Techniques used during labor can reduce risk of C-section

For people who haven’t experienced childbirth, peanut balls, puppy pose and spinning babies may sound silly. But they’re actually important tools, positions and techniques used to help promote vaginal birth.

At Sharp Grossmont Hospital, staff in the Labor and Delivery Unit are dedicated to maintaining low cesarean, or C-section, delivery rates. The most recent data, from January 2024, indicates the hospital has a C-section rate of just 20%. Nationwide, nearly one third of babies are delivered by C-section, according to the Centers for Disease Control and Prevention.

“Our C-section rate speaks for itself,” says Amber Napier, a lead nurse on Sharp Grossmont’s labor and delivery team. “I think that’s in part because we take a lot of pride in empowering our patients and our nurses, providing education and making sure they both know how big of a role they play in the labor and delivery process.”

While C-sections may be medically necessary, or even a lifesaving procedure, there are risks involved. That’s why doctors typically recommend them only when there is a high-risk complication making vaginal birth unsafe.

One mother’s drive for vaginal birth

For new mothers like Darcee Nichols, who gave birth to a healthy baby boy in December 2023, vaginal birth was a priority. “But it was really slow going for the first 24 hours,” she says.

Darcee, age 37 when she delivered, was induced one day after her due date. It wasn’t until a full day later that her water broke and things began to progress.

“They had talked to me about a C-section maybe 12 hours before I delivered just because things were progressing so slowly,” Darcee says. “But my nurse was really dedicated to helping me get the vaginal delivery that I wanted.”

Darcee’s infant son was positioned “sunny side up,” or facing up toward the ceiling, during labor, making it more difficult for him to pass through the birth canal. While not always possible, it’s recommended that babies face the mother’s spine during labor, positioning themselves in a way that allows for the smallest part of the head to descend first.

“My nurse worked with me and really involved my partner throughout the entire pushing process,” Darcee says. “The two of them were right by my side, flipping me back and forth, trying to get the baby to turn over.”

Napier was the lead nurse in charge during Darcee’s delivery. She says her team was determined to help Darcee get the vaginal delivery she wanted.

“I remember her nurse came out of the room and said, ‘I’m going to do everything I can,’ kind of taking it as a challenge,” Napier says. “Our whole team stepped up to determine which labor positions would be best for her as she progressed and what steps to take. After hours of position changes and patience, she was able to have an uncomplicated vaginal delivery.”

A dedicated team working together

To lower C-section rates, the Sharp Grossmont labor and delivery team implemented a comprehensive plan emphasizing patient safety. It included establishing a task force of obstetricians, nurses and administrative leaders who championed evidence-based strategies.

A labor positioning handbook was also created, advocating for frequent position changes and mobility during labor as well as the use of a peanut ball — a peanut-shaped exercise ball specifically designed for labor — to help shorten the process. Positions such as the puppy pose, where a laboring person on all fours slowly reaches their arms forward until their head rests between their forearms and the hips gently pull out and back, can help relieve pelvic floor tension during birth. The “spinning babies” method uses activities, movements and techniques during pregnancy and labor to improve the fetal position for an easier birth.

“Women can spend three days with us in labor and delivery, or they can spend 15 minutes,” Napier says, reflecting on how each experience is different. "I always encourage my patients to have an open mind when it comes to labor. Sometimes, it doesn't go exactly to plan, but we will be there to help and keep them safe along the way."

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