Vertical childbirth at Genesis Dnepr — individualized plan and safety

What are vertical births and who might they suit: vertical births are deliveries in upright positions (standing, squatting, or supported/leaning), in which gravity can assist with cervical dilation and pushing. This approach may be appropriate in the case of an uncomplicated pregnancy, absence of medical contraindications, and if the expectant mother wishes to try alternative positions. It is important to discuss in advance with the physician and midwife the individual indications and contraindications, the pain-management plan, the partner’s role, and the availability of the necessary equipment and monitoring. The final decision is made based on the clinical situation and the condition of the mother and baby, and the plan may be changed if necessary for their safety.

What does this birthing format mean

Upright (vertical) birth refers to managing labor predominantly in upright positions, where the birthing person uses supports, squatting, or standing. This format emphasizes natural body movements and assistance from gravity, but it is not always appropriate for medical reasons. It is important to discuss indications, the monitoring plan, and pain-relief options with the doctor and midwife in advance. The final decision is made individually and may change for the safety of the mother and baby.

Practical meaning: labor in positions with vertical load and body support
Sensations for the mother: a more active role and the ability to change position
Difference from traditional lying-down births: use of gravity to help the baby descend
What to discuss in advance: indications, contraindications, monitoring, and possible analgesia methods
Required equipment: supports, a comfortable surface, and the ability to switch quickly to an alternative plan
Limitations: not used in cases of serious pregnancy complications or if the condition of the mother or baby worsens

The decision to use an upright approach is always based on the clinical situation and the current condition; if necessary, the team will promptly change tactics.

Who may be suited to upright childbirth

Upright childbirth may be appropriate when a woman wants to labor in active positions and this does not contradict the clinical situation. This approach is often discussed in advance to assess indications, prepare equipment, and agree on monitoring. It remains important to discuss with the doctor and midwife; the decision is always individual and can change depending on circumstances.

Discuss the birth scenario in advance with the doctor and midwife
Presence of a partner who is planned to be involved in the birth process
Need to discuss pain relief and monitoring options beforehand
The woman’s desire to remain active and change positions during contractions
Pregnancy is progressing without serious complications for the mother or fetus
Consideration of previous birth experience when planning the management strategy
Need for a clear, calm birth plan for the mother
Considering this format as one possible option, not a final decision

The final decision on the upright approach is made based on examination and the progress of labor; if necessary, the team will change tactics for the safety of the mother and baby.

When this format may be inappropriate or require restrictions

Upright labor may be unsuitable in a number of clinical situations, so it is important to understand possible limitations in advance. The decision to continue in an upright position is made by the team, based on the condition of the mother and baby and the available resources. The birth plan may change at any time for safety reasons.

Obstetric complications requiring urgent intervention or a change of tactics
Signs of fetal compromise on fetal heart monitoring (cardiotocography)
Need for operative delivery (cesarean section)
Contraindications to the chosen method of analgesia/anesthesia
Infectious or organizational restrictions on the presence of a birth partner
Serious maternal comorbidities that limit upright positions
Lack of necessary equipment or conditions for safe management in an upright position

The obstetrician and midwife regularly assess the situation; if the condition worsens, the plan is changed in favor of the safety of the mother and baby.

Who and how decide on the mode of delivery

The decision about the mode of delivery is made jointly by you and the medical team, taking into account your preferences and the clinical situation. You have the right to state your preferences in advance, for example for upright (vertical) birth, but the final choice is based on examination findings and the condition of the mother and baby. The physician and midwife evaluate the pregnancy, ultrasound and other tests; an anesthesiologist and neonatologist are involved if necessary. The plan is not final and can be adjusted during labor.

Expressing the patient’s wishes and position preferences
Assessment of the pregnancy, tests and ultrasound by the physician and midwife
Evaluation of the fetal condition and cardiomonitoring results
Consultation with an anesthesiologist regarding pain relief
Involvement of a neonatologist in case of increased risk or need
Consideration of previous birth experience and the patient’s individual characteristics
The medical team’s readiness to change the plan if indications arise

The decision is always made with priority given to the safety of the mother and baby and is recorded as a joint plan of action. During labor the team responds promptly to changes to ensure the best possible outcome.

