's usually like they look like that and then they have a baby. Like there's not, and of course it's a movie. They're not going to, you don't get everything that led them to that point. And all there is is like a quick push and a baby's there. That's just not how it goes in.

Dr. Shannon (03:54.369)
Yeah.

Dr. Shannon (03:58.847)
Mm -hmm.

Dr. Shannon (04:05.445)
Uh huh.

Rachael Hutchins (04:06.008)
real life for most people. So if that's all you've ever seen, we encourage you to explore real birth videos and real childbirth education so that you can learn about what pushing actually is and how to push effectively. I think there's no, I've witnessed a lot of birth. I've been doing this for nine years now. There's no magic position. There's no,

Dr. Shannon (04:31.329)
Mm -hmm.

Rachael Hutchins (04:33.048)
do this exact thing and your baby will just come right on out. There isn't. Like I've seen moms push babies out in like one contraction and I've seen pushing stages go on for five hours. And I don't think anyone did like the one who did it in one push didn't necessarily do anything specifically. Yeah, there's just not there, but there are things.

Dr. Shannon (04:37.119)
Mm -hmm.

Dr. Shannon (04:49.929)
Mm -hmm.

Dr. Shannon (04:56.669)
Different or better, right? Mm -hmm. Mm -hmm.

Rachael Hutchins (05:02.296)
So there's no way we can like guarantee a certain outcome with pushing. But when you can learn about what's normal with pushing, some tips for pushing, what helps like gravity, so being more upright or gravity neutral or changing positions regularly, how it's not just about staying in one position the whole time. Like you might envision yourself like squatting your baby out, but like you can't stay in a squat for.

Dr. Shannon (05:22.367)
Mm -hmm.

Rachael Hutchins (05:29.88)
your entire pushing stage unless it's like a super, you know, unless it's like I said, like one contraction, which is just not the normal, right? A lot of first time moms push like one to two hours. So that's more of like your normal, what would be considered a normal range for pushing. But knowing that using gravity, changing positions every like five to seven contractions and, and avoiding staying on your back for the whole time.

Dr. Shannon (05:34.593)
that room with one one.

Dr. Shannon (05:52.575)
Mm -hmm.

Dr. Shannon (05:58.591)
Mm -hmm.

Rachael Hutchins (05:58.904)
And so I think the idea of like not pushing on your back gets a little bit of a, the reason it gets a bad rap is because so many people are told that they need like, because they're in a hospital and because of either protocol or because of their epidural or medications they're on that they have to stay on their back. And then they're not offered any other positions through the laboring process and the pushing stage. So they don't even know that they can change positions. And that's the downside to the back. That's the problem. And we know.

Dr. Shannon (06:14.409)
Mm -hmm.

Dr. Shannon (06:25.057)
That's the problem. Mm -hmm. Is when you feel confined to that. Mm -hmm.

Rachael Hutchins (06:28.854)
Yeah, you're confined and you're and when we when you stay on your back when you're laying especially with pressure on the sacrum you close the pelvis by like 30 percent and the baby needs as much room as possible to get through so it makes sense to be off of the sacrum and giving as much room for the baby to move through the pelvis as possible that is going to make a more effective labor. But really the goal is changing positions every time you change positions you change the shape of your pelvis.

Dr. Shannon (06:39.071)
Mm -hmm.

Dr. Shannon (06:57.459)
Mm -hmm.

Rachael Hutchins (06:57.56)
Right? Like every time you move, even slightly, it's gonna, it's gonna provide room.

Dr. Shannon (07:02.113)
And you know, I remember because I wanted to talk about this too, because I only pushed on my back with both babies and I wish I had tried some other positions. And I remember that that thing in your body that comes to your brain and you're like, I would like to change positions. Like you it's this innate thing that happens and you're and it's.

Rachael Hutchins (07:24.472)
Mm -hmm.

Dr. Shannon (07:26.867)
moms will say it and they'll be like, I just, I think I need to move. I think sometimes I'll say it I think I need to push. Like it's all of these little things. Like it's listening to that. And sometimes I don't think we're, we let moms listen to that voice when it's like, I really think I need to move or one Mia, whatever it is. So that's another reason why I want to talk about this is like that whole, like innate thing of mom saying, okay, you, your body.

Rachael Hutchins (07:30.36)
Mm -hmm.

Rachael Hutchins (07:37.752)
Mmm.

Rachael Hutchins (07:43.446)
Mm -hmm.

Dr. Shannon (07:52.395)
knows what to do to a degree, you know? And so that's where you've got to listen to it. And that's where I love the like changing those positions exactly. And it's not like, oh, well, if I squat, I'm going to have the baby. It's like, well, maybe a squat now helps baby engage this way. Because it's that beautiful dance. It's all these little turns that baby needs to use to shimmy out of birth canal. And so changing those positions can help so much with that, can help so much.

Rachael Hutchins (07:55.)
but you gotta be willing to listen to it.

Rachael Hutchins (08:11.968)
Mm -hmm.

Mm -hmm. Yep. Yep. And like it's when people visualize it might be hard for people to visualize the path that baby takes. So if I had my pelvis here and my baby, I would show you and this is where if you took childbirth education or I'm sure in your office, you can show them what is happening with their pelvis at this point is you can show, you know, you have a baby in their head and it has to fit into the pelvis and it's not a straight line out like.

Dr. Shannon (08:23.551)
Mm -hmm.

Dr. Shannon (08:31.327)
Mm -hmm.

Dr. Shannon (08:40.905)
Mm -mm.

Rachael Hutchins (08:41.368)
the baby enters in one direction and then they rotate to come through the pelvis and then their shoulders have to come through. So they have to be in a certain way to come through and then they rotate, you know, it's like they call it the seven cardinal rotations or movements or something that a baby takes to get through the pelvis. It's more of a down and a rotation through. And what helps that is movement and changing positions. It's going to facilitate a more efficient labor. And so,

Dr. Shannon (08:57.247)
Mm -hmm.

Mm -hmm.

