Earlier this month, Mindy Cockeram wrote a blog post, Narrow the Knees to Push with Ease- Challenge the Norm and Get the Job Done, that examined the current research and theory behind birthing people internally rotating their femurs in order to open the pelvic outlet during second stage.  Perinatal professionals are using this technique to help babies navigate the pelvis once they are below zero station and progress to birth.  Please review that post to get the background information that supports this month’s exciting Brilliant Activities for Birth Educators idea.  This quick and easy activity helps families understand how and why the knees together pushing position is a great technique to add to their toolbox.  Follow this link to find all the Brilliant Activities for Birth Educators ideas posted in the past.

Materials

• Dot stickers in assorted colors – 2 stickers per family (I like these.)
• Cell phone belonging to family to record/reinforce pelvic opening
• Pillows or mat for comfort on floor (optional)

How long to allow for this activity

This simple activity takes but five minutes!

When to do this activity

I conduct this activity when we are talking about physiological pushing and practicing helpful positions for the second stage of labor.  This activity also reinforces Lamaze Healthy Birth Practice 5: Avoid Giving Birth on Your Back and Push with the Urge to Push.  I have already demonstrated (and the class has practiced themselves) some excellent positions for pushing that open the pelvis (lunge, squat, side-lying and hands and knees with the knees apart). I like to then suggest closed knee pushing.

How to do this activity

Introduce the idea of closed knee pushing, explaining how internally rotating the femurs by bringing knees together and separating the feet opens the pelvic outlet.  I suggest that this could be a very helpful position when the baby is well engaged and below zero station.  I take a moment to show this quick 17 second video that demonstrates this principle effectively.

I pass out two dots for each family and ask the pregnant person to find their own sitz bones, by placing their hands underneath their bottom while sitting or squatting and feeling for the “sharp” bones at the bottom of their pelvis.  They are instructed to place one sticker on each sitz bone.

I invite them to get on their hands and knees (using the optional pillows/mats.)  I ask partners to take out their phones and record the pregnant person’s bottom and the dots while the pregnant person practices closed knee and open knee positions.  The narrowing of the dots is easily observed as the knees are opened.  Upon bringing the knees together, dots move further apart, as the outlet widens.  Partners are observing first hand and recording as well.  I then ask them to show the recording to the pregnant person so they can see for themselves how the dots move on their own bodies!  If you have time, you can even have them reverse roles and ask the partners to go through the same exercise.

After running through this exercise, everyone returns back to their seats and we discuss as a group how this might be an effective position for pushing out their babies.

How this activity is received

Families love this activity.  While talking about closed knee pushing and watching the video of someone else doing it hits the mark, actually going through the motions with dots on their own bodies brings the point home in a way that talking and videos never can.  This is a very easy and effective activity that requires almost no supplies and takes but a few minutes but provides an impactful learning opportunity that they will hopefully remember as they are pushing their babies out.

Conclusion

Would you be willing to try this activity in your classes?  Would you modify it in any way?  Do you already do this?  How do your families find this activity?  Please let me know in the comments section of this blog.

Gif Image courtesy of Pronatal Personal Training

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