Position d’accouchement : et si les professionnels s’adaptaient davantage au corps de la femme ?

Accoucher les pieds dans les étriers. Telle est "la norme" en Occident. La Haute autorité de santé (HAS) précise qu’en France, la majorité des futures mamans accouchent allongées sur le dos. Une aberration pour les spécialistes qui prônent un accouchement plus physiologique et naturel. Et cette photo virale, initialement publiée en janvier 2019 sur Instagram par un hôpital de Dallas, aux Etats-Unis, et largement partagée ces dernières semaines, donne une tout autre image de la naissance. On y voit une femme de dos, sur les genoux en plein travail. On aperçoit une sorte de bosse au niveau du losange de Michaelis, une zone située entre les fossettes sacro-iliaques et le sillon interfessier.

 

 

 

 

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Our bodies are AMAZING!!! I love witnessing its majesty! This second time mom had a precipitous/rapid birth and used chiropractic care throughout her pregnancy & postpartum @cafeoflifedallas “The rhombus of Michaelis (sometimes called the quadrilateral of Michaelis) is a kite-shaped area that includes the three lower lumber vertebrae, the sacrum and that long ligament which reaches down from the base of the scull to the sacrum. This wedge-shaped area of bone moves backwards during the second stage of labour and as it moves back it pushes the wings of the ilea out, increasing the diameters of the pelvis. We know it’s happening when the woman’s hands reach upwards (to find something to hold onto, her head goes back and her back arches. It’s what Sheila Kitzinger (1993) was talking about when she recorded Jamaican midwives saying the baby will not be born ‘till the woman opens her back’. I’m sure that is what they mean by the ‘opening of the back’. “The reason that the woman’s arms go up is to find something to hold onto as her pelvis is going to become destabilised. This happens as part of physiological second stage; it’s an integral part of an active normal birth. If you’re going to have a normal birth you need to allow the rhombus of Michaelis to move backwards to give the baby the maximum amount of space to turn his shoulders in. Although the rhombus appears high in the pelvis and the lower lumbar spine when it moves backwards, it has the effect of opening the outlet as well. “When women are leaning forward, upright, or on their hands and knees, you will see a lump appear on their back, at and below waist level. It’s much higher up than you might think; you don’t look for it near her buttocks, you look for it near her waist. (Text credit @Dr Sarah Wickham) ???? North Dallas Doula Associates #chiropractor #chiropracticadjustment #chiropractic #bestdoulasindallas #northdallasdoulas #ndda #childbirth #unmedicated #naturalbirth #birth @TLC @Discovery @taprootdoula @birthwithoutfear

Une publication partagée par North Dallas Doula Associates (@northdallasdoulas) le 5 Janv. 2019 à 3 :30 PST

 

 

 

 

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Our bodies are AMAZING!!! I love witnessing its majesty! This second time mom had a precipitous/rapid birth and used chiropractic care throughout her pregnancy & postpartum @cafeoflifedallas “The rhombus of Michaelis (sometimes called the quadrilateral of Michaelis) is a kite-shaped area that includes the three lower lumber vertebrae, the sacrum and that long ligament which reaches down from the base of the scull to the sacrum. This wedge-shaped area of bone moves backwards during the second stage of labour and as it moves back it pushes the wings of the ilea out, increasing the diameters of the pelvis. We know it’s happening when the woman’s hands reach upwards (to find something to hold onto, her head goes back and her back arches. It’s what Sheila Kitzinger (1993) was talking about when she recorded Jamaican midwives saying the baby will not be born ‘till the woman opens her back’. I’m sure that is what they mean by the ‘opening of the back’. “The reason that the woman’s arms go up is to find something to hold onto as her pelvis is going to become destabilised. This happens as part of physiological second stage; it’s an integral part of an active normal birth. If you’re going to have a normal birth you need to allow the rhombus of Michaelis to move backwards to give the baby the maximum amount of space to turn his shoulders in. Although the rhombus appears high in the pelvis and the lower lumbar spine when it moves backwards, it has the effect of opening the outlet as well. “When women are leaning forward, upright, or on their hands and knees, you will see a lump appear on their back, at and below waist level. It’s much higher up than you might think; you don’t look for it near her buttocks, you look for it near her waist. (Text credit @Dr Sarah Wickham) ???? North Dallas Doula Associates #chiropractor #chiropracticadjustment #chiropractic #bestdoulasindallas #northdallasdoulas #ndda #childbirth #unmedicated #naturalbirth #birth @TLC @Discovery @taprootdoula @birthwithoutfear

Les pieds dans les étriers, une position imposée

Bien souvent, la position gynécologique est imposée aux femmes surtout pour le confort qu’elle apporte à l’équipe médicale. Or, la posture du quatre pattes, sur le côté, ou encore l’aménagement de la position gynécologique peuvent faciliter la trajectoire du bébé.

Comme le rappelle l’OMS, toutes les femmes devraient pouvoir choisir (sauf cas d’urgence) la position dans laquelle elles souhaitent accoucher. Mais on en est encore loin…