Rachael Hutchins (09:09.656)
something we tell our moms of like, because a lot of moms will ask like, talk, let's talk about pushing positions. And we always show a few and we're going to highlight some here, but we do tell them that they have to be willing to listen to their body because only they can feel baby on the inside. Even if you're medicated, there's some innateness going on and you've got to tap in more intentionally and try to listen to your body because it will guide you.

Dr. Shannon (09:24.223)
Mm -hmm.

Dr. Shannon (09:30.441)
Mm -hmm.

Rachael Hutchins (09:38.276)
Especially if you're unmedicated you can really feel everything that's going on and that's what we see a lot of people like we don't have to tell them what to do a lot of people will assume certain positions that feel good to them and they're going to help their baby come through. But if you are medicated or if you're struggling to know what to do then that's where a doula or an educated partner can help give you these like okay let's try this for five contractions let's try this for five contractions just to kind of maybe sometimes you do need that external guidance.

Dr. Shannon (09:42.143)
Mm -hmm.

Rachael Hutchins (10:07.672)
And that's okay, too.

Dr. Shannon (10:07.689)
Mm -hmm. Yeah, because sometimes you or if you are in that Maybe you're at suffering stage or something, you know You're you're really having some aches and pains and it's hard to manage that that change in position can be like make or break the aspect of how labor goes but sometimes you do need that little like I feel like the doula like whispering in your shoulder like hey remember you can you know squat or kneel and

or laying your side, we got a peanut butt, like we got all these other little things. It's just that little reminder sometimes you might need that. So.

Rachael Hutchins (10:35.384)
Yeah, just got to remind them. Sometimes they need that reminder. And if you've had like childbirth education or talked with someone beforehand who's like kind of planted the seeds, when the doula or the educated partner who's taken childbirth education or has made themselves aware is like giving you that reminder, you're gonna be more likely to be like, oh yeah, like I, yes, I remember that. And then.

Dr. Shannon (10:46.985)
Mm -hmm.

Dr. Shannon (10:57.921)
I don't think this was in my childbirth education because like I've said before, I only took the hospital one and I can guarantee you I did not. I didn't talk about this. Yeah. Outside the hospital. We do.

Rachael Hutchins (11:03.032)
Yeah, the hosp, yeah, not, yeah, so we're talking like comprehensive childbirth education. So different than hospital -based. I think we have an episode on that. Like the difference in hospital -based versus comprehensive outside of hospital -based childbirth education. Definitely we encourage that out of hospital, which I think if you're able to take both, it's still a cool, it can be a cool experience to go through the hospitals class if they have it and if it's free, especially.

Dr. Shannon (11:28.009)
Mm -hmm.

Rachael Hutchins (11:28.184)
but definitely taken out of hospital. You're going to learn about all of these positions, stages of labor, what's normal, tips, tricks, resources. And again, having a doula there too, who has all of this information and can kind of identify labor patterns and maybe positional things going on with the baby to offer various specific positions based on how your labor is going that can help reduce pain and maybe make it more efficient.

Dr. Shannon (11:32.289)
so much more.

Dr. Shannon (11:51.401)
Mm -hmm.

Rachael Hutchins (11:54.322)
But again, there's no magic wand. I wish I had it. I wish I could be like yes do XYZ and baby will come right on out But that's today. We're going to talk about some different positions

Dr. Shannon (12:00.737)
Exactly.

Dr. Shannon (12:04.769)
But being aware of the positions that, not that you can do, it's not like, I don't know. It's just being aware that you can change these positions. And I think hearing it and talking about it now, it'll bring forth to your mind a lot easier while you're in labor. So yeah.

Rachael Hutchins (12:19.992)
Yeah, and if you're giving birth like in a hospital setting, like the vast majority of the population, what like 97 or 98 % of people get birth in a hospital, this is definitely something you have to advocate for. This is not a given in most settings. So talking with your provider ahead of time about how they, my favorite, one of my favorite ways of phrasing a question is how do they support the pushing stage? That is an open -ended question.

Dr. Shannon (12:33.855)
Mm -hmm.

Dr. Shannon (12:46.271)
Mm -hmm.

Rachael Hutchins (12:49.336)
and let them share with you a little bit about what they do in that stage. And then you can say, how do you support me pushing in upright positions? How do you support me changing positions? You know, and really try to get some insight into how they support birth. And it really should be supportive of changing positions often. Like you don't have to go in and say, I don't want to push on my back. It doesn't have to be combative. It's just really advocating for being able to change positions often.

Dr. Shannon (13:00.223)
Mm -hmm.

Dr. Shannon (13:11.167)
Right.

Rachael Hutchins (13:16.664)
and that your provider supports that and understands the benefit of it. So working on that autonomy ahead of time, that informed and shared decision -making ahead of time, and what you can expect in their birth space and being supported by them. So in the home birth setting, most of my experience with home birth, all of it actually, they are very supportive of changing positions. So not to assume anything, again, I would still...

Dr. Shannon (13:16.819)
Mm -hmm.

Dr. Shannon (13:38.623)
Mm -hmm.

Rachael Hutchins (13:42.136)
ask the same question to my home birth midwife because they all do it maybe slightly differently. But again, it's insight, it's information gathering, it's relationship building, communication building. And every little time you do this, you learn a little bit something new. So it's a bit of a process leading up to the birth.

Dr. Shannon (13:59.231)
Mm -hmm. Yep. Yep. Yep. Okay. So our first position is gonna be the We call our traditional I would assume like laying on your back but also known as semi reclined position because it's typically if you're this again in the hospital, well, I guess if you're in your bed at home, but You're not laying flat. It's you are somewhat, you know Lift it. Yeah, like kind of seated up. This is that traditional. Mm -hmm

Rachael Hutchins (14:23.)
It's kind of like a C shape.

You got a little bit of support back. You kind of, the goal is to kind of curl around your belly, kind of pulling your knees back. Ideally, if you're in this position, you're, if you're pulling your knees back, you are the one doing it, not the support staff or a doula or your husband, because you kind of know your range of motion and you don't want anyone pushing your legs beyond that. So yeah, usually you got either pillows or the bed behind you.

Dr. Shannon (14:32.841)
Mm -hmm.

Dr. Shannon (14:41.097)
Mm -hmm.

