Birthwheel puts women in charge

Patsy Westcott reports on a novel Swiss delivery chair

In the delivery suite at the University Women's Hospital in Basel is a structure that looks part modern art object, part space-age rocking chair.

Inside an enamelled spiral frame a high-backed, padded chair is slung from four strong straps. Only the horseshoe cut-out at the base of the seat is a clue to the contraption's true purpose.

The 'Roma' birthwheel is like no delivery bed in existence. Designed to facilitate labour and birth, it can be used as a prop to allow women to stay active and to deliver the baby in a squatting or upright position.

The trend towards active birth is gathering pace in Europe, and demand for the Roma has exceeded all expectations. Since 1994, when it began to be marketed, 90 have been installed in maternity units in Switzerland, Germany and Austria.

"More and more women want the freedom to move around. They are no longer content to lie on their backs to give birth," observes Dr Andreas Koller, an obstetrician and gynaecologist at the hospital, where hundreds of women use the wheel each year.

Koller believes the Roma has significant advantages. "Being upright improves blood flow to mother and baby," he says. "It lessens pressure on the pelvic nerves and gravity aids the descent of the baby, so labour is less painful and delivery is quicker."

Brigitte von Arx, 34, whose fourth baby, Mirina, was born on the wheel after just two-and-a-half hours of labour, confirms the theory: "I had the first three babies conventionally, Iying in bed. The contrast was enormous. The wheel was so comfortable. I had no tear and no stitches, and I was up and about much quicker than after my other births. I felt so well. It was the most natural experience I have had."

Studies done elsewhere in Europe, says Koller, show that sitting can convert unco-ordinated uterine action into more efficient contractions, speeding up labour. Mothers who deliver squatting also have fewer vaginal tears, he confirms.

But the wheel is not just for those who want a natural birth. "Its construction is such that the doctor or midwife can attend the mother from all sides, and the seat can be fixed to allow vaginal examinations, episiotomy and even forceps," Koller explains.

The wheel was designed by Swiss artist Paul Degen and named after his three-year-old daughter Roma, who was born on an early prototype.

"The whole thing revolves around the idea of spirals," says Degen, 54. "The woman is instantly comfortable and she floats in the wheel in the same way that the baby inside her floats in her womb. The wheel puts women in labour back in control of giving birth." He says doctors have reported a 90 per cent increase in interest from women wanting to give birth in the Women's Hospital since its wheel was installed.

The idea of giving birth in an upright position is not new. Midwives throughout Europe used birthing stools until the mid-17th century. It was only the introduction of forceps and, later anaesthetic drugs that made it more convenient for obstetricians to have women lie on their backs.

At Sfr 39,000 ($ 35,000), the chair costs about twice the price of a normal delivery bed. Nevertheless, with interest among doctors and midwives in France, Italy, Finland and the UK, it looks as if the birth revolution is only just beginning.

The European, May 4, 1995 / No 259