2024-07-13 00:26:46
Czech obstetrics is changing, according to Michal Koucký, head physician of the high-risk pregnancy department of the Gynecology and Obstetrics Clinic of the General University Hospital in Prague, called U Apolinář. According to him, one retreats from the position on the back, returning to the vertical position. He also considers movement or changes of positions suitable.
Koucký spoke about the state of Czech obstetrics when handing over the so-called maternity couch, which is supposed to enable women in labor to take different positions during childbirth. The same equipment is used, for example, by maternity wards at university hospitals in Pilsen or Ostrava, Litoměřice or Šumperk.
“I think that patients and non-profit organizations have put pressure on Czech obstetrics, which has changed significantly. This is certainly one of the manifestations,” said David Cibula, head of the gynecology-obstetrics clinic. He added that doctors and midwives will have to get used to the new device.
Koutský admitted that “Apollinář” had a reputation as a rather conservative workplace, which he believes is changing. “We have been trying to change the approach to obstetrics for the past few years. We are building on what is happening in the entire Czech Republic,” he added.
According to Koutský, similar devices return women to a vertical position. “The goal is for them to spend the birth as much as possible moving, changing positions, and not lying down,” he said. He sees it as a sort of throwback to natural birth in earlier times. “Our great-grandmothers dug the fields, threw away the hoe and gave birth in the bushes,” he added. Then, according to him, for decades, women tied themselves to beds in maternity hospitals in order to better monitor the baby. “It’s blown up to absolutely monstrous proportions,” he added.
According to him, about 12 percent of women request other procedures in the maternity hospital there. According to Cibula, the goal is therefore for women in labor to have such options at Apolinář. “It is optimal for us to be able to offer everything from birth on the couch, through active birth, where the woman can walk until the last moment, through the traditional delivery bed, and possibly water birth,” he said. He added that the maternity ward will never have all the aids in such numbers that everyone can choose from them all.
Maternity couch
The couch consists of parts that can be assembled in different ways. Mothers can spend more time in vertical positions on it during childbirth. For example, they can lean on the couch in different ways, they can also kneel or lie on it, or change positions or move freely.
According to the founder of the Propolis foundation fund, which donated the couch to the hospital, Lilia Khousnoutdinová, the wife of Czech billionaire Karel Janeček, it can make the work of midwives easier and increase the comfort of women in labor.
According to her, certain positions and movement can speed up labor. “If a woman is on her back for most of the birth and does not move much, she is more likely to end the birth with a caesarean section, (…) the use of forceps or incision,” she said.
For example, in Ostrava, about 300 women have already given birth using a couch. Midwife Anna Fančovičová, who works in Ostrava, added that women who have the opportunity to move freely during childbirth often avoid the administration of painkillers.
Sometimes a change of position or movement is sufficient as an intervention against pain. “I don’t have to go first for the epidural or for the oxytocin, but I can try to say to the woman, ‘Come try to lift yourself into this position, we’ll assess how it feels, and then we’ll try another one,'” she said. According to her, water has a similar effect against pain.
Check out the Aktuálně.cz special dedicated to the state of Czech obstetrics.