Dr. Shannon (14:50.655)
Mm -hmm.

Rachael Hutchins (14:54.488)
You can also do this position with your partner sitting behind you. I see this at home often, but it can be achieved in a hospital setting. It can be really connective and supportive and you can still be in that semi reclined. It can be a restful position. You know, this is the position that I think some people definitely see most in the movies or have heard most people birthing, you know, kind of on their back, semi reclined coach pushing kind of knees up to their ears type of thing.

Dr. Shannon (14:57.993)
Mm -hmm.

Rachael Hutchins (15:24.536)
And this might be the position that a lot of people don't want to be in, but I do want to talk about it in a way of like, this is not the, a bad position. Some people I've seen people work through all the other positions first and end up in this position and it'd be the most effective way for them to get their baby out. But I guarantee you everything they did before that helped. Right? So like I said, you can do this with your partner behind you. You can be in charge of pulling your knees back. Like,

Dr. Shannon (15:41.599)
Mm -hmm.

helped the movement. Yeah.

Rachael Hutchins (15:52.024)
You can breathe and push on your own counts. It doesn't have to be purple pushing or force pushing. But just kind of painting like the pros and cons. The cons is that it can reduce the openness in your pelvis if there's too much pressure on your sacrum.

Dr. Shannon (16:06.625)
Yes.

And sometimes to baby position and that'll be that's where you might feel it's probably because both of my kiddos were Sunny side up, you know what we say like Oxford? Anterior and so if you are on your back and baby is it in necessarily the best position? That's where you might feel more of that back labor more of that pressure and that desire to want to change and move because when you can change and move

Rachael Hutchins (16:20.792)
Ooh.

Rachael Hutchins (16:35.67)
Mm -hmm.

Dr. Shannon (16:37.761)
then that can help baby into better position as well. So it's again, you know, reading those signs from your body as well, but it can be done.

Rachael Hutchins (16:46.52)
Yeah, and I think being in a reclined, semi -reclined or on your back position with a posterior baby is one of the hardest positions to be in because, you know, the baby's like, the widest part of the baby's head is trying to come through versus the smallest and it just, it can be hard.

Dr. Shannon (16:53.577)
Mm -hmm.

Dr. Shannon (17:04.159)
Mm -hmm.

Rachael Hutchins (17:09.32)
So if you know that, and some people don't know that that's the position the baby in, but if you're feeling that pressure in your back constantly, especially between contractions, definitely try, like you could try some of these other positions, even sideline can help get pressure off the sacrum and make more room for baby to come through.

Dr. Shannon (17:09.481)
Mm -hmm.

Dr. Shannon (17:13.673)
Yeah.

Dr. Shannon (17:27.195)
Okay, so what's another, what do we have next? Some upright positions. Talk to me about upright positions with birthing.

Rachael Hutchins (17:34.936)
Yeah, so upright positions, I like to call them gravity friendly positions. So think about anything where you're working with gravity versus against gravity, like laying on your back is kind of against gravity. Whereas being standing or squatting is is gravity friendly. Gravity neutral is going to be hands and knees or sideline. So upright is really any standing position or squat or a

a modified lunge or a asymmetrical lunge. You can even sit on the toilet and push. That's a great, if you're starting to push.

Dr. Shannon (18:07.145)
Mm -hmm.

Dr. Shannon (18:17.525)
Oh, even if you're like facing the toilet too, have I seen that sometimes? Not necessarily like you're sitting to have a bowel movement, but like also the aspect of like...

Rachael Hutchins (18:21.592)
Yeah, I mean you can.

Yeah, facing backwards, like I'd say beginning stages of pushing this would be supported. Obviously, a lot of providers don't want to catch a baby on a toilet or risk baby being born in the toilet. So I see this more supported at home in the hospital setting. I see most nurses and doctors and midwives getting a little like twitchy around the idea of you being on the toilet and pushing, but it can be a great place to start pushing.

Dr. Shannon (18:33.097)
Mm -hmm.

Dr. Shannon (18:38.857)
Mm -hmm.

Dr. Shannon (18:50.207)
Mm -hmm.

Rachael Hutchins (18:50.392)
and just see how it goes because you're you relax all the right muscles when you're on the toilet. Gravity is on your side, so you just sort of like test it out. Again, it can be part of the rotation, but upright is enhancing the pelvic opening, right? Because there's no pressure on the sacrum. You're able to every time it's just walking like if you were lying down in bed and got up and went to the bathroom, just that that action like between contractions is going to could help, right?

Dr. Shannon (18:57.343)
Gravity is working.

Dr. Shannon (19:20.159)
Mm -hmm.

Rachael Hutchins (19:20.44)
Another gravity friendly squat position that you can do in the hospital is using the squat bar. So the hospital beds have an attachment that isn't on the bed. You have to ask for them to bring it to you, but it's like a bar that goes over the end of the bed. So you can get into a good supported squat where you're hanging onto the bar with your hand and then in that squat position. And there's lots of modified ways you can do a squat. You can do it with your partner.

Dr. Shannon (19:28.457)
Mm -hmm.

Dr. Shannon (19:49.537)
Yeah, I was going to say you can have that support there with the partner.

Rachael Hutchins (19:50.008)
You can do it with a rebozo or a sheet. And so that can, that's, those are some different upright positions. If you're like leaning over a birth ball, you could do like a lunge and then curl around your belly when you're pushing. There is something called a birth stool.

Dr. Shannon (20:04.927)
Mm -hmm.

Rachael Hutchins (20:14.776)
That is also great for, it's like a semi, it's similar to sitting on the toilet, but yet it's a, it's got usually like a bag, like a plastic bag under it and some handles on it. So you can really kind of, you get that same sort of feeling and sensation. You can kind of pull up on the handles and then you're, it's, you know, midwife or provider can catch the baby or assess things if needed a little bit easier. But you get that gravity on your side and just being upright.

Dr. Shannon (20:32.447)
Hmm.

Dr. Shannon (20:41.513)
Mm -hmm.

Rachael Hutchins (20:43.896)
is really beneficial for pushing.

