If your car stalled at the bottom of a hill, you certainly wouldn't try to push it uphill. So why does it make sense to fight gravity by lying down during labor? This is just one reason why the standard hospital labor position—semi- or fully reclining—is not ideal. For one thing, when you're lying on your back, your uterus compresses major blood vessels, potentially depriving the baby of oxygen and making you feel dizzy or queasy. "Most women feel better when they are not lying on their back during labor," says certified nurse-midwife Katy Dawley, Ph.D., C.N.M., director of the Institute of Midwifery at Philadelphia University in Pennsylvania.
In addition, when you're reclining, the baby's head puts pressure on pelvic nerves in your sacrum, increasing pain during contractions. Remaining upright and leaning forward reduces this pressure while allowing the baby's head to constantly bear down on your cervix. As a result, dilation tends to occur more quickly.
"Lying on your side, standing, sitting, walking, rocking—anything that keeps you active can help decrease pain and speed up labor," says Dawley. Just be aware that a prenatal visit is the time to discuss with your doctor or midwife the different positions you think you'd like to try. "In the throes of labor, you're not going to be able to advocate for yourself," she explains.
Upright positions also tend to offer:
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.
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.
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.
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.
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.
While the position may be less convenient for hospital personnel, squatting is especially effective when you're ready to push. In fact, squatting is sometimes called the "midwife's forceps" because of its ability to work with, not against, gravity, enlarge the pelvic opening and speed the pushing phase of labor. Many women find sitting on the toilet comfortable. Try squatting supported by another person, a beanbag, or a low stool.
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.
This can help make uterine contractions more effective in bringing the baby down. Drape your chest over a table, bed, countertop, pillow or exercise ball.
Place one foot on a sturdy chair or footstool and lean into that foot during contractions.
Sit on an exercise ball, the edge of the bed or a chair and gently rock back and forth.
Put your arms around your partner's neck and sway back and forth; pretend you're slow dancing.
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!