In the medical field, the term “lithotomy position” will be used quite regularly. It describes the way a patient is positioned if they require surgery on their lower abdomen or pelvis. It is also used commonly in the Western world as a childbirth position, although more and more midwives are now suggesting that the position is actually unnatural.
What Is the Lithotomy Position?
Essentially, in this position, the feet tend to be placed at the same level as the hips, or above. To achieve this, surgical stirrups have to be used. While feet are placed inside the stirrups, the perineum is place at the edge of the surgical table. Interestingly, the position has been used for thousands of years and it is even referenced in the Hippocratic Oath, which is one of the oldest known medical documents, as well as in a variety of other documents.
The name of the position references to the surgical procedure for which it was used in the past. This procedure was designed to remove bladder, gall and kidney stones through the perineum. It is one of the most popular and most recognized childbirth positions as well. The patient lies down on their back, with their knees bent. The knees are then positioned above the hips and the legs are then spread through the position of the stirrups.
The benefits for surgeons of this position are very clear. Most notably, it gives them excellent physical and visual access to the pelvic region. This may be necessary during surgery on reproductive organs, but also gastrointestinal procedures and urology. However, as the medical field and science advances, it is becoming more recognized that many patients do not enjoy this position and find it humiliating. Furthermore, some questions are arising about just how beneficial it is during prolonged medical procedures and childbirth in particular.
Medical Stirrups and Prolonged Procedures
Studies have shown that there is a direct link between prolonged lithotomy positions and compartment syndrome, which is a circulatory problem. Furthermore, there is a chance of injuring the peroneal and/or femoral nerve. As a result, scientists are now looking into new methods of performing lengthy procedures on the pelvic or lower abdominal area.
Medical Stirrups and Childbirth
According to the World Health Organization, the lithotomy position should not be used during childbirth. Although they agree that it is easier to access the patient in this position, it makes the process of giving birth much more difficult. Furthermore, the position narrows the birth canal quite significantly, which means complications could arise. It is recommended that expecting mothers review the various positions that they could give birth in and use the one they find most comfortable. Squatting is believed to be one of the most natural positions for childbirth.
Medical Stirrups and Pelvic Examinations
There is no physical reason why stirrups should not be used during pelvic examinations. However, patients find it uncomfortable and feel as if they are vulnerable and exposed. As such, physicians are now looking into different methods for examinations.