From standing to crouching on your hands and knees, experts explain why the best positions to give birth don't involve lying on your back and offer alternative baby birthing positions to consider.

Advertisement

Nothing matches childbirth in terms of excitement, anticipation, and reward. Also, nothing matches the pain, stress, and discomfort, which is why many create birth plans to take control of their labor and delivery. For about 68 percent of people, they will give birth horizontally, which is actually the most unnatural way to do so.

What many don't know is that there are other positions that may be easier, and they also may not know that they often have a choice in their position. This is evident in the fact that fewer than 10 percent of birthers use traditional positions. Reproductive psychotherapist and birth doula Saleemah McNeil CLC, MS, MFT is a believer in taking control of your labor experience. She explains that for many women, the birthing position has a lot of influence over their level of comfort during labor.

"There are many positions more comfortable than lying on your back like a beetle," says McNeil. This became common practice because it was easier for physicians (men) to inspect. However, this doesn't necessarily make the experience better, and lying on your back is working against gravity. "Many popular positions involve standing up, working with the universe's natural pull to help your baby descend," she says. "Whereas when you're on your back, the baby's journey takes a dip. Then they go up a hill which is the original canal." McNeil says that this can lead to tearing or certain cervical lacerations.

That is why McNeil implores clients to explore other positions. Here are four popular birthing positions recommended by mothers and experts.

An image of a pregnant woman in the hospital.
Credit: Getty Images.

Standing

Standing can encompass a few positions, including lunging and squatting, or leaning onto your partner for support. Kimberly Eversly, 32, gave birth to her first two babies on her back, and her third standing. She says that the first two births were miserable, so for her third, she began to do her research. "I got myself a midwife, and I was able to create a birthing plan," says Eversly. "They followed my birthing plan from beginning to end."

She knew that, in case of an emergency, there would be changes, but she incorporated a pool and shower during her labor. "I was getting massages, and I felt so relaxed, it was the easiest labor I ever had. I barely felt pain. You know when you watch on TV and women are screaming like they're dying? This was the first time I didn't scream."

Doggy Style-On Your Hands and Knees

By Eversly's fourth pregnancy, she felt like she was a pro. This time she opted to be on her hands and knees. She says, "It was the best experience. This time I was on all fours like a dog, but on more of an incline. She just came right out and the doctor was like, 'Man, I need you to tell other moms about this.'" Her labor times respectively were nine, three, one hour, and less than an hour.

She says that advocating for herself was the key, and her physician was not enthusiastic. "I had to flip out some. After having access to a midwife and having such a good experience, I told them 'I'm not doing it on my back.' He looked scared even though he let me do it. He was holding his hands like he was waiting for a football. 'Oh my god, I gotta catch someone's baby.'"

Squatting-Sitting or Standing

Kimberly Howell, DPT is a pelvic floor specialist, and she says that being on your back puts you at a disadvantage. "You can't utilize your core and pelvic floor to facilitate pushing. Many people find that a squatting position—either active or assisted with birth partners—allows gravity and adequate muscle recruitment to play a larger role."

At a hospital, this can be done with a birthing bar. Squatting can help to expand your pelvis, and it takes advantage of gravity. There is only one place for the baby to move when you are squatting.

Side-Lying

Howell explains that lying on your side has been known to reduce the risk of tearing. This is because it can open the pelvis more easily, and it gives control over pushing.

After walking around at home for as long as she could, Genelle Adrian, 33, of Columbia, Maryland, gave birth to her daughter on her side. She pushed for only 25 minutes. "I was able to do without getting any pain medication, which was really nice," says Adrian. "The biggest thing that made it possible was having conversations with my doctor and my doula beforehand. I was really adamant about what I wanted, and though it didn't go exactly as I wanted, I stuck to my birth plan as much as I could."

Choosing the Best Birthing Position for You

There are instances where a chosen position may not be used. That includes after an epidural, if there are complications, and if the baby needs to be monitored. However, McNeil recommends asking for intermittent monitoring, if possible, so that you can still walk around. Also, as long as you are not tangling up in IV's, you may ask to get up and move some.

Quite often, people find that their birth plans can't be followed exactly, or as McNeil puts it, "there's always a plan for the plan." She says that building in a contingency plan will help things to still go your way, but that you should do whatever is best if the baby's life is at risk.

Howell also recommends being proactive before your big day by maintaining an active pregnancy to make childbirth easier. "A combination of aerobic exercise and resistance training during pregnancy can really help prepare the body for birth," she says. "As a physical therapist, I aim to incorporate targeted exercises for the hip and thigh muscles for many pregnant persons. Each person's program is tailored to their needs and altered based on tolerance."

As far as the best position? Our experts and mothers all agree that whatever the birthing person decides is best. No two birth experiences are the same.