Positions for labor and birth

There are many different positions that women can assume during the labor as well as the birth. The ability to move around has enormous benefits to mom, baby, labor progress and birth. However, with more and more interventions you will be limited in the amount of movement that you can do in labor. In women with low risk pregnancies every intervention can pose a risk to the mom and babies.

  • folio7Walking in an activity that is greatly encouraged in the early stages of labor. There have not been any studies to date on any adverse effects of walking in labor. Although it does not speed up the labor process for some women it relieves pain is a great distractor to hold off on an epidural.

 

  • Standing is another position that you will likely do in the early part of labor. Using your partner for support or a wall for support.

 

  • Rocking can be done in a chair, standing up or even on a birth ball. Rocking helps expand the pelvis and rotate the baby into an optimal position for birth.  

 

  • Squatting is a position that is great in the early labor to help with positioning the baby. Using the squatting position while pushing out the baby has shown to help with pain and time it takes. There are specially designed squatting stools made for pregnant women that help during labor as well as during the birth. Often a bar can be placed over the bed and the women can hold onto the bar as she squats. Squatting helps open up the pelvis and allows the baby to enter into the birth canal.

 

  • Birthing balls are large exercise balls that you can lean on or sit on during
    By Rshumway, via Wikimedia Commons

    By Rshumway, via Wikimedia Commons

    labor. Sitting on one helps to open up your pelvis, and it’s a lot easier than squatting for long periods. One great tip is to put a towel or cloth over the birthing ball incase your water breaks.

  •  Kneeling over a chair is a great position for when the baby is OP and there is a lot of back labor. This position helps the baby to move forward, taking the pressure off your back. This is also a great position for a partner or support person to massage your lower back which helps with the back pain.

 

  • Sitting, in bed or in your partner’s arms, can ease the pain of contractions and allow gravity to assist in bringing your baby down into the birth canal. You can assume this position even if you’ve been given an epidural or have a fetal monitor strapped on.

 

  • Hands and knees (on all fours) is another position to cope with intense back pain.  This position, which can be assumed even if you’re attached to a fetal monitor. This position can be done on the floor or on the bed and allows your support person to massage and apply pressure on your sacrum. For some women it is even possible to deliver in this position.

 

  • Taking a bath is a great way to relax. This has been shown to decrease pain and the use of pain medications. The only worry is that if you take a bath too soon, it can almost relax you too much and risk the chance of labor slowing down, however there are a few things you can do to bring them back.

 

  • Side lying positionSide-lying is much better than lying on your back because it doesn’t compress the major veins in your body. Depending on the position of the baby it may be beneficial to lie on one side more than the other. Often the knees are bent and you can even have the top leg up and over onto the bed in an exaggerated side lying position. This position help great to rotate a baby that is OP or occipital posterior.

 

Watch these videos for a great demonstration of some of the positions in labor:

Epidural and positions

Having an epidural will limit your movement greatly. An epidural will typically make your legs go numb and will not be able to move them on your own. With an epidural comes a Foley catheter for emptying your bladder as well as IV fluids. Delaying the epidural as long as possible so that you are able to move freely and help position your baby in a better way for the birth. Having an epidural you may end up lying on your back, but this should be avoided as it puts pressure on a major artery, and will impact blood flow to the baby. With an epidural you will most likely turn side by side every few hours. Depending on the position of the baby you may be kept on one side longer than the other or even have the top leg up and over onto the be in an exaggerated side lying position or with a wedge between the legs. This position help great to rotate a baby that is OP or occipital posterior. There are some other positions, however a lot of it will depend on how much movement you have in your legs.

This is a great video on the positions in labor with an epidural:

 

 

References:

Berghella, V., Baxter, J. K., & Chauhan, S. P. (2008). Evidence-based labor and delivery management. American journal of obstetrics and gynecology199(5), 445-454.

 

 The options for your birthing classes.