What to discuss with your doctor in advance

When planning an upright birth, it’s useful to prepare a list of questions ahead of time and review it with your doctor and midwife. This will help you understand which conditions and restrictions apply to your specific pregnancy and develop a shared plan of action. Discuss pain relief options, the role of your partner, and possible scenarios that might require changing the plan.

Is it possible to plan an upright birth in my particular case?
Will my partner be allowed to be present, and under what conditions?
What pain relief options are available and how do they affect positions?
How do previous births or a cesarean section affect the choice of delivery format?
Are there any chronic conditions that would limit upright positions?
Which ultrasound findings and test results are important for the final decision?
What is the plan of action if the mother’s or baby’s condition deteriorates?
What should I bring to the maternity hospital and which documents should I prepare?
When is it best to go to the clinic when labor starts or if my waters break/there is leaking?
What accommodation and postpartum care does the clinic offer?

Write down the answers and bring your test results to the consultation; this will make joint decision‑making easier.

If anything remains unclear, ask additional questions at your next visit.

How to prepare for upright childbirth

Preparation for upright childbirth involves sequential steps to assess safety and coordinate practical details. The process usually includes medical examinations, discussing the plan with your doctor and midwife, and organizational arrangements with the clinic and your partner. If necessary, an anesthesiologist consultation is arranged in advance to clarify which positions are safe in your case. Preparation helps reduce uncertainty but does not guarantee a fixed birth scenario.

Consultation with a doctor and midwife to assess indications and contraindications
Review of the maternity record and up-to-date test results
Discussion of a detailed birth plan: positions, monitoring, and possible contingency scenarios
Examinations appropriate to gestational age and monitoring of the fetus’s condition
Consultation with an anesthesiologist when planning pain-relief methods
Preparing the birth partner: role, rules for presence, and logistical details
Familiarization with required documents and the conditions of stay at the clinic
Packing necessary items for the maternity hospital according to a basic list and staff recommendations

Preparation is carried out together with the clinic team and does not replace assessment of the situation during labor; if necessary, the plan is promptly adjusted for the safety of the mother and baby.

How upright births proceed

Upright births usually follow a sequence of interconnected stages that the team discusses with you in advance. The process may look different for different women depending on the course of labor and the clinical situation. During labor, the doctor and midwife monitor safety and, if necessary, adjust positions and pain relief methods. The plan is not fixed and may change for the health of the mother and baby.

Admission to the clinic: registration, brief examination, and paperwork
Examination and assessment of the mother’s and fetus’s condition by the doctor and midwife
Positioning and choosing a comfortable upright position, with support or squatting
Monitoring contractions: frequency, duration, and the mother’s subjective sensations
Fetal monitoring intermittently or continuously as indicated
Support from the doctor and midwife when changing positions and managing contractions
Pain relief if necessary and after consultation with an anesthesiologist
The pushing stage, highlighting positions that are comfortable for delivering the baby
Birth of the baby, initial examination, and warm placement of the newborn
The first hours after birth: observation, help with breastfeeding, and recovery

The team discusses possible scenarios in advance and is ready to change tactics quickly if clinical indications require it. The safety of the mother and baby remains the priority at every stage.

Analgesia during vertical childbirth

Analgesia during labor is discussed in advance at a consultation, especially if you plan to use vertical positions. At the meeting, the doctor, midwife and anesthesiologist assess possible methods and take into account the effect of pain on the progress of labor and your mobility. During labor, the pain-relief plan is adjusted if necessary depending on the condition of the mother and baby.

Discussing pain-relief options in advance at a consultation with the doctor and anesthesiologist
A consultation with the anesthesiologist to choose the most appropriate and safest method
Available methods (including epidural anesthesia) at the clinic are discussed individually
Considering the effect of the chosen method on mobility and the ability to use vertical positions
Contraindications to specific methods are discussed based on examinations and medical history
The possibility to change or adjust the pain-relief plan during labor if necessary
The decision is made jointly by you, the obstetric team (doctor and midwife), and the anesthesiologist
Honest explanation: the level of pain cannot be predicted; methods reduce but do not eliminate it

Discuss your preferences and any possible limitations in advance; the anesthesiologist will answer questions and help weigh the risks.

Safety and monitoring during upright births

Monitoring during upright births is aimed at timely assessment of the condition of the mother and baby and at preserving the ability to promptly adjust the plan. The team regularly checks vital signs, fetal condition, and labor progress, using additional monitoring methods when necessary. This is a standard part of labor management, not a sign of a problem.

