Birthing Slings for an Active Birth

Ceiling mounted birthing sling

We at Softbirths make birth equipment for the NHS at a reasonable price and we do this by keeping our designs simple and safe.  Take our ceiling mount for birthing slings for example.


testing birthing slings
Weight-testing the sling cloth

We know that the average Midwife Led Unit or Birth Centre sees thousands of births a year with thousands of different women. Therefore quality, functionality and durability were our priorities when putting our prototype slings through their paces.

The metalwork is made in the UK by experienced, skilled craftsmen, our  steel ceiling mount and carabiner clips are virtually indestructible, yet incredibly easy to fit at a fraction of the price of other mounted fittings currently on the market, leaving you room to spend your budget on other home comforts for birthing women and midwives caring for them.

The tensile strength of the fabrics have been tested  up to 175 kilos. (We recommend using a ‘larkshead’ loop with the fabric through the carabiner clip for maximum strength – see photo of rope).

The metalwork is an area where savings to the NHS come in because it uses generic off-the-shelf components.  There is no mystery to fixing an eye-bolt to a beam or joist, no special components with patents.  We’ve added in two safety features so that there are two ‘locks’ to stop this metalwork ever unscrewing. The metalwork itself has been tested up to 400kg without it budging.  

Long and Strong

All our birthing slings are a generous six meters in length, giving plenty of length for loops and knots. They are manufactured in a beautiful series of jacquard weave, heavyweight cottons with for extra luxury and durability. They feel comfortable, strong and secure for labouring women to lean through or hold onto.

Birthing sling rebozo material
Beautiful, robust weaves in a range of designs



SoftBirth birthing sling fabrics are cotton or cotton blend and have been wash tested to 60°C with no noticeable loss of colour and a shrinkage allowance of just 3%.

Have a look

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There is a whole range of beautiful colours and patterns of birthing slings to choose from, more than we can show here.  Take a look at Softbirth’s birthing sling page or contact us for more details.

Kick starting labour – a new model of uterine function

Guest blog by Margaret Jowitt

The current management of women in labour is based around RCTs of what health professionals do – or don’t do – to women under their care. Physiology comes right at the bottom of the hierarchy of evidence in evidence based medicine, but in the case of childbirth, a physiological process rather than a disease to be treated, physiology should head that list. We should be managing care according what the woman’s body needs in order to labour efficiently and effectively.

Traditionally, the forces of labour are described in terms of the Powers, the Passenger and the Passage. Somewhat bizarrely, this model denies both the mother and her baby any active involvement in the process.  We can make a better model of labour when we consider the mother and her baby as active participants. The uterus is the interface between them. Both the mother and her baby have bodies which can move and affect the effectiveness of uterine activity.

It is true that in mechanistic terms the uterus is the ‘engine’ of labour. It is the strongest muscle in the body but it is acting upon that most delicate of human beings, a baby. Mistreated engines tend to seize up, sometimes with catastrophic consequences.  Understanding how the uterus works is central to good maternity care but most textbooks have little to say on the subject, they simply refer to uterine function as the ‘Powers’. Contractions just happen – or not. And if not, labour can usually be kick started with artificial oxytocin.

Labour is a hormonal event. We have only to look at the effects of syntocinon (Pitocin) infusions to know that oxytocin has a very powerful effect on the uterus but physiologists are aware that blood levels of natural oxytocin do not increase until second stage.  What drives labour before second stage seems to be the increasing sensitivity of the uterus to these lowish levels of oxytocin.  We also know that, even in established labour, contractions can stop and that the likely mechanism is antagonism of  oxytocin by the stress hormones secreted by anxious or fearful mothers. Preventing or alleviating the mother’s stress will improve uterine function. This is where supportive midwifery care comes into the picture.

But there is another driver of contraction which physiologists know about but doesn’t make the clinical textbooks and that is stretch. Most smooth muscle, including that of the uterus, is activated by stretch. That is how food moves along the intestines, faeces through the colon and blood through the veins.

