WO2009115833A1 - Birthing apparatus - Google Patents

Abstract

The present invention relates to a birthing apparatus that enables a woman to give birth safely and comfortably in the "all-fours" position. The birthing apparatus includes a base (2) and a support frame (4). The support frame (4) is pivotally mounted relative to the base (2) and has support means in the form of pads for supporting the arms, knees and buttocks of the woman when the birthing apparatus is in use.

Description

BIRTHING APPARATUS

DESCRIPTION Technical Field

The present invention relates to a birthing apparatus, and in particular to an apparatus that enables a woman to adopt an "all-fours" position during labour.

Background Art It is widely accepted that women who give birth in an "all-fours" position (i.e. resting on their knees with their legs bent and supported by their hands with arms straight or by their forearms and elbows with arms bent) may have a shorter and safer labour. Despite an increase in the promotion of "active birth" techniques where woman are encouraged to stay as active as possible during labour, there is still no easy way for a woman to adopt an all-fours position in a way that provides the necessary degree of safety and support. The current approach is simply for the woman to kneel on the floor or the maternity bed, usually with cushions or pillows under her knees and hands or elbows to try and stay as comfortable as possible.

There is therefore a need for a birthing apparatus that is specifically designed to provide support for a woman who wants to adopt the all-fours position during her labour.

Summary of the Invention The present invention provides a birthing apparatus comprising a base, and a support frame pivotably mounted relative to the base and having support means (typically, but not exclusively, in the form of ergonomically-shaped pads or cushions) for supporting the arms, knees and buttocks of a user adopting an all-fours position when the birthing apparatus is in use.

The birthing apparatus preferably includes an adjusting device (e.g. an electric motor or a hydraulic or pneumatic system) for selectively adjusting the angle of the support frame relative to the base. The support frame is preferably pivotable between a first position where the support frame is upright and a second position where the support frame is substantially horizontal. It is anticipated that a user will get on and off the birthing apparatus when the support frame is in the upright position.

The support frame preferably further comprises handle means that can be gripped by the hands of the user when the birthing apparatus is in use.

The support frame preferably further comprises support means (typically, but not exclusively, in the form of an ergonomically-shaped pad or cushion) for supporting the forehead of the user when the birthing apparatus is in use.

One or more of the support means are preferably adjustably mounted to the support frame.

The support frame optionally comprises a pair of arms spaced apart by a gap that allows access to the front of the user when the birthing apparatus is in use. The support means for supporting the arms of the user may be provided on a unit that is slidably mounted between the arms of the support frame. The unit may further comprise handle means that can be gripped by the hands of the user and support means for supporting the forehead of the user when the birthing apparatus is in use.

The base may be provided with wheels, glide members, roller balls or castors to enable it to be moved easily. The base may also be provided with a handle for facilitating the movement of the birthing apparatus. The handle can be pivotably and/or rotatably mounted to the base. This enables the handle to be moved out of the way when the user wants to get on and off the birthing apparatus and/or to enable the birthing apparatus to be collapsed for convenient storage and transport.

The birthing apparatus preferably further comprises an adjustable safety unit that includes a catching membrane. The catching membrane includes one or more drainage areas through which bodily fluids may pass. The physical dimensions of the catching membrane (and hence any frame to which it is secured) will be sufficient to make sure that a baby is properly and safely caught by the catching membrane in the event of an accident.

The safety unit may include a removable container for the safe and hygienic collection of bodily fluids. The removable container is preferably adapted to enable a volume measurement of collected bodily fluids to be made.

The safety unit is preferably adjustably mounted to the base and can be positioned at a suitable position relative to the user (e.g. directly underneath the birth canal) when the birthing apparatus is in use.

