Choosing a Labor Position

When you imagine yourself in labor, how do you see yourself? The position you choose should be a comfortable one that helps you do your job with as much ease as possible. You should discuss your options with your doctor or midwife -- but remember, the positions you choose are up to you.

Most people in the U.S. picture the classic and cliche woman-flat-on-back kind of labor. But there are a lot of reasons to try to get off your back during your child's birth. Upright positions tend to offer:

• Shorter labor
• Reduced need for medication
• Help in dilating your cervix and widening your pelvic opening
• Greater sense of self-confidence and self-control
• Stronger, more efficient, and less painful contractions
• Aid for the baby's descent through the birth canal
• Help in bringing oxygen to the muscles in your uterus and to the baby
• Reduced need for episiotomy or cesarean section
• Less stress on the baby

There isn't just one best birthing position for you. In fact, it's a good idea to change position during your labor so you don't develop a cramp or strain your muscles. And don't forget to use pillows as support. Here are some effective birthing positions to consider:

Standing: The more upright you are, the more you let gravity aid you. During the first stage, simply walking around can help your labor progress, but take care not to become too tired.

Sitting: Try sitting with one knee bent and the other relaxed. Don't lean too far back. When you sit, your uterus drops forward, improving the blood supply to the contracting muscles and easing pressure on your diaphragm. Use cushions or your partner for support.

Kneeling: If you want to remain upright, but no longer feel comfortable walking, try kneeling on a pillow. This can help if baby is pressing against your spine.

Lying on your side: A sideways position is good if you're tired or have had an epidural. It takes weight off the main blood supply to the baby and reduces tension on your perineum.

Squatting: Squatting is ideal for the second stage of labor, but it may be difficult to sustain without support. Many women find sitting on the toilet comfortable. Try squatting supported by another person, a beanbag, or a low stool.

On hands and knees: If upright positions are tiring, or the contractions are too fast or overwhelming, an all-fours position is useful. It gets gravity to work for you. It can slow down contractions, and is also good for easing back labor. which occurs when the baby is positioned with the back of his head pressing against the rear of your pelvis.

You'll need to listen to your body as your labor progresses. As you change positions, your baby will find the best way to fit through the birth canal.

If you practice squatting during pregnancy, it will be easier during labor. If you try squatting down right now, you can probably feel where your upper leg bones, the femora, are attached to your pelvic bones. When you squat, the leg bones act like levers to widen your pelvic outlet by 20 to 30 percent. In the privacy of your own home, assume each one of the other positions. Which position seems to be most comfortable? Next time you watch TV, try squatting and see how long you can last!

Sources: The World Health Organization (www.who.int); Curtin University, School of Nursing

All content here, including advice from doctors and other health professionals, should be considered as opinion only. Always seek the direct advice of your own doctor in connection with any questions or issues you may have regarding your own health or the health of others.