The Best Birthing Positions, According to Experts and Parents

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

Many of us are used to seeing images of people giving birth in a standard "hospital" position: reclining in bed with legs up, as a doctor coaches the laboring to push from the foot of the bed. And about 68% of people give birth in that supine (on their backs) position, according to research published in BMC Pregnancy and Childbirth.

But what some may not know is that there are other positions that may actually be more effective—and even more comfortable—for childbirth, such as squatting or standing. Here's what the experts and real parents say about the best birthing positions.

Why Birthing Positions Matter

Learning about different birthing positions not only offers laboring people options but can also help them feel more empowered through the birthing process, which can translate into better outcomes like lowered pain. 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 people, their 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. In fact, this supine position only became common practice when male physicians (as opposed to female midwives) began attending births because it was easier for them to inspect and "manage" the birthing process. However, this doesn't necessarily make the experience better, and lying on your back is actually 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.

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

Birthing Positions to Try

McNeil encourages her clients to explore different birthing positions to find what works best for them. Here are four popular birthing positions recommended by real birthing parents and birth experts.

1. 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."

2. 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.'"

3. Squatting

Kimberly Howell, DPT is a pelvic floor specialist, and she says that being on your back puts you at a disadvantage when it comes to delivery. "You can't utilize your core and pelvic floor to facilitate pushing," she explains. Squatting, on the other hand, 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.

"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 or birth center, a squatting position can be accomplished with a birthing bar.

4. Side-lying

Howell explains that lying on your side has been known to reduce the risk of perineal 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 birthing position may not be used. That includes after an epidural, if there are complications, and if the baby needs to be continuously monitored. McNeil recommends asking for intermittent monitoring, if possible, so that you can still walk around. As long as you are not tangling up in IVs, 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 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 to give birth? Our experts and parents all agree that whatever the birthing person decides is best. No two birth experiences are the same.

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