LABOR POSITIONS
1. Get on all fours - This position eases back pain and helps the baby rotate into the
optimal position for delivery—face down. (When the baby is face up, the result is the
dreaded “back labor.”)
2. Lean forward - This can help make uterine contractions more effective in bringing
the baby down. Drape your chest over a table, bed, counter top, pillow or exercise ball
(see “Get on the (Birthing) Ball,” below).
3. Lie on your left side - This may increase blood flow to your baby and can help
reduce back pain. Support your belly and legs with pillows.
4. Lunge - Place one foot on a sturdy chair or footstool and lean into that foot during
contractions.
5. Rock - Sit on an exercise ball, the edge of the bed or a chair and gently rock back
and forth.
6. Sit and lean - Sitting in a chair, prop up one foot and lean forward into it during
contractions.
7. Sway - Put your arms around your partner’s neck and sway back and forth; pretend
you’re slow dancing.
Ready, set, push!
While the position may be less convenient for hospital personnel, squatting is especially
effective when you’re ready to push. In fact, squatting is sometimes called the
“midwife’s forceps” because of its ability to work with, not against, gravity, enlarge the
pelvic opening and speed the pushing phase of labor.
One study found that first-time mothers who squatted while pushing had labors that
were 23 minutes shorter on average than women who labored semi-reclining. What’s
more, they had less back pressure, fewer forceps or vacuum deliveries, and fewer and
less-severe perineal tears and episiotomies.
Don’t try squatting unsupported unless you’re sure you can hold the position and keep
your balance. In fact, you should get in shape by practicing squats during your
pregnancy: You don’t want to find out at the crucial moment that your leg and thigh
muscles aren’t up to the task.
Other options for delivery include sitting on a birthing stool, kneeling or crouching on
your hands and knees. No problem if you’re having a midwife deliver your baby at home
LABOR POSITIONS
or in a birthing center. Otherwise, make sure in advance that your doctor and hospital
policies give you the green light.
Get on the (birthing) ball
Using an exercise ball could help you get through labor. The ideal size for most women
is about 65 centimeters in diameter. When you sit on it, your knees should be bent 90
degrees. Here are various ways to use one:
Place the ball on a bed or sturdy chair, stand facing it and lean forward so that your
upper body rests on the ball. This will enable you to stand up longer without overtaxing
your muscles. Kneel in front of the ball and drape your body over it. This will encourage
a baby who’s face up to rotate into the proper position for delivery (face down) and
relieve the pain of back labor. Sit upright on the ball. This relieves pain and pressure on
your back and perineum (the area between the vagina and rectum).
Angle the head of the bed 45 degrees and put a pillow or rolled-up towel under one hip;
this will help “tip” the uterus off of your large blood vessels, improving circulation to the
baby and your brain. If the baby is face up and this is causing back labor, lie as far on
one side as possible, then rest your top leg on the mattress in front of your belly. This
encourages the baby to rotate into the ideal (face down) position for birth.
Changing positions every 10 contractions while you’re pushing can help “corkscrew” the
baby out. Start lying on one side, go onto your back, turn to the other side, then get on
your hands and knees.
There are many different positions that may be used for pushing. In all positions, keep
your chin down and use a rounded back to help your abdominal muscles assist your
uterus in pushing your baby.
The following are suggestions of various positions for pushing and some advantages of
each. You may be able to speed the progress of the labor if you try positions where
gravity assists you (i.e. sitting, or squatting). However, if the baby is delivering quickly,
you may be able to slow the stretching of the perineum by trying positions where gravity
is neutral (i.e. lying on your side, or getting on your hands and knees). It is important for
your comfort to experiment with pushing in different positions.
Squatting
Advantages
LABOR POSITIONS
•
Opens pelvic outlet to its maximum width (up to an extra one-to-two centimeters)
•
Takes advantage of gravity
•
May require less bearing down
•
May enhance the baby's rotation and descent in a difficult birth
•
Helpful if you do not feel the urge to push
•
If you have difficulty with squatting, try a semi-squatting position on a stool or a
stack of pillows. Birthing beds have a squatting bar which may be attached to the
bed so that squatting is more comfortable.
Semi-Sitting/Upright
Advantages
•
Some gravity advantage
•
Partner should place his/her hands on your lower back and instruct you to push
toward his or her hand, encouraging you to tilt your pelvis.
•
Pelvic tilt allows for greater opening of pelvic outlet
•
Good resting position
•
Can be used with fetal monitoring
•
Vaginal exams are possible in this position
Sitting
Advantages
•
Some gravity advantage
•
Good resting position
LABOR POSITIONS
•
Can be used with fetal monitoring
•
May lean forward to help relieve backache; a good position for a back rub
•
You may consider pushing on the toilet as it is a familiar place to push and offers
a firm surface against which to push
Hands and Knees
Advantages
•
Gravity neutral - slows a rapid delivery
•
May help relieve backache by bringing the baby forward
•
Assists rotation of the baby in a posterior position
•
Takes pressure off hemorrhoids
Lying on Your Side
Advantages
•
Gravity neutral - slows a very rapid delivery
•
Very good resting position
•
Can be used with fetal monitoring
•
Vaginal exams are possible in this position
•
May be helpful in avoiding episiotomy