Drawings

Figure 1 is a rear view of a birthing apparatus according to the present invention with a support frame in an upright position, a safety unit in a stowed position and push handles rotated to allow easy access;

Figure 2 is a rear view of the birthing apparatus being used by a woman with the safety unit and push handles in a use position;

Figures 3 to 6 are side views of the birthing apparatus being used by a woman with the support frame set at different angles;

Figure 7 is a side view of the birthing apparatus being used by a woman with the support frame set at a horizontal angle during an emergency situation of cord prolapse and with an additional pad for supporting the head of the baby;

Figure 8 is a rear view of the birthing apparatus as shown in Figure 7; Figure 9 is a side view of the birthing apparatus in a collapsed configuration ready for storage or transport;

Figures 10 to 14 are section views through the birthing apparatus showing the safety unit in a variety of different positions;

Figure 15 is a detail side view of the safety unit; Figure 16 is a top view of the safety unit showing a frame to which a catching membrane is secured and a holder for receiving a removable container; Figure 17 is a top view of the safety unit showing the frame and the removable container;

Figure 18 is a top view of the catching membrane; and

Figures 19 to 22 are top views of the birthing apparatus being used by a woman showing how the arm and knee pads can be adjusted.

A birthing apparatus includes a base 2 and a support frame 4 that is pivotally mounted to the base.

The base 2 includes a pair of centre wheels 6 and four corner wheels 8. The birthing apparatus is highly manoeuvrable and can be turned in its own length. The centre wheels 6 can be lowered by a lowering mechanism (not shown), raising the four corner wheels 8 off the ground slightly, which allows the birthing apparatus to be pushed over uneven ground.

The base 2 is provided with a pair of push handles 10 that can be rotated outwardly to allow the woman to get on and off the support frame 4 more easily. The push handles 10 are fitted with brake release handles 12 that must be manually operated in order to release a braking mechanism (not shown) that can lock one or more of the wheels. The support frame 4 includes a handrail 14 that runs around its outer edge and allows a second person to assist in the manoeuvring of the birthing apparatus.

The larger structural components of the birthing apparatus are manufactured from lightweight materials such as aluminium, titanium, composites or medical plastics. All parts will generally be designed and constructed with the aim of keeping the birthing apparatus as clean and as hygienic as possible to minimise the risk of infection.

The support frame 4 is substantially u-shaped and includes a pair of side arms 4a, 4b. An upper support unit 16 includes a cross member 18 that extends between the side arms 4a, 4b and is slidably mounted to them. The upper support unit 16 can therefore be adjusted by moving it up and down the side arms 4a, 4b to accommodate women having different heights.

A pair of arm pads 20, a u-shaped handle 22 and a head pad 24 are adjustably mounted to the cross member 18.

The arm pads 20 are sized and ergonomically shaped to support the lower arms and elbows of the woman and are fully and independently adjustable to accommodate women of different sizes and to relieve pressure points. The arm pads 20 include a curved part 20a that provides additional elbow support. The arm pads 20 can pivot relative to the cross member 18 of the upper support unit 16 to enable them to adjust to the position that the woman adopts on the birthing apparatus. The arm pads 20 can also slide along the cross member 18 (i.e. they can move outwardly towards the side arms 4a, 4b or inwardly away from the side arms) and pivot within the plane of the support frame 4 as shown in Figures 19 to 22.

The ends of the handle 22 are fixed to the arm pads 20 and to accommodate the sliding movement of the arm pads along the cross member 18 the handle may be formed from two or more parts that are pivotally or flexibly connected together.

The arm pads 20 and the handle 22 provide a comfortable, ergonomic arrangement and allow the woman to bear down strongly during labour by gripping the handle and pulling. Such an action is not normally easy to achieve on a conventional maternity bed in any position.

The head pad 24 is ergonomically shaped to provide support for the forehead of the woman and may help her to relax between contractions. The head pad 24 can be moved closer to, or further away from, the cross member 18.

A pair of knee pads 26 are mounted to a lower part of the support frame 4 and are independently adjustable. The knee pads 26 are ergonomically shaped and include a recess 28 for accommodating the feet of the woman and which define a foot support. The knee pads 26 are pivotable within the plane of the support frame 4 as shown in Figure 19 to 22. Such movement may help to relieve pressure points, but may also improve access to the woman's birth canal. As such, a medical attendant such as a midwife or doctor may deliberately move the knee pads 26 inwardly to the position shown in Figures 19 and 21 during labour.

