Shellie Poulter
Doula and Educator
Abdominal Lift and Tilt
This is a highly effective technique to help the baby into the pelvis over the sacral promontory at -2 or -3 station, if contractions are not increasing in strength, if the contractions are strong but the baby remains high or above the pelvis, if you are having back labour pain. It can also be helpful with back pain prior to labour and if the baby is anterior over the pubic symphysis.
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When using in Labour:
It should be done during a contraction – if you begin lifting too late and it is uncomfortable, just stop and wait for the next contraction to begin again
Do for 10 contractions is a row
This can be done standing with a companion behind using hands or a rebozo, on your own against a wall with your own hands lifting the abdomen or on all fours with a scarf or rebozo
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It is not needed when labour is progressing well or rapidly or you feel pressure on your cervix – the baby is already on the way so it won’t help here
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The Abdominal Lift and Tuck needs to be done during a contraction to be effective. Move into position as soon as, but not before, the contraction starts.
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1. As a surge begins, link the fingers and lift the abdomen about two inches.
2. Bring your abdomen in (towards your spine) by one or two inches, depending on your size. Try to be as comfortable as possible - this can really help if the baby is over the pubic symphysis
3. At the same time, flatten your lower back. This is where using a wall can be helpful as shown in the pictures. Knees should be bent. Bending the knees, even just a little, is necessary to do a Posterior Pelvic Tilt.
4. Support your abdomen up and back for the entire contraction. It can feel nice or helpful to sway or rock a little on your feet, just maintain the lift and the tilt.
5. When the surge ends, lean forward slightly and slowly let go of your abdomen - when contacting the body alway introduce and release gently, slowly and gradually - this feels more caring and calming for the nervous system. Between surges, move your legs to encourage circulation, stepping or slow dancing can feel nice.
6. Then repeat the Abdominal Lift for ten contractions in a row, resting in between and circling your wrists and ankles for circulation.
A scarf or rebozo can be used to lift the abdomen or you can do this leaning back against a wall or on all fours
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When to use:
• In labor, if the baby is not in the pelvis. Remember to do for 10 surges in a row
• If surges are frequent enough that you can predict when another is coming, this is helpufl as then you won't miss the start
• If surges have not been increasing in strength, the baby may not be able to move into the brim. This will help
• When surges are really strong but the baby remains high in or above the pelvis.
• If you are experiencing back labor, pain in the back during surges. This technique can help the baby to move into the brim
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The Abdominal Lift and Tuck will encourage labor surges to become closer together and stronger if they have been stuck at one strength for a long time. Or, when dilation is not increasing or when you’re experiencing an achy back labor.
The lift and tilt, helps the baby's head to flex, working with a surge which should improve labour progress and help to relieve back ache.
The abdominal lift and tilt can be used in latent or pre-labor to get active labor underway by helping the baby to flex and opening the pelvic inlet.