The Lunge opens the midpelvis. It is a good technique to be used in labor, during a contraction, for:
• Helping an occiput posterior baby rotate or descend
• Helping an asynclitic baby descend
• Overcome a stall in active labor
What is a lunge?
The lunge is a technique to rock open the midpelvis between the ischial spines. This makes the most narrow part of the pelvis plus the outlet open as the laboring woman leans towards her foot.
This simple technique can be used by a laboring woman if she can
stand up and put one foot on a stool or a chair.
Why do a lunge?
The lunge helps when labor stalls and the baby is near the midpelvis - at 0 station give or take a cm. It can help a baby who is lower than that when the stall in labor is due to a narrow pelvic outlet.
It may help a transverse arrest (baby stuck between the ischial spines while facing the side, hip).
Before doing a lunge
Make sure the baby is engaged first. Do the sidelying release to make the lunge more successful.
When to do a lunge in labor
Use when regular contractions are present (especially if baby is at "0 Station" or near it).
Fairly moderate or strong contractions seem to work best with the lunge. This is because of the “spinning” power of the contractions. Once you get regular contractions, you will be able to move into the lunge position as the contraction begins. Put your foot down after the contraction finishes to relax your leg and prevent tired legs.
Drawing: The lunge with a spotter…
How to do a lunge during childbirth
The mother faces forward. The chair (or stool) is to her side, not in front. The mother hangs on to the back of the chair or a support person. The person can stand in front of the mom, giving her eye contact. Her foot is flat on the chair. The chair is stable.
During a contraction, she rocks towards her knee and back to standing straight again. Repeat through contraction. Breath deeply and slowly when possible. Relax the belly and the buttocks. Relax the shoulders and neck.
It is important that she not extend her knee past her foot. She could strain her knee ligaments if she does.
Rock gently towards the knee and away, like a fencer lunging towards an opponent. It doesn't work if the mother's knee is directly in front of herself.
Between contractions she can put her foot down and rest her knee and move her legs for circulation. Repeat for 10-12 contractions, switching legs according to results. The mother may have a hunch which leg is the right one, or she can do 5-6 contractions with each leg.
Her partner, doula or friend can hold her for balance and comfort.
When labor is asymmetrical, make the pelvis asymmetrical.
One foot raised
One foot raised on a calabash shell for a foot rest
This mom lifts one leg to open that side of her midpelvis. This makes more room between the ischial spines, or the narrowest part of the interior pelvic passage.
Lifting one leg up on a chair opens the midpelvis more, of course, but any amount of lift can be a good thing.
A complementary technique is the Abdominal Lift. It is effect during active labor contractions, as well. And helps occiput posterior babies rotate. It can be used when the baby is higher in the pelvis, at the brim down to the midpelvis. The lunge is more effective for babies at the midpelvis.