- you have to work harder pushing the baby uphill;

- pain may be greater in this position than in a vertical one;

- the tissues of the birth canal may be slow to open and be stimulated by the descending baby, thus possibly prolonging labour;

- there is a greater need for an episiotomy;

- there may be an increased chance of a forceps delivery;

- it inhibits spontaneous delivery of the placenta;

- there is a greater possibility of lower back strain.

Slow Deliveries

What is considered to be the normal length of labor varies from hospital to hospital— and it is the marrying of what is right for you with what is normal for the hospital that causes problems. Procedures that are more likely to be used when the medical staff wishes to hurry you include:

- rupturing the membranes (if still intact), or setting up a Syntocinon drip to speed up contractions.

- use of an episiotomy and forceps.

The unkindest cut?

An episiotomy is an incision that helps deliver a baby`s head; it isn’t always needed if the head is delivered slowly.

The mid-line cut

To perform this the doctor have to cut straight down into the perineum, between the vagina and anus.

The medio-lateral cut

A local anaesthetic in your perineum, known as a pudendal block, is usually necessary beforehand.

If you have already had an epidural for your labour, you will probably not need any further anaesthetic, unless it has worn off, in which case it may be topped up.

Episiotomy

This is a surgical cut to enlarge the vaginal oudet at delivery, and is the most commonly performed operation in the West. Episiotomies are employed in order to avoid tears, which have ragged edges and are difficult to stitch together and were believed to heal less well. This is not the case. Tears can be avoided if a woman is encour­aged to stop pushing while the head is being born, and is allowed to let her uterus ease out the head gradually rather than quickly. When the head delivers too fast, an episio­tomy may be done because the perineum is thought to be under stress. If you wish to avoid an episiotomy, have it noted that you don’t want one unless absolutely necessary.