Continuous assessment of the mother's condition by the physician and midwife
Fetal heart rate monitoring by auscultation and by CTG (cardiotocography) when indicated
Regular assessment of contraction frequency and strength and of cervical dilation progress
Monitoring of blood pressure, pulse, and the mother's overall tolerance of positions
Team readiness to change position, management approach, or birth plan if needed
Involvement of an anesthesiologist and neonatologist when indicated
Rapid organization of interventions or transfer to the operating room in an emergency

This is a routine, pre-agreed approach: the goal of monitoring is to ensure the safety of mother and baby, not to create unnecessary alarm. The plan may be adjusted during labor depending on the current situation.

What happens if labor doesn't go according to plan

Even a carefully prepared birth plan is a flexible roadmap, not a rigid instruction; if the situation worsens, the team will change tactics for safety. During upright labor this may mean changing positions, additional monitoring measures, or switching to a different mode of management. Decisions are made by the obstetrician and midwife together with you, and the team will always explain the reasons for any changes.

Change of position: moving from an upright position to one that provides more support
Restricting the partner’s presence for infectious or emergency indications
Use of measures to stimulate labor if contractions slow down
Transfer to the operating room if an urgent cesarean section is required
Withholding or stopping an epidural if there are contraindications at the time of labor
Increased monitoring of the fetus and mother when there are signs of risk
Rapid coordination with the anesthesiologist and neonatologist in case of complications

Changing the plan is routine medical practice aimed at protecting the health of the mother and baby. The team will explain in detail why a change in tactics is necessary and what steps will be taken next.

Risks and limitations when choosing the birth format

Any birth format has its limitations, including vertical (upright) births. Risks depend on the condition of the mother, the baby, and the course of pregnancy, so it is important to discuss possible scenarios in advance. The doctor and midwife will explain under what circumstances the plan may change during labor.

Limitations of a chosen format in the presence of serious obstetric complications
Risks depend on the condition of the mother, the fetus, and test results
The need to switch to a different format or to an operative delivery
Possible contraindications to certain pain-relief methods during labor
Organizational or infection-related restrictions on partner presence
Do not base your choice solely on someone else’s birth experience
The safety of the mother and baby takes priority over a preselected plan

Discuss these points with your care team in advance to have a clear and flexible plan.

During labor, tactics may be adjusted for the safety of the mother and baby.

What happens immediately after delivery

Right after birth the team assesses the condition of the baby and the mother and arranges the first comfortable contacts between them. The clinic always performs CTG and a mandatory newborn examination by a neonatologist to ensure stability. In the first hours there is observation, support with breastfeeding initiation, and preparation for transfer to the ward if everything is normal. The process may vary slightly depending on the specific situation.

First contact between mother and baby if there are no medical contraindications
CTG monitoring and a mandatory newborn examination by a neonatologist
Monitoring the mother's condition: blood pressure and overall well‑being
Assistance with the first latch and breastfeeding support
Ensuring warmth and basic initial care for the newborn
Prompt coordination with the neonatologist if additional help is needed
Transfer to the postnatal/postpartum ward when mother and baby are stable

The team will explain all procedures in detail and answer questions; the first hours are focused on safety and establishing contact between you and your baby.

Role of the doctor and the team

Labor is managed by a team: a physician and a midwife, along with supporting specialists, each with their own task. The team assesses risks, monitors progress, and makes decisions while explaining what is happening to the patient. In upright births the team arranges safe positions and the necessary monitoring.

Obstetrician-gynecologist: risk assessment, monitoring progress and making tactical decisions
Midwife: supporting the mother, assisting with positioning and performing observations
Anesthesiologist: consultation on pain relief and emergency administration of anesthesia if needed
Neonatologist: initial examination of the newborn and providing emergency care if required
Operating-room team: preparation and rapid organization of surgical intervention when indicated
Monitoring: control of CTG, blood pressure and the mother's tolerance of chosen positions
Communication with the patient: informing about the condition and discussing changes to the plan

The team works as a single unit to ensure safety during labor. You can ask questions about the specialists' roles and the reasons for decisions made.

Benefits of upright childbirth for the patient

Upright childbirth offers a clear course of action and the opportunity to discuss preferences with the team in advance. This approach suits those who want to remain active and understand how positions and monitoring will change. Discussing the details reduces uncertainty and helps build a realistic plan. The final decision always depends on the condition of the mother and baby.