Dr. Shannon (20:46.993)
Mm -hmm. I know I hear um Trying to think I feel like I have had a lot of moms with This is some sort of upright in like either a kneeling or a lunging with birth, maybe I'm just thinking as of late, but um, I

Rachael Hutchins (21:03.158)
Mm -hmm.

Dr. Shannon (21:08.907)
It's good to know. Hands and knees, I guess, and some, I hear a lot, I do hear this one a little bit as well too though. So, I mean, hands and knees is, I recommend hands and knees during pregnancy a lot because that helps with optimal fetal positioning while baby is in utero. But yes, you could also.

Rachael Hutchins (21:23.992)
Mm -hmm.

Dr. Shannon (21:34.337)
be in this position for pushing as well. So.

Rachael Hutchins (21:39.416)
It is, yeah, it's the position that I see assumed most in unmedicated births and without guidance. So like, I would say it's just the position that a lot of people gravitate to all on their own. And if that's the case, we just go with that. It's a great position if you're having a lot of back pain during pushing or labor takes pressure off the back, helps baby rotate forward. It's like if you're dealing with a posterior baby.

Dr. Shannon (21:51.657)
Mm -hmm.

Dr. Shannon (21:58.761)
Mm -hmm.

Rachael Hutchins (22:08.086)
And it's just like, it's like this in between from lying down and standing up. Sometimes standing up is maybe too much pressure and lying down just can't tolerate that. So like hands and knees is a great in between. And you can do hands and knees over a ball, over the back of a bed, over a stack of pillows. And I like it because then in between contractions, you can kind of rest your head on the pillows or on the ball. And then at the pushing stage, you're getting longer breaks between contractions versus like the end of labor.

Dr. Shannon (22:14.751)
Mm -hmm.

Dr. Shannon (22:29.759)
Mm -hmm.

Rachael Hutchins (22:35.712)
end of labor contractions are like a minute and a half, two minutes apart. But then once you get to pushing, you get like four or five minutes. I've seen moms doze off between pushing. So if you're in a restful -ish position, but still gravity friendly, you can maybe rest your head. And then when that urge to push comes, then you can bear down with it. So yeah, I definitely love the hands and knees position. And the more you are assuming that position in pregnancy, like you mentioned,

It'll be easier to access in labor. Mm -hmm. Yeah. Mm -hmm.

Dr. Shannon (23:05.025)
Yeah, maybe it feels more comfortable. Yeah, while in labor. Another one we have is the side lying position. I often think of this with either a doula or support person kind of holding that upper leg. Excuse me. I knew I had to sneeze. Sorry. Thank you. That support person may be holding.

Rachael Hutchins (23:26.968)
Mm -hmm.

Rachael Hutchins (23:30.616)
Bless you.

Dr. Shannon (23:35.105)
the upper leg or a peanut ball. So maybe we can talk about like that as well too, like having that between but sideline. I think I have a lot more moms that labor in this position, but I don't know if I have too many that birth in that position, you know, but like it's one of the positions that you can go to. I think people don't realize it.

Rachael Hutchins (23:40.374)
Mm -hmm.

Rachael Hutchins (23:53.08)
Yeah.

Yeah, all of these positions you can use in labor. I mean, it's a great restful position for in labor. And I see it more in labor with the peanut ball or a big stack of pillows between your knees and supporting your ankle to keep your pelvis open and then no pressure on the sacrum. So that's why it's a really great, great position. So you get a little bit of rest and keeping your pelvis open, things moving along. And then with pushing, I see it more where,

Dr. Shannon (24:02.921)
Mm -hmm.

Dr. Shannon (24:06.985)
Mm -hmm.

Dr. Shannon (24:12.991)
Mm -hmm.

Rachael Hutchins (24:25.57)
the partner or doula is holding that top leg, helping them hold it between contractions. And then when the contraction comes, it's encouraged that the birthing person grabs their own top leg. And then you kind of still do that like C curl. Like you can even grab your bottom leg and bring your knees up a little bit and curl around it, but you're on your side.

Dr. Shannon (24:28.617)
Mm -hmm.

Dr. Shannon (24:38.177)
they grab their leg.

Dr. Shannon (24:43.775)
Mm -hmm.

Dr. Shannon (24:49.609)
Mm -hmm.

Rachael Hutchins (24:49.72)
And so that again is pressure off the sacrum. You're getting that like curl around your belly, which sometimes that's really beneficial to help push baby down and help you feel grounded. Cause you kind of got that resistance with your own legs. Um, so you do that while you push. And I see that pretty regularly, especially in the hospital setting, because it's like, we're trying to change positions, but within, you know, keeping providers happy, they really like, even if you're changing positions for you to be in the bed, cause that's quote unquote safer.

Dr. Shannon (25:01.023)
Mm -hmm.

Dr. Shannon (25:15.263)
Mm -hmm.

Dr. Shannon (25:19.905)
Yeah. Safer. Safer for who? Yeah.

Rachael Hutchins (25:20.76)
You know, that's conversation for another day, but you can. Right. But the side, but it's still a great position, right? We can rest in between contractions. You have a partner helping with the upper leg. You're still in control of like when you're pulling your legs back and crawling around, you're staying off your sacrum. All, all pros in my category, in my opinion. And then to change positions, you can just go to your back and then to your other side.

Dr. Shannon (25:31.561)
Mm -hmm.

Dr. Shannon (25:49.855)
Mm -hmm.

Rachael Hutchins (25:49.912)
and all of that is still shifting your pelvis, right? And now you go to the other side and you push over there for five or so contractions. And then you could go to your back for a little bit and then you could go to the other side. And if you're able to kind of rotate all the way over and get onto your hands and knees, that could just be your rotation. You do hands and knees to one side, to your back, to other side, to hands and knees. Like that's wonderful. Like, you know, and you're kind of...

Dr. Shannon (26:04.575)
Mm -hmm.

Dr. Shannon (26:10.687)
Mm -hmm.

Mm -hmm, that's really cool.

