September 09, 2003

Of birth balls and birth stools

Another topic that was discussed at length during the Orange workshop was the use of birth balls and birth stools. Someone has thoughtfully provided a birth ball and many of the group took the chance to try it out.

One person said she had heard that birth balls were being banned in Sydney because of infection and I quickly squashed this rumour. In fact, some hospitals are phasing out bean bags because of the difficulty of cleaning the seams and installing birth balls instead, which being seamless are not a problem in this regard. One point I did make, however, was that once inflated, care must be taken with storage, so that they don’t come into contact with heaters (everywhere in this cold town!) or sharp edges or corners. If they are punctured they will deflate, although this happens slowly and there is time to get the sitter off. The medical quality birth balls that we sell are much stronger than cheaper balls that can be bought in many shops and have been approved for use in labour. They have a nice lemon scent as well, which is better than the plastic smell of most balls.

Birth stools were another story. In the video Giving Birth, Challenges and Choices, which I show on the first day of the workshop, a very unusual birth stool is shown - it looks like a metal bed cradle turned on it side. Even padded with some towels it looks very uncomfortable, and is quite high - the woman can’t get her feet flat on the floor. Nevertheless, it works well for the mother in the video. The birth stools in use in this district are an Australian design, but I was told that they are not very popular. The backwards slope on the seat encourages the woman to recline and she ends up in a semi-recumbent position, similar to the semi-sitting position on the bed which is so un-physiological. Even though the coccyx is free to move on this stool, the backwards tilt of the pelvis caused by the angle of the seat, does not facilitate the best “drive angle” for the descent of the baby, reducing the effect of gravity and putting more pressure on the perineal tissues. Caregivers like this stool because it places the woman in the same position as she would be on the bed, with the baby coming forwards and up, making it easier for the accoucheur to see and catch the baby.

The Dutch birth stool is much better. It was designed by an ergonomic expert in consultation with the Dutch midwives, who understood the necessary anatomy and forces that operate during birth. It also has a calibrated stainless steel dish that slots into the base, for measuring blood loss, and receiving the placenta. This stool is widely used around the world and is popular with women and midwives. Of course, like all birth stools, using one during labour is a very individual thing, and whether an any specific stool will work will depend on the woman’s size and shape and the design of the stool itself. They form part of the basic labour room equipment in a woman-centred maternity service, offering a simple alternative to giving birth on the bed.

Posted by andrea at September 09, 2003 08:18 AM

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The birth stool used in Giving birth challenges and choices (I think in Santa Cruz California) is the de Buy Birth stool also a Dutch design, you'll find it advertised in Midwifery Today magazines. Advantages are that it is easily transported by the midwife for homebirth (can be worn like a back pack) and as midwife you have access to mum from front, back, and sides. It is a little lower than the average toilet so most women should be able to plant their feet firmly on the ground when sitting on it. I have attended several women in California who chose to use this stool and it worked well. If the woman doesn't want to use it it can be sat on by the midwife. The bowl for placenta fits in under the seat. As with any birth stool it is a nice option to have.

marilyn

Posted by: Marilyn Kleidon on September 13, 2003 07:49 PM

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Posted by: blackjack on January 19, 2004 10:07 AM

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I'm pregnaut with my 1st child, but I have had troubles pushing in bed. Will I have to use a birth ball or stool? How do they work. How about pushing in the toilet. My doctor says that might help me push.

Posted by: katie on February 17, 2004 01:10 PM

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Posted by: katie on February 17, 2004 01:10 PM

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What does a birth stool look like? I might use and or the toilet for my labor and birth.

Posted by: oj on February 18, 2004 07:35 AM

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The Dutch stool has intrigued me, I think it would be wonderful to have available, but it is costly. I do not see it possible to gain here, an Amish/Mennonite birth center.
I use the old deBy stool I bought many years ago. It is indeed handy to portage about. For a few mothers the stool is high (books or bricks under the feet work).

oj, if you are laboring at home, sitting backwards on the toilet or a chair is inexpensive and useful...there are a lot of creative ways to get into that position. If you want to see what a birth stool looks like -go to the www.midwiferytoday.com or the www.birthinternational.com (for a view of the Dutch stool)

Posted by: Sandra Hess, CPM on September 10, 2004 03:41 AM