The heart, a special form of smooth muscle, has a pacemaker to drive its contractions and scientists have been searching in vain for a pacemaker site in the uterus. Instead they have found that any site in the main body of the uterus has the capacity to be either a pacemaker or a pace follower. 25 years ago I proposed that fetus him/herself ‘steered’ themselves towards the exit by means of what I called the stretch-contract reflex.  Visualise a balloon shaped trampoline and put a kicking baby inside. The origin of a contraction will be where the fetus is stretching the uterus. Shortly after my first book, Childbirth Unmasked, was published, Sheila Kitzinger rang me to suggest that the so-called neonatal reflexes could be involved. This was a vast improvement on my initial idea. Milani Comparetti, the father of paediatric neurology, proposed that the neonatal reflexes enabled the fetus to search for the ‘invitation to softness’.  The fetus himself may kick his way into the best position for his journey through the birth canal.

Is the fetus really able to position her/himself for entry into the birth canal? Does the fetus utilise his/her reflexes to negotiate the birth canal? Could cerebral palsy be the cause of a difficult labour rather than being a consequence? We don’t know, but a role for fetal positioning in labour is a testable hypothesis. I am no lover of electronic fetal monitoring, but we would need a few expectant mothers who were willing to undergo multi-channel monitoring for a few contractions.  Electromyography can already record electrical activity in the uterus at more than one place at once and the source and spread of a contraction can be mapped using powerful computer software. At the same time movement activated LED lights could be placed in a network over the mother’s abdomen and videoed to provide a corresponding map of activity. We could then see whether there was any correlation between fetal movements and uterine activity.  A few contractions from a few women with babies in different positions (e.g OP, AP, breech) and with the women adopting a different position for each contraction should yield a wealth of data for a computer to crunch.

If the results supported the hypothesis, the importance of maternal freedom of movement would become apparent. The mother, her fetus and the uterus would all need to have as much freedom of movement as possible in order to enable the fetus the manoeuvre him/herself in the optimum position for birth. Restricted movement would lead to pain and failure to progress, all too often found in ‘managed’ births where electronic fetal monitoring limits mothers’ choice of position.

My most recent mindshift has been in the area of the material substance of the uterus – by which I mean the composition of the biological tissue of which it is formed.  We already know that there are hormonal changes in terms of receptor sites for various contraction associated proteins (CAPs), but what if substantial changes to the gross anatomy of the uterus involving tissue remodelling was taking place during labour itself? What if the uterus started to remodel itself during labour (as we know it does during the days that follow)?

We already know that the cervix has scaffolding of collagen  which keeps it shut during pregnancy and which can be artificially ripened (broken down) by prostaglandins so that it can to stretch to 10 cm in the course of labour.

The uterus also has collagen scaffolding.  This is less well known  – tissue samples from the main body of the pregnant uterus are harder to come by. What if uterine collagen performs the same task as the collagen scaffolding at the cervix, preventing stretch-initiated contraction? What if this collagen is also broken down (by prostaglandins, IL-8 and MMP8, collagenase) during labour? The loss of collagen scaffolding then affects the biomechanics of the uterus, allowing it to become progressively more stretchable and more contractable. The ‘trampoline’ of the uterus becomes ‘bouncier’. Contractions become more effective. The fetus starts searching for the best way out.

Now for the final piece of the puzzle, the onset of labour. We know that in other mammals the fetus is involved in initiating labour by a hormonal mechanism which changes the balance between oestrogen and progesterone, but in humans progesterone levels remain high even at the onset of labour. In order to be able to give birth to a baby with a bigger head, we evolved to give birth earlier in pregnancy when the progesterone block was still in place. Rising oestrogen does still plays a part in the onset of labour. On a signal from the fetus, oestrogen rises and primes the uterus for labour by increasing oxytocin receptors and gap junctions. The oxytocin receptors make the uterus more contractile and the gap junctions allow electrical activity to spread to involve the whole uterus.

It looks as though the alternative mechanism (from a change in the oestrogen:progesterone ratio) for the onset of human labour may be stretch-activated inflammation acting on a primed uterus.  The only difference between Braxton Hicks contractions and the contractions of labour are that BH contractions are less powerful and don’t spread so far. In the oestrogen primed uterus, contractions can spread. Inflammation is a primary driver of labour, often associated with premature labour. According to Kim et al of Imperial College (unpublished paper, unknown date):

“The stimuli triggering inflammatory activation in normal human parturition are not fully understood.”

I think the elusive inflammatory event that precipitates labour is increased stretch made possible by loss of collagen, the same biochemical mechanism that causes cervical ripening. Both twin pregnancy and polyhydramnios are associated with premature labour. The uterus is already distended so it takes little more to push it over the edge into labour. Breaking the waters can kick start labour in a uterus that is already primed for labour because now the fetus is able to stretch one part of the uterus with more force.

