![]() Although women reported experiencing less pain when they were able to be mobile in 2003, the 2013 follow-up survey, Listening to Mothers III, reported that only 40% of mothers changed positions in labor and only 43% walked after admission to the hospital ( Declercq et al., 2013 Declercq, Sakala, Corry, Applebaum, & Risher, 2002). The percentage of polled women who believe that birth should not be interfered with increased from 46% in 2003 to 59% in 2013 ( Declercq et al., 2013). Women value the choice to be mobile during labor, and most feel that the process of birth should not be interfered with unless medically necessary ( Declercq, Sakala, Corry, Applebaum, & Herrlich, 2013 Scotland, McNamee, Cheyne, Hundley, & Barnett, 2011). This article is an updated evidence-based review of the “Lamaze International Care Practices That Promote Normal Birth, Care Practice #2: Freedom of Movement Throughout Labor,” published in The Journal of Perinatal Education, 16( 3), 2007. Understanding the role of hormones of labor, as well as the role of movement in comfort and the progress of labor, can give women more confidence in the process of labor and birth and in their own ability to manage labor. Women respond to the pain of uterine contractions by moving around to reduce their pain. In an environment where women feel stressed and fearful, the stress hormones (catecholamines) can increase, slowing the process of the first stage of labor. Movement is one coping strategy for pain, and freedom to be mobile in labor is a safe, healthy coping strategy in part because it does not disrupt the normal physiologic processes ( Romano & Lothian, 2008). In an environment where women feel safe, beta-endorphins help a woman respond to pain by using coping strategies. In the ideal scenario, the pain response signals the brain to continue to release more oxytocin and contractions become more effective. The physiologic process of birth is hormonally designed so that when labor starts, the uterine muscle responds to oxytocin. Freedom to be mobile in labor is more likely to be safe and healthy because it does not disrupt the normal physiologic processes ( Romano & Lothian, 2008). It includes supportive care practices and low-technology technics that facilitate the normal biological process of childbirth ( Goer & Romano, 2012). ![]() A 2012 consensus statement by The American College of Nurse-Midwives (ACNM), Midwife Alliance of North America, and the National Association of Certified Professional Midwives entitled “Supporting Healthy and Normal Physiologic Childbirth” defines a normal physiologic labor and birth as “one that is powered by the innate human capacity of the woman and fetus” (p.
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