Using a squat bar with an epidural to do the “tug-of-war” during pushing.
Did you know that every hospital labor + delivery unit has a squat bar that you can use? It can be a great tool, especially during the pushing stage of labor. You will just have to ask your nurse for it, and they will bring it in and click it into your hospital bed.
What is a squat bar?
A squat bar is a metal bar that clicks into a hospital bed, and can be helpful for getting into certain positions during labor and pushing.
How can I use a squat bar in labor?
There are a few main ways that birthing people use a squat bar in labor. One way is to hold onto it while you…you guessed it…squat during pushing. For some people, a squatting position can be just the right thing to help them move their baby down and out of their body.
Another way to use a squat bar during labor is to tie a flat sheet or a non-stretch scarf to it for a “tug-of-war” position. This can be super helpful during pushing because it allows you to brace the top half of your body and focus all your energy down into your pelvis to push your baby out.
The images below show a birthing person with an epidural using the squat bar during a contraction to push, and when the contraction is over, she rests back on the bed in a seated position. The foot of the bed has been lowered so she can sit comfortably with her feet below her knees. Notice in the first photo that the nurse and partner are each supporting one of her legs with a towel wrapped around her thigh. Since she had an epidural, this extra support of her legs was essential in allowing her to get into a squatting position.
Can I use a squat bar if i have an epidural?
This will depend on a few things:
how strong is your epidural and how is your body metabolizing the medicine? For some birthing people, they find they’re still able to have quite a bit of mobility in their legs with an epidural, while others can’t move their lower half at all without a lot of help from their partner / doula / nurse. You can’t really know how your body will respond to the epidural until you get it, so this isn’t something you can plan for ahead of time and will just have to see how it feels in the moment.
Do you have supportive providers and hospital staff? If your OB, midwife or nurse is not supportive or encouraging of you trying different pushing positions even with an epidural, it will be really hard, or even impossible, to use something like a squat bar. This is a great topic to bring up at your prenatal visits with your provider before your birth. A great question to as is “what positions are you comfortable with me pushing in if I have an epidural?”
Do you have hands-on support in the hospital room with you? A doula or supportive partner is very helpful in making the use of a squat bar a reality. Your nurse may be able to help with your positioning during the pushing phase, but their main focus is always on the health and safety of you and your baby. So if something else takes precedence, they may not have the availability to be as hands-on with you and help you get into a squat position. This is where having a doula and/or supportive partner can be really helpful. They are a continuous presence in your hospital room and can be an extra pair of hands to help you maneuver into different pushing positions.
Using a squat bar with an epidural. This birthing person is doing the “tug-of-war” with a flat hospital sheet that is wrapped around the squat bar.
Is there any time when I shouldn’t use a squat bar in labor?
First of all, having a supportive provider is imperative to being able to use tools like a squat bar during pushing. So if your provider is not on board for any reason and doesn’t think it’s a good idea, then it would be worth asking more questions about their thought process and hesitation, and possibly deferring to their decision not to use the squat bar if you feel like it makes sense for you.
Secondly, if you try the squat bar and find that it causes you any pain or discomfort, then stop using it and find a different position that feels better. You might be able to try the squat bar again at another time, or it just might not be the right tool for your particular body and needs.
Finally, if a squatting position causes your baby distress (such as heart rate decelerations or other signs of stress), the hospital staff will want you to move into a different position that your baby tolerates better.
I hope this blog post helps you better understand what a squat bar is, how it is used, and in what circumstances you can and cannot use it during labor!