09/23/2025
We have seen this really help a few times!
This crazy-looking position is called Walcher’s and dates all the way back to 19th-century Germany and was first described by Gustav Adolf Walcher, a German obstetrician, in 1889.
The goal was to physiologically (naturally with no medicine) increase the anteroposterior (front-to-back and also medically known as the true conjugate) diameter of the pelvic inlet (top of the pelvis), potentially allowing the baby to descend and get into the pelvis. It can increase the pelvic inlet size by 1-2 cm!
This position is meant to be used if the baby is high in the pelvis, and you’ve tried everything else to help it get in (lower), especially if the pregnant person is very dilated but the baby is still high.
Nurses, you know those cervixes that are super dilated and stretchy and all that needs to happen is the baby drop and you’ve tried everything… consider Walcher’s!
Thank you for this incredible birth photo! Be sure to follow them!
Some Walcher’s tips to remember:
- You (nurse) needs to be there and make sure the sacrum is anchored on the top part of the bed.
- Lower the lower end of the bed first before you fully disconnect the bottom of the bed (you can see this here, the bed is broken in 2 pieces, so that you can assure that you or your patient doesn’t fall off!
- Do this for 3 contractions only. If you feel light-headed, let your nurse know and then readjust so they don’t pass out due to aortic compression.
- Be prepared that if it works and this was the reason baby wasn’t coming down, you may have an immenent birth!
- Expect the FHR (fetal heart rate) tracing to potentially have decels. It’s 3 contractions, ideally the reason is for rapid descent.
- This is NOT to be used as a routine position, but rather one as a back-pocket trick.
Have you tried this and seen it work?
Share your stories below for both families & nurses!
