What’s the best position for labor?
There’s no one best position. In fact, most women end up changing positions frequently during labor. Let your body be your guide. Learn positions and movements that help ease labor pain naturally.
A recent study analyzed the research on this topic and recommended that women labor in whatever position they find most comfortable and not be required to lie down for long periods of time. The study found that women who tended to walk or stay upright during early and active labor shaved about an hour off their labor time and were less likely to have an epidural. In early labor your contractions probably won’t require the same attention that they do later on. You may want to putter around the house or take a walk outside. Or, if you’re tired, you may want to take a warm bath or lie down and try to doze off between contractions When labor becomes more active, you can try a variety of positions to help you manage the pain during the increasingly intense contractions. You may choose to be upright at some points and want to recline at others. One position you don’t ever want to stay in is flat on your back. In this position, your uterus compresses the vena cava (the large vein that returns blood from the legs to the heart), which compromises blood flow and may make your contractions less effective.
What are some good positions to try during active labor?
Left to her own devices, a woman laboring without pain medication will often assume the position that’s best for her without even making a conscious decision. Sometimes, though, the challenge of labor is so overwhelming that it’s helpful to have your partner or caregiver suggest various positions and help you get into them. If you’re looking for inspiration, below are some positions that may work for you. If you haven’t already done so in childbirth classes, it’s a good idea to go over these positions ahead of time with your partner or labor coach.
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Standing and walking
Some women like the sense of control they get from standing and walking during active labor. During contractions, you can stop to lean against the wall or on your partner.
Swaying back and forth in rhythm with your breathing can be comforting during labor. You can do it while standing or leaning on your partner in a sort of slow dance, or by using a rocking chair if one is available.
Sit on the bed or a chair with pillows supporting your back. You can also try to sit leaning forward, which takes some pressure off your back. Or try “tailor sitting” – sit cross-legged on the bed (or on the floor if you’re still at home).
Straddle an armless chair (or open toilet seat), facing backward. Place a pillow between the chair back and your belly, and lean into it, resting your arms and head on the top of the chair. This position takes some pressure off your back and makes your back available for your partner to rub or massage, if that appeals to you. If you’ve got a plastic chair, try sitting this way in the shower, letting the warm water pour down your back.
Hands and Knees
Get on all fours on the bed. Research shows that being on your hands and knees may offer some relief from back pain before and during labor. If your wrists get tired, raise the head of the bed so you can rest your forearms on it as you kneel. Or lean the front of your body into a stack of pillows if that makes you feel more comfortable.
Using an Exercise Ball
Sit on an inflatable exercise ball (sometimes referred to as a yoga or birthing ball). Have someone there to spot you so you don’t roll off. While sitting, try leaning into a stack of pillows on a bed. This position allows you to stay in a squat position and move your hips around while most of your weight is supported. Alternatively, you can lean over the ball while kneeling or set the ball on a chair and lean over it while standing.
Lying on your side
This restful position can give an exhausted laboring woman a much-needed break, while avoiding the compression of major blood vessels that may occur when lying on your back. Start by lying on your left side, which is preferable for blood flow. Slide a pillow between your knees for comfort. If you need a change or your baby doesn’t seem happy with you in that position, have your partner help you turn onto your right side.
Here are some great laboring positions from Fitpregnancy.com
What are some good positions for pushing?
Many of the positions you’ve used throughout labor will also help you during the pushing stage. Again, it’s important to listen to your body and change positions whenever the one you’re in is no longer working for you.
Many women find that being upright – whether kneeling, sitting, squatting, or even standing – is more comfortable than lying down at this point. Plus, it may put gravity to work for you.
Squatting has an added advantage: It slightly increases the diameter of the outlet of your pelvis. This gives your baby more room to maneuver his way through your pelvis and out into the world.
Depending on where you give birth, there may be some options available to help make squatting less difficult:
A birthing bar is an attachment that can be added to most labor beds to help facilitate a squatting position. The squatting position helps to expand the size of your pelvis, and uses gravity to promote the downward movement of your baby. When using the bar, the foot of the bed can be dropped, and the head of the bed raised high. Between contractions, you can sit, supported by the head of the bed, and then during contractions, move forward to squat, supported by the bar.
There is an alternative way to use the birthing bar. The vertical supports of the bar are used to rest your feet, and a sheet or towel is looped over the top of the bar. During the contractions, you grasp and pull back on the sheet as you push downward. This alternative might be helpful if you are too short to be comfortably supported by the bar in the squatting position or if you have had an epidural and your legs are too numb to safely support you in a squatting position.
A birthing stool can help you push in a very familiar position: the position you are used to using for having a bowel movement. Additionally, the low height of the stool flexes your legs and expands the size of your pelvis, and the upright position helps use gravity to promote the downward movement of the baby. You would push in the position shown, and then between contractions can lean backward to rest supported by your partner.
This upright sitting position is a variation on the use of a birthing stool. Notice how the mother is curled forward around her baby, with her elbows out as she pushes. The head of the bed is raised high, and the foot of the bed is lowered, giving you a place to place your feet. Like the use of the stool, this position helps you use gravity effectively. Between contractions, you can lean backward supported by the bed. If you like, your partner can also sit behind you in bed as you use this position.
pregnant woman kneeling during laborWhile pushing or giving birth on your knees may be used by any woman, it may be especially effective if you have had back pain during labor, as it helps to encourage movement of the baby. During the contraction, you flex your hips and lower your buttocks slightly as you push. Between contractions, you can drape yourself over the head of the bed to rest and relax. You may try this position on your hands and knees, but, as your wrists may quickly become tired of supporting your body, you may find it easier to rest on your forearms as illustrated by this mother. In an alternative to this position, you may drape your upper body over a birthing ball.
Semi-seated, with support
This position is not as effective in opening the pelvis as the upright positions illustrated above, but is probably the most common position used for the actual birth of baby – not necessarily because it is the best position for birth but, as you can imagine, it is the most convenient position for your doctor or midwife. In this illustration, notice that the head of the bed is raised to at least 30 degrees or greater, and that the mother has a pillow placed under her right hip, helping her turn slightly to the left. These adjustments help keep the weight of her uterus and baby from interfering with blood flow through the vessels that flow behind them. Notice also that she is curled forward around her baby, holding behind her knees, and that her support people are merely supporting her legs and her upper back, not pushing on them.
Side, curled position
The side-lying position is especially useful in promoting rest and relaxation between pushing contractions. Some research suggests that this is the most effective birthing position for preventing tears.
Here are some great Birthing Positions online at Pregnancy.org