Birthing And Labor Positions

6 min read

For the majority of Indian women, whether giving birth in hospitals or homes, the most-common birth position is still lithotomy – flat on the back with legs spread wide and pulled back to each side. And just to make matter worse -in hospitals you will be strapped to ensure that you don’t slip or slide out of place.
woman walking in labor
Unfortunately, this is one of the most primitive and outdated method of birth which is only convenient for doctors and midwives as this position permits them easiest access to the woman’s belly for checking the fetal heart rate. It is also a matter of habit, and many times they are more comfortable with lying position because this is how they are taught to attend births.
But what is easy and best for your doctor isn’t that worthy for you! The lying-down birthing position implies that you have to push baby without any help from gravity and in addition lying back can also compress major blood vessels of mother and can lower the maternal blood pressure. While giving birth in this position, it becomes likely to give episiotomy to lower the risk for baby and mother.

What Are The Disadvantages Of Labor In A Bed?

The most popular and most-used birth position for the baby is still lithotomy (lying flat on the back) though it is associated with numerous disadvantages such as:

  • It lacks the help of gravity
  • Puts too much pressure on major blood vessels
  • Painful and less effective contractions
  • Provides a narrow passage to your baby
  • Can be a cause of long labor
  • Labor in bed can place you at a higher chance of having a C-section

Research has it that women who keep moving during contractions have shorter labor and the contractions are also more effective. Mobility also reduces the need and use of drugs for labor. How you give birth is also dependent on the birthing center you choose, the better the facility, the more your chances of giving birth in different, yet effective positions.

What Are The Most Effective Positions For Labor?

At the onset, you will feel pretty restless and would probably lose patience with each contraction. However, focusing on the baby and your breathing will help you ease the process of birthing. Changing positions, walking around and thinking about other things may help you cope better with labor. Some women put to use the techniques taught in ante-natal classes, which can be highly beneficial. However, the first thing to keep in mind is not to over exhaust yourself before real labor strikes. Try to relax and be positive. The other positions that can be applied with due permission from the doctor are:

    1. Upright Positions (standing or sitting position): Upright positions for childbirth contributes the advantage of gravity to the mother. These positions can ease the pain of the contractions by assisting the baby to descend into the pelvis and it also allow your birth partner to provide you comfort massage on your back or help you in breathing through the contractions. These positions can be best for you during first stage of labor but once the contractions start coming faster and harder standing or leaning against wall, bed or your partner can be difficult and complex. If you cannot stand, you can also lie in bed and sit as upright as possible. Can you really stand and deliver – it will not be that easy so you can use squatting position during the second stage of labor (see below)

Labor position sitting

  1. Squatting Position: This can be the best and effective pushing position for you especially when you are in your second stage of labor as squatting can opens your pelvis to the maximum and can help your baby to find the prime position for birth. For squatting you can take the help of your birth partner or a squatting bar
  2. Kneeling positions: Pregnancy can mean a lot of unbearable back pain, and if you are suffering from the same, you can try to kneel and deal with contractions. Take support of a sofa or a wide chair or simply prop up some cushions and pillows and kneel forward. You husband can probably massage your back in between this position
  3. Hands and Knees Positions (on all four or crawling position): The hands-and-knees position is good for trying to turn a posterior baby especially when you are having backaches during your contractions. All four position can often be the best birth position for delivering a large baby as well. This position can also give you an advantage of back massage by your partner while you are busy in doing pelvic tilts

While in labor ask your doctor to help you in finding the best position for delivery especially which can help you with easing and coping up with contractions.
Woman in labor

What Positions Work Best When You Are Not Pushing?

For you to deliver a healthy baby it’s essential to achieve the state of full cervix dilation and often your labor time can stretch for several hours if full dilation is not there. During this period you are requested not to push even if you are feeling slight or mild contractions. Your doctor will tell you not to push the baby though you could be very much feeling to push hard. The position which can work best for you in this condition is the Side -Lying Position. Side-lying positions can work best for you in long labor phase especially when you don’t want gravity to speed up the process as you are not yet fully dilated. This position will be extra beneficial if you are under constant monitoring. It can help you to rest and relax when pushing is not required. You can also go on all fours, with your face facing the floor and your bottom upwards. This may tip the baby off the cervix, because of gravity, and you may not feel a strong urge to push.

What Labor Position Is Best When I Have An Epidural?

Mothers who elect for epidurals sometimes lose all the sensation below their waist, which makes it difficult for them to sense the force she is applying while she is at pushing stage. It can also restrict the mobility of mothers and they have to stay on the bed which restricts her choice of birthing position.
If you have no choice but to stay in a bed then try not to be flat on your back as it can reduce the oxygen supply of your baby. And if in case you are lucky and can feel some sensation below your pelvis then you could try the sitting position by sitting on a birthing stool or chair. Keeping mobile for as long as you can will ease the birthing process, so focus on the same.
When it’s time to push the best way for you is to take help from your partner with each contraction. Also mothers who go for epidural are also at greater risk for developing symphysis pubic dysfunction.
back massage in labor

Key Factors To Help You Cope With Labor
  • Keep in mind that you might need to change your birthing position depending upon the progress of your labor.
  • If possible try to keep moving.
  • If it’s a long labor then you may get tired then lying down on your side can be the best option.
  • Contractions can be more difficult to bear in lying position so ask help in maintaining a balance between rest and moving.
  • Don’t hold your breath during contractions and don’t push when you don’t feel the urge.
  • If it helps you then ask your partner to massage your back with each contraction.

Remember that there’s not ‘one’ good labor position for delivery. In most of the cases women keep changing from one position to another so try the one that makes you feel more comfortable even if it is for a shorter period of time. When contractions starts become stronger let your body to decide what is working best for you. Don’t compel or commit yourself to one birthing position, change the position if you think it’s not working. Be prepared and read about the different positions well in advance and if possible try them a little bit – just don’t practice pushing only try breathing exercises. Also, keep in mind that each woman has a different experience of labor and until you actually go in labor you won’t know what will work to get the desired results for you.

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