The effects of squatting while pregnant on pelvic dimensions: A computational simulation to understand childbirth

Hemmerich, Andrea; Bandrowska, Teresa; Dumas, Geneviève

doi:10.1016/j.jbiomech.2019.02.017

Cited by 37 publications

(71 citation statements)

References 19 publications

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“…It suggests a potential functional motion at the sacroiliac joint during pelvic rotations. It also supports the idea that changing one's posture could lead to a change in pelvic incidence and pelvic tilt and, consequently, to a change in the pelvic space of the birth canal [11][12][13][14]. Loading conditions during dynamic labor positions and increased ligament laxity during pregnancy would expand the pelvis [13].…”

Section: Introductionsupporting

confidence: 70%

“…Description of the body positions that can be easily assumed by every pregnant woman, with particular regard to the procedure of shifting from a position to another, in observance of the evidence from previous researches [2][3][4][5]11,[13][14].…”

Section: In Which Postures To Measurementioning

confidence: 99%

“…Some evidence suggests that the intermediate positions (hands-and-knees position) have a better impact on the dimensions of the diameters of the birth canal than the supine or squat position [11,13]. The dynamic activities and alternative positions are encouraged by midwives during labor and moving may generate greater pelvic mobility than the comparable static posture [14].…”

Section: Introductionmentioning

confidence: 99%

“…Research with optical-electronic instruments evaluates the change of the position in the space of the sensors placed on the external surface of the body [5,11,[13][14], but some studies show that external landmarks move with body movement due to the soft tissue artifact that would affect external markers located above those points during movement analysis [15]. The human hand is a very precise and reliable sensor; the hand is one of the most complex and beautiful pieces of natural engineering and it allows us to manipulate small objects with great precision [16].…”

Section: Introductionmentioning

confidence: 99%

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A Postural Approach to the Pelvic Diameters of Obstetrics: The Dynamic External Pelvimetry Test

Siccardi

Valle

Matteo

et al. 2019

Cureus

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In recent years, there has been a renewed interest in internal and external pelvimetry, in relation to the diagnosis of dystocia from a "contracted pelvis." Dystocia is still one of the causes of maternal-fetal morbidity and mortality in the world. The main cause is the fetalpelvic disproportion, of which mechanical dystocia and contracted pelvis are most probably involved. Clinical pelvimetry was the diagnostic method of "contracted pelvis" and still seems to have its place in the clinical obstetric routine. Studies have been conducted in order to measure anatomical diameters and correlate them with operative or vaginal delivery. Some studies have been published regarding the diameters' variation with the shifting of the patient's posture. The positions used in the research for the analysis of changes in pelvis measurements are the same as those used for centuries to assist and promote childbirth. This technical report is to define a method of measuring changes in classical pelvimetric external diameters in relation to the postural change of the subjects, taking into consideration the needs of the operators, the postural difficulties of pregnant women and the evidence acquired from instrumental research. It aims to propose a dynamic postural method suited to daily practice, according to the directives and principles of the classical external obstetric pelvimetry.

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Section: Introductionsupporting

confidence: 70%

Section: In Which Postures To Measurementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A Postural Approach to the Pelvic Diameters of Obstetrics: The Dynamic External Pelvimetry Test

Siccardi

Valle

Matteo

et al. 2019

Cureus

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“…Since relaxin has endothelium-dependent vasodilation effects on the uterine artery [31], it seems feasible that the uteroplacental flow was more efficient during the labour in women with higher relaxin. Another plausible reason is that women with greater flexibility have greater laxity of the pelvic ligaments, which increases the degree of bone movement and pelvic diameters [47] and this could favor better birth outcomes. This result is clinically important since lower arterial pH levels (pH<7.20) in the umbilical cord blood are strongly associated with increased neonatal morbidity and mortality [48].…”

Section: Association Of Maternal Physical-fitness Measures With Umbilmentioning

confidence: 99%

Association of objectively measured physical fitness during pregnancy with maternal and neonatal outcomes. The GESTAFIT Project

et al. 2020

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AimTo analyse i) the association of physical fitness during early second trimester and late pregnancy with maternal and neonatal outcomes; and ii) to investigate whether physical fitness is associated with the type of birth (vaginal or caesarean section). MethodsPregnant women from the GESTAFIT Project (n = 159) participated in this longitudinal study. Maternal physical fitness including upper-and lower-body strength, cardiorespiratory fitness (CRF) and flexibility were measured through objective physical fitness tests at the 16 th and 34 th gestational weeks. Maternal and neonatal outcomes were collected from obstetric medical records. Umbilical arterial and venous blood gas pH and partial pressure of carbon dioxide (PCO 2 ) and oxygen (PO 2 ), were assessed. OPEN ACCESS Citation: Baena-García L, Coll-Risco I, Ocón-Hernández O, Romero-Gallardo L, Acosta-Manzano P, May L, et al. (2020) Association of objectively measured physical fitness during pregnancy with maternal and neonatal outcomes. The GESTAFIT Project. PLoS ONE 15(2): e0229079. https://doi.

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Textbook typologies: Challenging the myth of the perfect obstetric pelvis

VanSickle

Liese

Rutherford

2022

The Anatomical Record

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Medical education's treatment of obstetric‐related anatomy exemplifies historical sex bias in medical curricula. Foundational obstetric and midwifery textbooks teach that clinical pelvimetry and the Caldwell–Moloy classification system are used to assess the pelvic capacity of a pregnant patient. We describe the history of these techniques—ostensibly developed to manage arrested labors—and offer the following criticisms. The sample on which these techniques were developed betrays the bias of the authors and does not represent the sample needed to address their interest in obstetric outcomes. Caldwell and Moloy wrote as though the size and shape of the bony pelvis are the primary causes of “difficult birth”; today we know differently, yet books still present their work as relevant. The human obstetric pelvis varies in complex ways that are healthy and normal such that neither individual clinical pelvimetric dimensions nor the artificial typologies developed from these measurements can be clearly correlated with obstetric outcomes. We critique the continued inclusion of clinical pelvimetry and the Caldwell–Moloy classification system in biomedical curricula for the racism that was inherent in the development of these techniques and that has clinical consequences today. We call for textbooks, curricula, and clinical practices to abandon these outdated, racist techniques. In their place, we call for a truly evidence‐based practice of obstetrics and midwifery, one based on an understanding of the complexity and variability of the physiology of pregnancy and birth. Instead of using false typologies that lack evidence, this change would empower both pregnant people and practitioners.

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The effects of squatting while pregnant on pelvic dimensions: A computational simulation to understand childbirth

Cited by 37 publications

References 19 publications

A Postural Approach to the Pelvic Diameters of Obstetrics: The Dynamic External Pelvimetry Test

A Postural Approach to the Pelvic Diameters of Obstetrics: The Dynamic External Pelvimetry Test

Association of objectively measured physical fitness during pregnancy with maternal and neonatal outcomes. The GESTAFIT Project

Textbook typologies: Challenging the myth of the perfect obstetric pelvis

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