Rachael Hutchins (26:15.256)
you're conserving some of your energy being upright and maybe that's all you can access because you've labored for a couple of days and you're really tired and standing up your legs just can't tolerate it. So, you know, I love the sideline and you could even just do a slight, a modified sideline with just like a wedge. Like imagine if you're lying flat and then you take either a pillow or a styrofoam wedge and put it under like one hip just to get you like elevated on one side. That's, that's a subtle,

Dr. Shannon (26:39.617)
Just to prop that side up.

Rachael Hutchins (26:45.522)
difference that can help with pushing and then get a wedge for the other side and switch sides and maybe that's all you can access. That's still better than lying flat on your back for the entire time. Not even flat, even semi -reclined on your back. Yeah.

Dr. Shannon (26:47.945)
Mm -hmm.

Dr. Shannon (26:52.575)
Mm -hmm.

Dr. Shannon (26:56.609)
Yeah, exactly. I like that visual of moving everything around. I have a lot of moms that want to do a water birth and different aquatic positions. I have to say, I think most of my moms want a water birth and they're always like, and then I was kneeling outside the tub and I had my baby. It was like, yeah, I hear that a lot, but I think...

Rachael Hutchins (27:10.008)
Yeah, love water.

Rachael Hutchins (27:20.856)
Hey, guilty as charged.

Dr. Shannon (27:25.281)
It could even be a little bit of you labor in the pool and have the water and that aspect of things to help with that. And then so maybe you do birth in the pool or you don't. You move around. But yeah, you could definitely birth in the birthing pool. You see all the pictures. They're so pretty. I love it. It's very serene. It's very calm. Mm -hmm. Mm -hmm.

Rachael Hutchins (27:28.832)
Mm -hmm.

Mm -hmm.

Rachael Hutchins (27:36.502)
Yeah.

Rachael Hutchins (27:44.6)
Yeah, and the same principle applies. You don't just sit in one position in the water. So benefits of the water is that buoyancy and that kind of takes the pressure off. You feel a little bit weightless and less gravity pulling down on you. So you get a sense of relief. I love the antidote, aquadural. Because the water provides that therapy in a way of pain management. Really warm water.

Dr. Shannon (27:54.697)
Mm -hmm.

Dr. Shannon (28:05.663)
Uh, uh huh.

Dr. Shannon (28:10.345)
Mm -hmm.

Rachael Hutchins (28:12.34)
deep water, like if you can get into a true birth pool, it's like covering your whole belly up to your shoulders. Like that's just providing a lot of relaxation, releasing tension. It's also softening your tissues. It can really help reduce tearing too. So just laboring in water, being in the shower and even pushing in the water. Like you said, even if you don't deliver in the water, there's still many benefits to laboring. I can share my personal story. My first was born in the water and

Dr. Shannon (28:17.129)
Mm -hmm.

Rachael Hutchins (28:39.48)
I, it took me a while to kind of figure out pushing and we were almost to the point of like they were wanting me to maybe try getting out of the water because I was having a hard time grounding and getting enough like, like, um, counter pressure to effectively push. And I was a first timer so I could see that they were, and this is a lot hindsight with what I know now, like, you know, maybe she would push better on earth, on land versus on earth, on land versus in the water.

Dr. Shannon (28:55.529)
Uh -huh.

Dr. Shannon (29:05.311)
Mm -hmm.

Rachael Hutchins (29:09.432)
but they were very patient. And I would just rotate through and we rotate through similar positions as we've just walked through, but you're in the water. So squat, being on my side, hands and knees. And I was in a big, deep birth pool, so I was covered in water the whole time. And then the position that finally helped me was a squat, but then tug of war added in. So tug of war is where...

Dr. Shannon (29:20.319)
Mm -hmm. Mm -hmm.

Dr. Shannon (29:33.601)
Okay, I was gonna mention that, yeah.

Rachael Hutchins (29:35.864)
The medulla held a sheet. I think she actually held a robozo scarf, but sheet works the same. And then she leaned back. I stayed in the pool in a deep squat and I pulled towards my body. And when I did that, it sent the pressure down in the right way. And all of a sudden I was like, Oh, I get it now. I can feel like that work. And so that just speaks to like, it took me like an hour just to figure out how to coordinate things.

Dr. Shannon (29:43.977)
Mm -hmm.

Dr. Shannon (29:49.695)
Mm -hmm.

Dr. Shannon (29:54.209)
Yeah. Yeah.

Rachael Hutchins (30:05.08)
to push effectively. We talk about that a lot with our expecting moms, especially if they haven't done it before. If like, be gracious with yourself. It takes some time to sort of learn how to effectively push. And so that helped me. So I was in a squat, but I was like, I went from squat to kind of leaning forward as baby was emerging. And so baby actually came out like behind me. He...

Dr. Shannon (30:05.129)
Mm -hmm.

Dr. Shannon (30:11.977)
Mm -hmm.

Dr. Shannon (30:30.303)
Mm -hmm.

Rachael Hutchins (30:30.456)
was born because I ended up almost like moving towards hands and knees or like leaning over the side of the tub and ever it came out behind me and then I like rolled over and got him. But that supported squat with a robozo tug of war was really helpful for me. And then my second, I was in and out of the water a bunch and kind of got to like eight centimeters and was just like hanging out around eight. And my midwife suggested, OK, you've been in the water a while. We've been at the same stage for a while. Like, let's.

Dr. Shannon (30:33.025)
Sort of. Mm -hmm.

Dr. Shannon (30:48.289)
Hahaha.

Rachael Hutchins (31:00.536)
So we did a couple of positions with my doula and then things went very quickly from there. Went to the bathroom, water broke. And then it was like two contractions later he was here. And I was like next to the tub, just like you were saying. Like I, there was no getting back in the tub. Like that, even though it was like maybe 15 feet, like that was, I couldn't get there. It wasn't happening. And that one, I was in a supported squat.

Dr. Shannon (31:13.665)
Yeah, yeah, yeah.

Dr. Shannon (31:23.233)
Uh.

Rachael Hutchins (31:29.504)
laying on like leaning on my husband's knees. So imagine like a squat, he was behind me sitting on a stool, and then I was like draped between his knees. So that's a good supported squat. And then I was like leaning my armpits were over his knees. And you know, so again, changing positions, trying different things, water is great, but then sometimes being out of the water is what's needed. So again, trying to hold it all loosely, but knowing there are many, many benefits to just simply laboring in the water.