Clear plan: discussion of positions, monitoring, and possible scenarios for change
Opportunity to voice and agree on personal preferences for labor management in advance
Reduced uncertainty thanks to clear criteria for switching to another delivery format
Ability to choose and agree in advance on the presence of a specific physician
Partner support while maintaining organized and medical conditions
Discussion of pain-relief options and consideration of their impact on the mother’s mobility
Observation and access to necessary monitoring for the safety of mother and baby
Team readiness to promptly change tactics if the condition of the mother or fetus changes

These advantages make the birth plan clearer and more comfortable for you. At the same time, the team prioritizes safety and may adjust the plan if necessary.

How a pre-delivery consultation is conducted

A pre-delivery consultation is a structured meeting in which the current condition is assessed and the possible mode of delivery is agreed upon. The doctor and the midwife review the pregnancy history, test results, and discuss your wishes, including interest in upright (vertical) births. At the appointment they explain possible limitations and help choose a safe option taking risks into account. Sometimes additional tests or a follow-up visit are required to clarify the plan.

History-taking by the doctor and midwife: chronic illnesses and previous deliveries
Review of the maternity record and current ultrasound and test results
Review of examinations to assess the condition of the fetus and the mother
Discussion of your preferences and expectations regarding the mode of delivery
Explanation of possible limitations and situations when the plan might change
Help choosing a safe mode of delivery and agreeing on a plan of action
Explanation of when it is best to go to the clinic once labor begins
Answers to questions and referral for additional consultations if necessary

The consultation helps develop a clear and flexible birth plan; if there are concerns or complications, additional tests or follow-up visits are scheduled.

Please note that online consultations are available for patients from other cities. We often receive requests from Zaporizhzhia, Pavlohrad, Kamenskoye (Dniprodzerzhinsk), Novomoskovsk (Samar), Kryvyi Rih, Nikopol, Marganets, Sinelnikovo, Pokrov, Zhovti Vody, and other cities.

Preparation for admission for childbirth

Before admission, it's helpful to gather required documents and medical information in advance so intake goes quickly and calmly. For those considering upright labor, it's important to agree on preferences with your doctor and midwife beforehand. Preparation reduces uncertainty and helps you and the team begin monitoring and care promptly.

Personal identification and health insurance policy for admission to the maternity ward
Maternity record (exchange card) with discharge summary, current test results, and ultrasound findings
A list of regularly taken medications and an agreement to discuss them with your doctor
Items for the mother according to the clinic’s basic list (no need to list every detail)
Items for the newborn per recommendations (do not detail the contents)
Items for the partner and their documents, if their presence is planned
A copy of the agreed birth plan and emergency contact numbers
Arrival plan: when to go to the clinic and how to get there when contractions start

Check with the clinic for specific requirements and recommendations for packing. If you have questions, discuss everything at your pre-delivery (antenatal) consultation.

Conditions of the Genesis Dnepr Maternity Ward

The maternity ward is organized to ensure safe management of labor and adequate postnatal monitoring. Multidisciplinary teams coordinate care during routine situations and when circumstances change. If there are no contraindications, support for upright positions and other patient preferences is discussed. All organizational details and restrictions are agreed in advance with the physician and obstetrician/midwife.

Delivery rooms with facilities for changing positions and necessary monitoring
Postpartum rooms with the option of rooming-in for mother and baby
On‑call neonatologist for initial examination and assistance if needed
Anesthesiologist available for consultation and emergency intervention
Monitoring of mother and baby’s condition, including CTG (cardiotocography) when indicated
Support from the physician and midwife in implementing the agreed birth plan
Possibility of partner-supported childbirth, subject to medical and organizational requirements
Information support: review of the plan, explanation of procedures, and answers to questions

Please clarify the details and visiting procedures in advance during a consultation; the team will explain what is available in your case. During labor, priority is given to the safety of the mother and baby, so the plan may be adjusted.

When to seek urgent medical attention

If you notice one or more of the signs listed below, do not delay contacting the maternity ward or your doctor. Even if you are planning an upright (vertical) birth, a quick examination will help assess the situation and decide on further monitoring or hospitalization. In emergencies, seek help immediately.