As shown in Figures 4 to 9, a pair of buttock pads 30 are mounted to a lower part of the support frame 4 by a mounting structure. The buttock pads 30 are sized and ergonomically shaped to support the buttocks of the woman. The buttock pads 30 are fully and independently adjustable and may be moved closer to, or further away from, the support frame 4 (i.e. raised or lowered). The buttock pads 30 may also be moved along the support frame 4 as shown in Figures 4 to 6. The mounting structure allows the buttock pads 30 to be pivoted outwardly when they are not needed and to allow the woman to get on and off the support frame 4 more easily.

The combination of the buttock pads 30 and the knee pads 26 provide a "seating" position that is similar to that provided by orthopaedic stools and which supports the woman in a safe and secure manner during labour. It is therefore possible for the woman to be safely transported using the birthing apparatus if this should be necessary.

All of the pads are filled with a suitable resilient compressible material to provide the necessary degree of comfort and support to the respective body parts of the woman using the birthing apparatus.

The movement and adjustment of the various pads may be motorised (e.g. using electric motors, hydraulics or pneumatics) and controlled by means of a control pad (not shown). The control pad will normally be positioned in a suitable place to enable it to be operated by the woman while the birthing apparatus is being used. Alternatively, the various pads may be moved and adjusted manually. The angle of the inclination of the support frame 4 relative to the base 2 may be adjusted to suit the needs of the woman or medical attendant. Figure 3 shows the support frame 4 in an upright position which is how the woman will normally get on and off the birthing apparatus. In this position, the shaped recesses 28 in the knee pads 26 that define the foot support are close to the ground. It can be most clearly seen from Figure 4 to 6 that the support frame 4 includes an upper part defined by the side arms 4a, 4b and a lower part 4c that is stepped back and to which the knee pads 26 are mounted.

The support frame 4 is mounted to an upwardly extending arm 2a of the base 2 by a suitable bearing or pivot point 2b. The angle of inclination of the support frame 4 relative to the base 2 is determined by a motorised unit (e.g. using electric motors, hydraulics or pneumatics) and controlled by means of a control pad. In other words, the motorised unit (not shown) can be controlled to raise and lower the support frame 4 to any preset or user-defined position. For example, Figure 4 shows the support frame 4 inclined at approximately 50 degrees relative to the base 2 and with the buttock pads 30 in a suitable position; Figure 5 shows the support frame 4 inclined at approximately 30 degrees relative to the base 2 and with the buttock pads 30 adjusted forwards along the support frame; and Figure 6 shows the support frame 4 inclined at approximately 20 degrees relative to the base 2 and with the buttock pads 30 adjusted rearwards along the support frame.

In the position shown in Figure 6, it can be seen that the woman's head is about level with her buttocks. In a cord prolapse situation where the umbilical cord presents itself outside of the uterus when the baby is still inside the woman then it is essential that she adopts the so-called "knee-chest" position with the head lower than the buttocks so that gravity may assist in holding the baby back to relieve pressure on the umbilical cord. With the birthing apparatus of the present invention, the knee-chest position can be quickly and easily adopted by lowering the support frame 4 to its lowest position shown in Figures 7 and 8 where the side arms 4a, 4b are horizontal. A special pad 32 that can be releasably secured to the mounting structure support for the buttock pads 30 may be placed in position within the woman's vagina to alleviate pressure on the umbilical cord while preparations for an emergency caesarean section are made. The woman may be transported to the operating room or theatre on the birthing apparatus. The use of the special pad 32 is a significant improvement on conventional methods where the pressure will often be relieved by the hand of a medical attendant.