Dr. Shannon (31:32.777)
Uh huh.

Okay. Uh huh. Uh huh.

Dr. Shannon (31:42.547)
Mm -hmm.

Dr. Shannon (31:57.417)
Mm -hmm.

Rachael Hutchins (31:58.392)
But all those positions, like you can lean over the edge in a squat or in a lunge, hands and knees, laying back, side lying, it all works in the water too. So just being in the water isn't enough. You gotta be willing to kind of move around. Yes. No. Right. For the most part, yeah.

Dr. Shannon (32:12.129)
Yeah, you still need to move. Like the water's not going to do the work for you, I suppose you could say. Yeah, yeah. For the most part, yeah. I love it. Now, there, I know a, well, not a majority, well, maybe a majority. A lot of, if you are birthing in the hospital, a lot of folks will use an epidural for pain coping mechanisms and...

that can and some other interventions as far as like internal fetal monitoring or if you're hooked up to IV bags and all this sort of stuff, limit your ability to necessarily move freely through all positions. It really, I mean, it really depends, but you do have to think about...

Rachael Hutchins (32:52.984)
Mm -hmm.

Dr. Shannon (33:08.065)
pain coping mechanisms, what you are comfortable with and what you want and what you desire. And then if you do have those, it's good to know, okay, what are my pushing positions that I can use now? You know, so you got to think about that.

Rachael Hutchins (33:21.752)
Mm -hmm.

Yeah, we hear this all the time. We hear this all the time because people are like, well, if I get an epidural, I'm not going to be able to move around. And so that would be like that would go in their reason for not wanting an epidural. And we are still like, we want to be pro whatever you want. And we believe in normal physiological birth. But we also like to paint the picture of like getting an epidural doesn't mean you then have to stay in one position and stay stuck on your back. It's actually like the evidence tells us.

Dr. Shannon (33:34.025)
Mm -hmm.

Dr. Shannon (33:46.463)
Mm -hmm.

Rachael Hutchins (33:49.976)
Otherwise, even with an epidural, you should still be moving and rotating through positions during labor and then especially during pushing. And you can achieve that in the hospital. So it's kind of like good to know, like you still have some options available to you, but you are still, of course, limited and restricted because you're medicated, right? Because you're numb from the waist down or because. Yeah, like you can't just get up and stand next to the bed as at all. Like typically there's no standing.

Dr. Shannon (34:08.287)
Mm -hmm.

You're not going to be in the water, you know?

Mm -hmm.

Mm -hmm.

Rachael Hutchins (34:19.448)
but we can still try to find different positions with the epidural based on how your body's responding to the epidural. So there's a couple, like, this is like the unknown. This would be like a downside of the epidural. It's like, we don't exactly know how it's going to take. If you get a perfect epidural, great. We should still be able to have some movement in our legs. We should still be able to change positions, but you also shouldn't have any breakthrough pain and you should be very comfortable if that's, that's like an ideal epidural. But sometimes the epidural is either.

Dr. Shannon (34:28.255)
Mm -hmm.

Rachael Hutchins (34:48.408)
very, very heavy. So you get what's called like noodle legs. Like your legs are just like, you can't do anything with them. And like, even if I were to go pick it up, it would weigh like so much because the person's like not helping at all. So it's hard even for your support team to maybe even move you in different positions. And in that situation, it's harder to move and change like we've talked about here, right? And then, or you're having breakthrough pain. So.

Dr. Shannon (34:49.897)
Mm -hmm.

Mm -hmm.

Dr. Shannon (35:01.119)
Mm -hmm.

Dr. Shannon (35:10.625)
Mm -hmm.

Rachael Hutchins (35:14.04)
you got the epidural, maybe it's only numbing one side of your body and the other side, like you're having a lot of pain and still feeling the contractions and we just can't get the dosing right. I've seen this plenty of times and when that's happening, you're just typically in a different state of stress and for your whole experience that changing positions either is uncomfortable or you're just like not tolerating it. So therefore you're not moving as much. So again, cause just like a downside of if that epidural doesn't go as planned.

Dr. Shannon (35:28.129)
You're in a different head space.

Rachael Hutchins (35:43.968)
Um, but with a good epidural, um, and I've seen more good epidurals than I've seen bad epidurals. You can, you can assume all the positions, um, almost all of them that we've talked about here, besides like being in the water, you can even, you can use the squat bar to squat. You can get in hands and knees. You can do sideline. Um, you can obviously do your back. You can lean over the back of the bed. Like that's if you just did that rotation, he said,

Dr. Shannon (35:49.889)
Mm -hmm.

Dr. Shannon (35:57.001)
Mm -hmm.

Dr. Shannon (36:09.089)
I know. I wish I had done some other positions when I look back on them. That's why I was like, I really want to do this episode. Yeah. Yeah. Mm hmm.

Rachael Hutchins (36:15.32)
Yeah, like you see like you're like, okay, well I'm in the bed but like that just that rotation I said earlier side uh hands and knees if if accessible and then your other side and then your back and if hands and knees isn't because you really do have to be able to support yourself and like with your knees under you so maybe that's not available but you could do side back other side then wedge back wedge other side like

Dr. Shannon (36:21.097)
Mm -hmm. Very.

Mm -hmm. Mm -hmm.

Dr. Shannon (36:31.753)
Mm -hmm.

Dr. Shannon (36:37.385)
Mm -hmm. Mm -hmm.

Rachael Hutchins (36:44.374)
If you just went back and forth with those every five, like that's, that's good movement. Um, so, you know, and then if you've got real good mobility, you could get the squat bar out. Cause really all you've got to have is be able to get your feet under you and hold yourself up with your hands. And what I encourage, and this is sometimes a picture I have to paint for their provider. If they're a little bit like a squat bar with an epidural.

Dr. Shannon (36:44.607)
There's stuff you can do.

Dr. Shannon (36:55.049)
Mm -hmm.

Dr. Shannon (36:59.519)
Mm -hmm.

