How will you spend your labor and delivery? Maybe you'll walk around and then switch to squatting to push. Maybe you'll lie on your side during contractions and then get on all fours when baby's ready to make his appearance. Maybe you'll rock on a birthing ball when those contractions are coming fast and furious and then choose to recline in your partner's arms when it's time for delivery.
Or maybe it'll be a combination of all the above … or just one of the above. There's not necessarily one "right way" to give birth — it's something that you can decide (and adjust) in the moment with your doctor or midwife to ensure that both mom and baby are safe. Plus, some light movement and position changes might also ease your labor pains and potentially help your baby come a little faster.
How are labor positions handled in the delivery room?
Most women in the U.S. give birth while lying down on a bed, some with their feet supported in stirrups.[1] But you don't necessarily have to spend the entire labor like that.
The American College of Obstetricians and Gynecologists (ACOG) currently advocates for frequent position changes during labor to help moms feel more comfortable, so long as doctors are still able to monitor moms' and babies' well-being (and there aren't any complications).[2] Similarly, the World Health Organization (WHO) encourages birthing moms with low-risk pregnancies be allowed to move around or be upright during labor.[3]
And for good reason: While lying on your back can support your back and legs, some research shows that women without epidurals who are upright or mobile during the first stage of labor (i.e. before you start pushing) labor for less time and are less likely to need a C-section than women who labor lying down.
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Other research has found that laboring in an upright position is associated with shorter delivery times and fewer episiotomies or assisted deliveries. Changing positions during the first stage of labor in its early and active phases might also help you manage pain and feel more comfortable.
It's also important to note that once you start actually delivering the baby (you know, the pushing part), you'll inherently have less mobility. But there are still certain birthing positions (or labor positions appropriate for delivery) that you can try to feel more comfortable and potentially reduce the risk of tearing or spinal pressure.
Many hospitals and birthing centers offer equipment to make various positions easier, such as birthing balls, stools or squatting bars. Not all birthing equipment may be available where you choose to give birth, so do some research ahead of time. You might be able to bring some equipment from home.
That said, not all moms can try every labor position:
Labor positions with an epidural
If you opt for an epidural, you may not be able to stand or walk around during labor (even with a "walking epidural"), but there are plenty of other positions you can assume. You can try sitting or lying on your side, and you might be able to move or shift positions with assistance from nurses.
Labor positions with continuous monitoring
If you have a high-risk pregnancy or health condition, your doctor will want to keep close watch on your baby via fetal monitoring. This can rule out some labor positions, but even if you're being monitored for contractions and fetal heart rate, you can rock, squat, sit or lie on your side during labor.
Talk to your doctor, midwife and birthing team in advance (and throughout the process) to understand your options in order to be as comfortable as possible while still safe.
Labor positions for early and active labor
In the moment, childbirth might feel like one long, hard slog, but it's actually divided up into three distinct stages. Stage one is labor — which is itself divided into early labor (also known as the latent phase, where you start to have contractions) and active labor (when contractions get stronger, longer and more regular, and the cervix becomes fully dilated).
During this first stage, you may be able to move around and change positions to feel more comfortable. Here are a few examples of labor positions you could potentially try:
Standing or walking
There's a great reason to get vertical: It helps you work with gravity, allowing your pelvis to open and your baby to move down into your birth canal. Walking is something you'll be more likely to do earlier rather than later in labor since it'll be harder to head for the corridors for a few laps once the contractions come one right after the other. (If you get an epidural or spinal block, you likely will be unable to walk around due to the loss of feeling in the lower body.)
Standing, however, is something you can do throughout the first stage of labor, so long as you didn't get an epidural or spinal block. Leaning against a wall or your partner for support during contractions is best, since it's not that easy to stand up straight when you're getting squeezed down below.
Rocking
Rocking — either on a chair, birthing ball or just swaying back and forth — can feel soothing at this point in labor.
Sitting
Sitting upright — in bed, in your partner's arms or on a birthing ball or stool — can ease the pain of contractions and allow gravity to assist in bringing your baby down into the birth canal.
Leaning over
Leaning forward — over a chair, birthing ball or stack of pillows on a bed, for instance — can be super helpful when you have back labor (when the back of the baby's head is pushing against your spine and tailbone). It opens up your hips and can take some pressure off your back. Alternatively, you can lean over your partner's shoulder to relieve some of that pressure.
Birthing positions for pushing and delivery
Stage two of childbirth is pushing and delivery. This is where the hardest work begins — time to push! You're actively working to birth your baby, and while you're likely unable to move around as much anymore, you can still try some different positions to help bring your baby into the world — provided that your doctor or midwife says it is safe for you to do so.
Hands and knees
Going on all fours is one way to cope if you're experiencing back labor, since it helps move the baby. This position allows you to do pelvic tilts for comfort, while giving your partner great access to your back for massage and counterpressure. If your arms get tired, you can rest on your forearms.
Squatting
You'll most likely use this position only late in labor or during delivery itself. Like standing, squatting employs Newton's finest, and also stretches out the pelvis as wide as possible, which might make it easier for the baby to be born. (This position might not be possible without assistance if you've had an epidural, since your legs likely won't be able to support you while medicated. You can try it with assistance if your medical team gives you the go ahead.)
You'll probably feel a little wobbly, so you'll need all the squatting support you can get. You can rely on your partner or a squatting bar (also called a birthing bar), which is attached to the birthing bed. Leaning on the bar will keep your legs from tiring out as you squat.
Side lying
Side lying is a good option if you're too tired for squatting or sitting, or if you've had an epidural but still want to shift positions. (It might also reduce your risk of tearing.) Lying on your side also puts your partner in a good position to put some massage techniques to use.
Are there any risks to any labor positions?
As mentioned earlier, most women in the United States deliver their babies lying down on their backs. But there are some downsides to laboring and delivering in this way, including longer average labor and delivery times, potentially more pain and possible effects on the baby's heart rate.
That said, other labor positions can come with their own risks. Squatting and sitting, for example, may cause more second-degree tearing or blood loss than other positions, although more research is needed.
During labor, your doctor or midwife might find that certain labor positions are causing changes to your baby's heart rate. If that's the case, your practitioner might ask you to change positions, which can often make a difference.
Do any labor positions make childbirth easier?
An analysis of medical studies shows that upright positions — standing, walking, squatting and sitting — may shorten the first stage of labor by approximately one hour and 20 minutes.[4]
Remember that in many cases, experts recommend that women should be allowed to move around and change labor positions so long as there are no complications and health professionals can still monitor the babies' health. So if you want to move around or shift positions — and it's safe for you to do so — feel free to change things up. (And communicate with your OB/GYN or midwife in advance as well as during your labor so that everyone's on board.)
Read up on the different positions ahead of time and even give them a trial run, but remember that until you're actually in labor, you won't know what'll best bring you the relief — or the results — you're looking for.
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