by Donna Harvel Balo ARNP, CNM, MS
Q. My girlfriend is 37 weeks pregnant and is starting to thin. The doctor just informed her that her pelvis is narrow. Now she is afraid. I think her best chances of delivering naturally are using a birth ball, squatting or delivery on her hands and knees.
Am I correct or would it be better to tell her to plan for a c-section? Are there other positions and things she can do to prepare for a normal delivery?
A. I imagine she is scared, with a comment like "narrow pelvis". But, it is the same pelvis she has always had, so why the need to comment now about it, I wonder?
Sit down with the provider and have a serious discussion. Ask the c-section rate of the provider. What is the expected weight of the baby, average? Perhaps a birth plan, expressing her preferences and desires would be helpful. Include in the birth plan her desires if she has a c-section.
One thing I have learned is that we can measure pelvises and think we know something, but we can only reach so far. Women's bodies are powerful and amazing! I have felt pelvises that I have wondered about, and the woman has had no problems. With this little spark of doubt now in the way, she may need additional help and support. Perhaps hiring a doula would be a good idea. A doula would help you both with ideas and suggestions to help facilitate labor.
You are right that she will have the best opportunity of a successful vaginal birth if she is active and using many different positions to help the baby line up: squat, walk, lunges, dance, relax in a tub or shower, the birth ball, hands and knees, massage . . . She should stay hydrated and eat during labor to give all the fuel she will need. Aromatherapy and music can also be very helpful.
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