著者

永井 宏

出版者

日本産科婦人科学会

雑誌

日本産科婦人科學會雜誌

巻号頁・発行日

vol.39, no.8, pp.1281-1286, 1987

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Before the introduction of the recumbent birth position by Francois Mauricesu,an obstetrician of the 18th century French court,most women in the world had used various positions during childbirth. They sat,stood,squatted knelt according to their build or custom, but it is noteworthy that their trunk was always more vertical than horizontal. Now,in the 1980s,there seems to be a trend toward a return to natural birth positions after a two-century tradition of recumbency. Since the first advocation of the natural birth position by Forrest H. Howard in 1954,it has been widely admitted that the maternal upright position during childbirth has many physiological advantages both to the mother and to the fetus. Six years ago,we began to investigate the combined use of the sitting birth position with continuous fetal heart rate monitoring using radiotelemetry. Our delivery management,is based on the following: Walking in the first stage of labor;utilizing a sitting position with the aid of a labor chair;and employing the sitting position with the use of a birthing chair in the second stage of labor. Our results showed that delivery in sitting position have a lot of advantages. It is effective in the second stage of labor for an increased expulseve effort,and in coincidence of the line of fetal cescent with the delivery induction line,and for the utilization of the fetal weight. Viewed from a mental standpoint,this position allows a wider field of vision,enabling them to feel a mental superiority over the midwives. Another advantage of this position is that it enables mothers to hold their newborn babies in their arms and makes it easier for the newborn to breast feed. This is effective for promoting a more proper motherbaby interactions. The duration of labor is shorter,and blood loss was smaller in the group managed in a sitting position than in the group in a supine position. And result of analysis about umbical venous blood were favourable. Sitting labor using radiotelemetry gives maximum safety for the development and birth of babies,makes for a less stressful,more natural-childbirth and safe on the part of the mother and her baby. I hope that it will be a basic concept of perinatal medicine in the future.