Bloody or suddenly increased vaginal discharge
Your waters have broken (any amount), especially if bloody or foul-smelling
Regular, increasingly frequent and intense contractions before you can reach the clinic
Severe, unusual abdominal or back pain
Reduced or absent fetal movements compared with your usual level
A sudden rise in blood pressure or hypertension that is difficult to control
Severe headache that does not go away after resting
Visual disturbances: dimming, spots, blurring, or loss of vision
Marked weakness, lightheadedness or near-fainting, or confusion
Fever, chills, or other signs of infection
Any sudden or unusual change in how you feel that causes concern

If any of these symptoms occur, contact your clinic immediately or go to the maternity unit; if there is an immediate threat to health, call emergency services. A prompt assessment enables the team to take swift measures to protect the mother and baby.

Frequently Asked Questions

Question: Can I choose to have an upright delivery in advance?

Answer: Yes — you can discuss and express your wish to deliver in upright positions, but the final decision depends on examinations and the current condition of you and your baby.

Question: Are upright deliveries suitable for all pregnant women?

Answer: No — suitability is assessed based on the course of the pregnancy, the fetus’s condition and any contraindications; this is clarified at the consultation.

Question: Can the birth plan be changed during contractions?

Answer: Yes — the plan can be adjusted at any time for medical reasons; the team will explain the reasons and suggest alternatives.

Question: How can I discuss the birth format beforehand and can I meet the doctor in advance?

Answer: It’s best to discuss the format at a pre-delivery consultation, where your maternity record is reviewed and a plan is agreed; if you wish, you can be introduced to the lead physician or the on‑duty team.

Question: Can my partner be present during the birth?

Answer: In most cases partner presence is possible if medical and organizational rules are observed, but this must be agreed with the clinic in advance.

Question: How to prepare my partner for participation in the birth?

Answer: It’s recommended to discuss their role at the consultation, explain the rules for being in the delivery room and basic support techniques — this will reduce stress during the process.

Question: Can epidural anesthesia be used with upright births?

Answer: Epidural anesthesia is discussed individually; an anesthesiologist will evaluate its feasibility and potential impact on your mobility together with the doctor and you.

Question: Who decides on pain relief and is an anesthesiologist consultation necessary?

Answer: You make the decision together with your doctor and the anesthesiologist; an anesthesiologist consultation is performed when planning pain relief methods.

Question: What if the chosen pain relief method turns out to be unsuitable?

Answer: Pain relief plans can be adjusted during labor: the anesthesiologist will propose alternative methods or change the approach as indicated.

Question: When should I go to the clinic when labor starts or when my water breaks?

Answer: This depends on your doctor’s recommendations:

you should contact the clinic and go there according to its instructions when contractions are regular and more frequent, when your water breaks, or if there are other worrying signs.

Question: What should I bring to the maternity hospital and which documents should I prepare?

Answer: Bring personal identification, your health insurance card/policy, your maternity record and basic items for you and the baby; check the exact list with the clinic in advance.

Question: Can I come with already completed tests and examination results?

Answer: Yes — bring all current test results and examinations; this helps to make quicker decisions about the birth format.

Question: What happens if a cesarean section is required during labor?

Answer: The team will promptly arrange transfer to the operating theatre and perform the necessary procedure; you will be informed in advance about the reasons and the next steps.

Question: What is done immediately after the baby is born and how long is the usual hospital stay?

Answer: Immediately after birth they perform CTG if indicated and a mandatory neonatologist exam, arrange first contact (skin‑to‑skin) and assistance with latching; length of stay depends on the type of delivery and the condition of the mother and baby and is discussed individually.

Question: Can I discuss accommodation and partner deliveries in advance?

Answer: Yes — accommodation conditions, the possibility of rooming-in and rules for partner presence are discussed at the pre-delivery consultation and during admission to the clinic.

Question: How do I know that the planned birth format is no longer feasible and what should I do then?

Answer: The medical team will inform you based on the condition of you and the fetus; if the situation changes they will propose an alternative format or intervention and explain the reasons.

Question: Can I get a second medical opinion on the management of my delivery?

Answer: Yes — if you wish, you can request a consultation with another specialist; this is usually discussed with your attending doctor and arranged by the clinic when possible.

Question: How are previous deliveries or a prior cesarean section taken into account when planning the delivery format?

Answer: Your history of previous deliveries and cesarean section is carefully analyzed — it influences decisions about allowable positions and management, and is discussed at the consultation.