An adjustable safety unit 34 is mounted on the base 2. This safety unit 34 includes a catching membrane 36 that has a central aperture or mesh section 36a through which the woman's bodily fluids can pass. The catching membrane 36 will be disposable for infection control reasons and can be releasably secured to the resilient or spring- loaded arms of a frame 38 using any suitable means such as tabs or loops, for example. The arms of the frame 38 are biased outwardly to maintain tension in the catching membrane 36 but allow it to conform to the space between the woman's legs with inward pressure being applied by her legs. In the event that the baby is not properly caught by the medical attendant as it is delivered, it will be safely caught by the catching membrane 36. The weight of the baby falling on the catching membrane 36 causes the arms of the frame 38 to move inwardly against the bias to break the baby's fall and allow it to be safely enveloped by the catching membrane. This helps to suppress the baby's natural 'Moro' reflex (startle reflex) which might otherwise cause the baby to roll off of the catching membrane 36 and on to the floor.

A central part of the frame 38 defines an opening into which a removable container 40 can be received. The container 40 has a funnel part and a tray part and is located directly underneath the central aperture or mesh section 36a of the catching membrane 36. Any bodily fluids such as amniotic fluid, urine, meconium and blood will pass through the central aperture or mesh section 36a to be collected by the container 40. This is a significant improvement on existing methods where such bodily fluids are normally collected using absorbent pads and the like. The tray part of the container 40 includes a graduated scale 42 that allows the volume of bodily fluids to be measured. The container 40 therefore provides a more accurate way of measuring the total amount of blood loss if haemorrhaging were to occur. The type of bodily fluids is clearly visible and identifiable, which allows for correct and prompt intervention where necessary. The contents of the container 40 can be safely disposed of after use and it can be removed from the frame 38 and cleaned using appropriate detergents.

The safety unit 34 is mounted to the base 2 by a pivotable frame 44 that can also slide relative to the base. This enables the safety unit 34 to be raised and lowered and adjusted laterally as shown in Figures 10 to 14. For example, in Figure 10 the safety unit 34 is raised and in a forward position; in Figure 11 the safety unit 34 is raised and in a middle position; in Figure 12 the safety unit 34 is raised and in a rear position; in Figure 13 the safety unit 34 is partly lowered and in a rear position; and in Figure 14 the safety unit 34 is fully lowered and in a rear position - this represents a stowed position for the safety unit 34. Once the safety unit 34 has been moved to a suitable position, preferably where the catching membrane 36 is located directly underneath the woman's birth canal, the pivotable frame 44 can be temporarily locked to prevent further movement.

When the birthing apparatus is not being used or is being transported then it can be collapsed to adopt the configuration shown in Figure 9 where the push handles 10 are pivoted flat, the safety unit 34 is stowed and the support frame 4 is horizontal.

It will be readily appreciated that the birthing apparatus can be used instead of a conventional maternity bed. It may be preferred by women who want to employ "active birth" techniques and do not wish to give birth lying on their back. The birthing apparatus can therefore be placed in a delivery suite of a hospital or birthing centre, for example. The birthing apparatus will add further capacity to a busy delivery suite having only a certain number of conventional maternity beds and when not in use can be collapsed to conserve space and for easy transportation.

The birthing apparatus can also be used outside the delivery suites such as at home or in an emergency situation when a woman is at risk of giving birth in a corridor, bathroom, accident and emergency room or hospital car park, for example. In an emergency situation, the birthing apparatus can be quickly moved to the location of the woman and then used to transport her to the delivery suite or a more suitable area to give birth with only minimal disruption to labour.

To use the birthing apparatus, the push handles 10 and the buttock pads 30 are preferably pivoted outwardly to provide easy access to the support frame 4. With the support frame 4 in the upright position, the woman will hold the handle 22 so that her lower arms and elbows are supported by the arm pads 20 and step up to place her feet in the shaped recesses 28 so that her knees and lower legs are supported by the knee pads 26. The buttock pads 30 can then be pivoted inwardly to support the woman's buttocks. The position of the various pads can be adjusted for the particular woman using the control pad (not shown) as described in more detail above.

Once the woman is properly positioned on the birthing apparatus, the support frame 4 can be lowered to a comfortable angle of inclination using the control pad (not shown) as described in more detail above. A change in the angle of the support frame 4 relative to the base 2 may require a corresponding adjustment in the position of the various pads or vice versa.