Rachael Hutchins (37:07.19)
I'm like, well, they're not staying in the squat the whole time. So you get the, you take the hospital bed and you put it in like a throne position. So the bed breaks in three parts. And so the bottom, you lower it, you keep the middle like a chair, and then you take the back of the bed and you make it straight up. And then the squat bar is over the lowest part of the bed. And so you have your feet and you have your hands and basically all you have to do is scoot your butt off of the edge. And then you hang for the duration of the contraction. Then all you have to do is get your butt.

Dr. Shannon (37:15.039)
Mm -hmm.

Dr. Shannon (37:27.999)
Mm -hmm.

Dr. Shannon (37:32.319)
Mm -hmm. Yep.

Rachael Hutchins (37:37.144)
back up to that chair level and then you rest. Your legs, your feet are resting, your back is resting, you're safe. And so you just alternate that for a little while and that can, I've seen people be able to really make some good progress just by introducing that. But again, it's not as providers aren't as supportive. So you've got to be like, this is how we're going to do it. And, um,

Dr. Shannon (37:39.361)
and then hang out.

Dr. Shannon (37:45.193)
Mm -hmm.

Dr. Shannon (37:57.641)
Mm -hmm.

Rachael Hutchins (38:01.72)
Having a doula helps if you have an epidural in the hospital with these position changes, because they kind of understand it. But if you don't have a doula, just getting your partner on board with helping you through this and having good communication with the nursing staff and getting them on board with helping you change positions. And it's just something you got to advocate for. It's not like the nurse is going to come in always. Now, if you got a good nurse, they will. But they're not going to come in and say, OK, let's change positions. No.

Dr. Shannon (38:07.337)
Mm -hmm.

Dr. Shannon (38:21.727)
Mm -hmm. No, that's, yeah, no, that's not going to happen.

Rachael Hutchins (38:27.8)
So you can't assume that. So you have to be prepared and then whoever you decide to have is your partner supporting you and hopefully a doula, they're gonna be the ones who can guide you through that. So advocating for moving, even with an epidural and not being discouraged, it's not the end all be all. You can still have some movement. And if you have the noodle legs, then just do the wedge. Like just get a styrofoam wedge.

Dr. Shannon (38:37.759)
Mm -hmm.

Dr. Shannon (38:44.769)
even with an epidural.

Dr. Shannon (38:54.953)
Mm -hmm.

Rachael Hutchins (38:57.878)
or pillow and just put it under one side of your hip for 30 minutes and then do the other side and that still helps.

Dr. Shannon (39:04.769)
I will say that if you do not have a labor support person, then you are going to be dependent upon your provider to offer these position changes to you. And I feel like sometimes they might, but most times they're not, if that makes sense. I think was, I don't know if anybody understands what I'm trying to say. Cause like,

Rachael Hutchins (39:31.96)
Mm -hmm. Mm -hmm.

Dr. Shannon (39:34.881)
I didn't have that labor support person, but I think a wedge on one side, a wedge on the other side, and sideline, sideline when I had my epidural would have been beneficial, but the provider wasn't going to do that. So again, I don't want people to, whether you have a midwife or an OB, then yeah, that's where having that support person or...

Rachael Hutchins (39:47.448)
Mm -mm.

Rachael Hutchins (39:54.36)
Yeah, they're not in there for a bulk of it.

Dr. Shannon (40:02.625)
that childbirth education knowledge that comes to mind, you know, to move. So, and we did an episode, episode 92, all about epidurals as well too. So I can't remember if we touched, I think we did a little bit with movement in there. Yeah.

Rachael Hutchins (40:13.368)
And I think we talk about pushing with an epidural and like that as well, because it's a it's a popular question and concern. And it's something that that, you know, can make a big difference in how you feel about your birth. I've heard from so many people, I wish I had changed position similar to what you're saying. Like, I wish I had known I could. And that breaks my heart a little bit as far as like the I wish I know I could is just like, oh, because we all need to feel like we have an option.

Dr. Shannon (40:22.687)
Mm -hmm. Mm -hmm.

Dr. Shannon (40:28.383)
Mm -hmm.

Dr. Shannon (40:32.415)
Mm -hmm.

That's the big one. Mm -hmm.

Dr. Shannon (40:39.721)
Mm -hmm.

Rachael Hutchins (40:42.456)
options even if again I've had mommas who I'm like here's would you like to like change positions and sometimes they're like no like I know my options but like I just don't feel like moving it doesn't feel right to me and I honor that but that's different than not being given an option.

Dr. Shannon (40:43.369)
Mm -hmm.

Dr. Shannon (40:55.519)
Mm -hmm.

Dr. Shannon (40:59.969)
Yeah, yeah, then feeling like, okay, this is yeah, this is where I'm at. So check out that episode. I really only want to add a few nuggets about chiropractic care because I am not adjusting moms while they're pushing. You know, I've talked about, yeah, I've adjusted early stages of labor and those and those type of things. Because if there's stalls there, pelvis and sacral alignment,

can impact how long we're in those early labor stages sometimes. So with Webster technique, it's that pelvis and sacral analysis and adjustment that's really looking at the neurobiomechanical functions of the pelvis and sacrum because the nerves that are leaving there are going towards the uterus. It's providing that nerve input to the uterus and helping facilitate brain -body connection and allowing the hormones and that nerve supply to flow.

When we have our pelvis and sacrum that have proper biomechanical alignment and then we have a nervous system that is regulated in the aspect of that brain -body -body -brain connection is optimal, then that can impact the efficiency of pushing as well. So that's how I look at it from chiropractic care as far as like I want moms to be under care before they start pushing.

Rachael Hutchins (42:26.068)
Benefits that they can't even comprehend. It's like you can't, it's like not a tangible thing, but there's so much benefit to being under chiropractic care prenatally. And it's not just about that backache, it's about everything you just said that can help facilitate a more efficient labor and pushing stage. And that's, I know that's in the evidence as far as like shortening the whole process by being under care.

Dr. Shannon (42:29.677)
Mm -hmm.

Mm -hmm.

Dr. Shannon (42:39.423)
Mm -hmm.

Yeah.

