Aviva,
As a Mum who has actively sought an Active Birth it can be a fight - depending on what your description of active birth is. There was certainly no problem with me moving around in labour, assuming any position I wanted or using the shower. But among the OBs I spoke to there was certainly the perception that delivery should be on the bed, on my back.
I fought this and have got into the Birth Centre where I will be delivered by a lovely midwife in whatever position I want.
I am sure if the Mum is in a position other than on her back on her bed she can tell the OB (or whoever) to get stuffed if they insist she get back onto the bed, but knowing how open I was to suggestion during my first two labours most women probably wouldn't even argue. Therefore really the best course is to have it in her birth plan and for the woman to make sure her birth team support her in maintaining whatever position she is happy to birth in - easier said than done at time.
The insurance argument is ridiculous, if the birth is that difficult then the mother is going to be compliant to moving to a position where instrumentation can be used to assist, but I have never heard of anyone sueing because their baby was born with Mum on all fours instead of flat on her back.
Deb
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