If the birthing apparatus is to be moved then the push handles 10 may be pivoted inwardly to their use position and locked. It will be readily appreciated the birthing apparatus may be moved with the woman safely positioned on the support frame 4.

The woman can get off the birthing apparatus quite easily by raising the support frame 4 to the upright position and stepping backwards off the support frame.

The woman may wear a disposable dignity cape (not shown) or the birthing apparatus may optionally be fitted with a track or rail for pull round curtains to screen the woman.

During labour, the medical attendants, birth partner etc. have full access to the woman from both the front and rear. In particular, the front of the woman can be easily accessed between the side arms 4a, 4b of the support frame. Back massage can be administered from the rear by a midwife or birthing partner, which might prove effective in longer labours.

The birthing apparatus does not hinder, and in many ways facilitates, medical intervention during labour. For example, the fetal heart rate can be monitored before, during and after contractions without having to ask the woman to change position. The angle of inclination of the support frame 4 can also be changed during labour to improve the woman's comfort, to enable fetal blood sampling or to place the woman in the knee-chest position during a cord prolapse emergency, for example.

The birthing apparatus can also be used as a convenient epidural siting unit for mobile epidurals.

The birthing apparatus may optionally include the following additional features:

An intravenous stand or means for securing a conventional intravenous stand to the base.

A drinks system for on-demand delivery of liquids during labour.

Means for enabling medial equipment and/or entertainment equipment to be attached or secured to, or received in, the birthing apparatus for convenient storage and transport.

In-built medical equipment such as a contraction timer.

Additional pads or supports mounted on the upper support unit 16 for supporting the shoulders or underarms of the woman.

Claims

1. A birthing apparatus comprising: a base; and a support frame pivotably mounted relative to the base and having support means for supporting the arms, knees and buttocks of a user adopting an all-fours position when the birthing apparatus is in use.

2. A birthing apparatus according to claim 1, further comprising an adjusting device for selectively adjusting the angle of the support frame relative to the base.

3. A birthing apparatus according to claim 1 or claim 2, wherein the support frame is pivotable between a first position where the support frame is upright and a second position where the support frame is substantially horizontal.

4. A birthing apparatus according to any preceding claim, wherein the support frame further comprises handle means that can be gripped by the hands of the user when the birthing apparatus is in use.

5. A birthing apparatus according to any preceding claim, wherein the support frame further comprises support means for supporting the forehead of the user when the birthing apparatus is in use.

6. A birthing apparatus according to any preceding claim, wherein one or more of the support means are adjustably mounted to the support frame.

7. A birthing apparatus according to any preceding claim, wherein the support frame comprises a pair of arms spaced apart by a gap that allows access to the front of the user when the birthing apparatus is in use.

8. A birthing apparatus according to claim 7, wherein the support means for supporting the arms of the user are provided on a unit that is slidably mounted between the arms of the support frame.

9. A birthing apparatus according to claim 9, wherein the unit further comprises handle means that can be gripped by the hands of the user and support means for supporting the forehead of the user when the birthing apparatus is in use.

10. A birthing apparatus according to any preceding claim, wherein the base is provided with wheels, glide members, roller balls or castors.

11. A birthing apparatus according to any preceding claim, wherein the base is provided with a handle for facilitating the movement of the birthing apparatus.

12. A birthing apparatus according to claim, wherein the handle is pivotably and/or rotatably mounted to the base.

13. A birthing apparatus according to any preceding, further comprising an adjustable safety unit that includes a catching membrane.

14. A birthing apparatus according to claim 13, wherein the catching membrane includes one or more drainage areas.

15. A birthing apparatus according to claim 13 or claim 14, wherein the safety unit includes a removable container for the safe collection of bodily fluids.

16. A birthing apparatus according to claim 15, wherein the removable container is adapted to enable a volume measurement of collected bodily fluids to be made.

17. A birthing apparatus according to any of claims 13 to 16, wherein the safety unit is adjustably mounted to the base and can be positioned at a suitable position relative to the user when the birthing apparatus is in use.

18. A birthing apparatus substantially as described herein and with reference to the drawings.