Dr. Shannon (42:50.985)
Mm -hmm. Yeah, shortening labor and birth and also, you know, alleviating the need for pain meds as well, you know, because if things are lined up and we're functioning optimally then yeah, things can go a little bit smoother and then this normal physiological process that our body innately knows what to do can happen.

Rachael Hutchins (42:59.224)
Mm -hmm.

Dr. Shannon (43:13.857)
It's almost like chiropractic, something else I saw recently was like it's not, it doesn't heal. I guess it's like a healing art, but it allows the body to heal. So that's, I'm getting a little woo woo here, but how it's supposed to. So yeah, I always write, I always talk about like, I facilitate healing. Like I don't do anything, like everybody that comes in and gets adjusted.

Rachael Hutchins (43:25.336)
so that it can work how it's supposed to.

Dr. Shannon (43:37.025)
their bodies are healing and it's really freaking cool and I love to see it because it's not about me at all. Like it's just like, I just facilitate facilitate. Exactly. So.

Rachael Hutchins (43:38.712)
Mm -hmm.

Rachael Hutchins (43:42.68)
You're just helping connect the things so they're communicating. Like you said, uterus communicating with the pelvis and like the making sure all of that's happening so that things can flow how they it's like the best chance at having the best birth. Like it's like by opening up all these pathways and helping things flow and then helping mom feel good so that she wants to move during labor. Cause I know that's a huge component too. That's the actual tangible thing.

Dr. Shannon (43:57.225)
Mm -hmm.

Dr. Shannon (44:03.209)
Mm -hmm.

That's the big one that I've seen. Right, so that was really fun. I had a mom one time that said, I even wrote it in here. She was able to push in a kneeling position. So she had one knee up and was able to push. That's how baby was born. I'm pretty sure that was, and it was her VBAC and so her vaginal birth after cesarean.

But she was in such pain when she came in the office and I only had three adjustments with her because she came way late in the game. That's not what I recommend. I recommend coming in a little bit earlier. But anywho, we work with all stages. But she was able to kneel and she, I mean, she would not have been able to assume that position had she not gotten adjusted. So in my head, I was like, holy moly, look at how cool that connection was. So yeah, I want you to be out of pain. But that was like to her, that was more tangible as in like, golly, I'm not in pain. Now I can kneel.

Rachael Hutchins (44:39.928)
Hehehehe

Rachael Hutchins (44:52.15)
Yeah.

Dr. Shannon (44:58.977)
and now I can birth this baby in a different manner. So whenever I think of chiropractic care, I always go back to her and I think of that story as in like, that's the heart of it because then I know, okay, that birth has now impacted mom and baby and it all stemmed from, okay, we had some sciatic pain. So I know we had pain that accompanied that dysregulation there, but there's the structural and emotional aspects of care. And so that's what I was getting at with like, we've got the neurobiomechanical,

Rachael Hutchins (44:59.286)
Mm -hmm.

Rachael Hutchins (45:06.816)
Mm -hmm.

Dr. Shannon (45:29.153)
I'm really looking at structure, but also the aspect of reducing stress, helping the nervous system regulate in a more efficient manner. So that tends to be where my goal is. Yes, I want pelvis and sacral line and I want moms out of pain, but it's so much more to me than that. So I'm always looking at it as that emotional...

Rachael Hutchins (45:53.782)
Mm -hmm.

Dr. Shannon (45:58.305)
regulation stage, nervous system regulation stage. But I also want to mention that pelvic floor PT physical therapy can be very, very important as looking at like how to push and how to engage muscles correctly. So I feel like that's a little bit, there can be some dysfunction there. Maybe it's second birth and you know, things didn't heal probably his first time and it's just we're.

Rachael Hutchins (45:58.614)
Mm -hmm. Yeah.

Rachael Hutchins (46:17.76)
Mm -hmm.

Dr. Shannon (46:26.273)
How do we engage diaphragm? How do we breathe through it? How do we contract the muscles? How do we engage with that? Yes, there's some innate aspects to it, but you also potentially have 35 years of dysfunctional muscle movement, just saying. There's also those aspects that we have to work with. Yeah, you might be pushing, but it's like, am I pushing efficiently? I do want to mention pelvic.

Rachael Hutchins (46:42.752)
Mm -hmm.

Dr. Shannon (46:53.633)
in that manner of things. You know, chiropractic care for that too, but yeah.

Rachael Hutchins (46:54.744)
Yep. Pre. Yeah, pre and post. Yeah, I think those two in conjunction are max benefit because they're kind of addressing all of the all of the things. We definitely recommend pelvic floor PT before giving birth and as well as after. I love that it's becoming more of a mainstream thing and seeing more and more people seeking that. I think that's wonderful. And so, yeah, I mean, our.

Dr. Shannon (46:59.721)
Mm -hmm. Mm -hmm.

Mm -hmm.

Dr. Shannon (47:16.799)
Mm -hmm.

Dr. Shannon (47:21.663)
Mm -hmm.

Rachael Hutchins (47:23.032)
Our goal here is definitely to help, again, provide information about things maybe you didn't know, plant those seeds, help you stay curious, and just remind you that you are in charge of your body and your birth and that you have every right to advocate for pushing in whatever position you want to push in. We want you to aim for alignment with your care provider. So those conversations leading up to your birth will really help you.

feel like is this the right person to support me during my birth instead of waiting until you're in the birth space to learn this. It'll help really reduce stress, reduce fear, help you feel confident in your provider. So definitely we're encouraging you to explore this early on. And of course addressing any emotional and psychological aspects of pushing positions.

Dr. Shannon (47:56.639)
Mm -hmm.

Rachael Hutchins (48:16.98)
how that can have a great impact on your overall birth experience and just exploring that and staying curious.

Dr. Shannon (48:24.033)
Exactly. Okay, I'm gonna leave you with this. I gotta do it again. We hope you enjoyed talking about pushing positions today. I don't know that we'll have a soundtrack again, but I just, if you don't like this song, I don't understand. I just love this song. All right, thank you, Salt and Pepper. Thank you, Salt and Pepper. Thank you, Friend, for being, for...

me along in talking about pushing positions today. Stay tuned next Wednesday for another episode with maybe or maybe not a soundtrack.