What can we do to improve uterine efficiency?

RCTs have shown better outcomes with caseload midwifery and out-of-hospital birth. This suggests that the powerhouse of the uterus tends to work better when its owner is cared for by a midwife, preferrably a midwife already known to her. Labour progresses more quickly at home when measured by the simplest of parameters – length of labour. The Birthplace study (2011) doesn’t give average length of total labour for all women, but women giving birth in obstetric units laboured there for 9 hours and women giving birth at home had a midwife for 6.6 hours. Midwives encourage women to move freely, women are less likely to be tethered to a fetal monitor and asked to remain still. Midwives are expert in rearranging the furniture to allow women freedom of movement. Labouring in water is even better.

All women need freedom of movement, not just low risk women deemed suitable for midwife-led care. We should stop putting women to bed for labour and we should outlaw tight belts holding transducers in place, we may be preventing the very activity that we need to enhance. I found that forward leaning positions were least painful in my labours. These positions keep the main body of the uterus away from the maternal bones.

You can see a visual representation of the ‘collagen scaffolding’ on a youtube animation made to illustrate a kneeling chair I have designed for labour and birth and which, I hope, illustrates why I am so passionate about giving women freedom of movement in labour. Freedom of movement should not just be a ‘nice to have’ option for low risk women but a physiological imperative for all women in labour. (In case you were wondering, freedom of movement should also include freedom to choose the bed!)


Birthing Couch Trialed at Darent Valley Birth Centre

SoftBirth birthing couchAfter a design led by midwives and doulas, our Birthing Couch Kit underwent eight weeks of rigorous use in the busy Birth Centre at Darent Valley Hospital, Kent.

Here is a summary of the evaluations provided by the Midwives and women who used the Couch Kit.

Use of couch during intrapartum period:

  • 100% of women used the couch for sitting or laying
  • 70% used the couch and kneeling pad for kneeling
  • 77% gave birth using the couch

Use of couch during the post-partum period:

  • 92% of women used the couch for skin to skin and bonding
  • 70% used the couch for sleeping or resting

“Love it! A big improvement on the Bradbury couch.”

“I enjoyed the comfort of the couch for skin to skin and feeding my baby.”

“I really like that women can kneel and lean over the couch.”

Cleaning and Disinfection:

  • Midwives agreed the couch was easy to clean and disinfect according to current protocols.

Competitor comparison:

  • 100% of Midwives who have previously used a bradbury birthing couch in their practice agreed that the Softbirth Birthing Couch Kit is a significant improvement on the traditional design.


At the end of this trial, rather than return it, the Birth Centre bought it to keep!

Since then, other hospitals at Bath, Berkshire, Derby, Powys, Yarmouth…and abroad, have bought birth couches and birthing mats.

New SoftBirth Birthing Couch Kit

Couch CompleteSoftbirth™  have just launched their range of soft furnishings for the birthing room.  The most exciting piece being their birthing couch kit.

With its simple yet innovative design, its segments can be moved around to suit the needs of the moment.  The stool segment pulls out to give a seat for the midwife or birth partner.  The recess can be used for the mother to kneel – a kneeling mat is included for comfort.  Other couches charge for other items, such as inserts, as an optional extra whereas they are included in the price of the Softbirth couch.

The foam used is very firm for safety’ s sake but it is topped off with memory foam to give a very comfortable feel. The comfort is enhanced as the design tries to get away from the ‘clinical look’ whilst still being suitable for the birth room.   Its approximate dimensions are 2m x 0.9m x 0.45m.  And whilst it is firm and stable, it is not heavy or cumbersome like other similar products.  It can be easily moved and deployed or put aside to clear space.

The cover is hospital grade and has welded seams and is fully cleanable.  The cover is zipped so that it can be replaced and to enable inspection (the inner of the cloth is white so that any ‘strike-through’ can be quickly spotted.  The zips are covered by hygiene flaps.  The couch can come in mid-lilac as shown or navy blue and replacement covers can be purchased either with the couch or later as a replacement.

SB-couch and cushions


Another optional extra is the comfort cushions set consisting of a pillow, a square cushion and a cylinder-cushion.  Larger versions of these cushions are available.