KIKO Positioning 👣

I think by now everyone has taken note of the ‘knees in, calves out’ positioning that can help open the pelvic outlet (of course midwives who are into physiology have been aware of this forever, right😬? ).

But something doesn’t sit right with me.

Now, it’s a really wonderful piece of information that can be super helpful when things seem to be veering off normal physiology, and a little help is needed.

HOWEVER.

I think constantly reminding pregnant people of KICO as optimal positioning is almost as concerning as disrupting physiology in other ways.

I even saw it recommended for excellent positioning in the opening phase of labour, when the pelvic outlet is not being negotiated yet!

As a midwife who supports physiology, I don’t see people do KICO physiologically all that often. Sometimes, yes.

But not often.

I don’t actually think pelvic outlets need consciously widening unless there is an indication that the baby may have trouble negotiating the pelvis.

There have been instances when I DID see KICO more often and that was during hospital births in semirecumbent positioning, exactly the scenarios in which the pelvic outlet may well need some proactive opening, as it is compromised by a non mobile sacrum already…..ironically this is the exact scenario in which it is often discouraged by midwives a la ‘Open your legs to give the baby some space 🙄!’

So, can we keep KICO as a tool to help as opposed to something we suggest people do as a matter of course? It is disruptive to physiology, might be unhelpful in lots of situations and is just not necessary in straightforward birth!