Laboring Positions and the Importance of Movement

There are a lot of different things you can do to feel more comfortable or have less pain during labor. Changing positions can definitely be one of the simplest interventions, and can also help your labor in other ways.

Different Types of Birthing Positions

People ask me about positions for labor A LOT. That might be the top pain coping related question I get after questions about breathing. I think it’s great that so many people are hearing about the importance of position. First thing though is to recognize that laboring positions are different from pushing positions. I’m not saying that you can’t be in the same positions for pushing that you’ll be in for laboring, but it might make a difference for your care providers and for any plans you might have had for meeting your baby. For example, a great laboring position might be on the toilet, but you’ll probably want to change that when it’s time to push your baby out.

Laboring Positions That Support Comfort and Progress

When people ask about laboring positions, a lot of times I think they’re hoping to hear that there are one or two magic positions that work for everyone at all times. Unfortunately, that’s not the case. In birth classes, I always start the conversation about laboring positions by reminding people that their body will likely try to direct this for them.

When you’re in labor, certain positions will feel much better than others, but then that will probably change. A lot of it depends on where your baby is and how they’re moving, but it can also depend on how much energy you have, whether you have any pre-existing injuries or sticky spots, how far along in labor you are, and more. That’s why it’s very important that you be the ultimate expert in your positioning. Pay attention to how your body feels, then try lots of things. You’ll probably find something that works. If it stops working, do the same thing again.

Your position matters for keeping you comfortable, but it can also make a difference in how your labor progresses. When you move and change positions, you give your body and your baby the opportunity they need to make the little movements and changes that will keep your baby and your cervix advancing in the right direction. During the first stage of labor, you may have a lot of freedom of movement to change your position, and it’s usually a great idea to do a lot of it for as long as you can.

Some favorite laboring positions include BUT ARE NOT LIMITED TO:

• Standing
• Standing while leaning over onto something

• Standing while rocking and swaying

• Standing while hanging onto your partner’s neck (AKA partner slow dancing)

• Hands and knees

• Hands and knees but resting your top body over a yoga ball or piece of furniture

• Lunging

• Squatting

• Kneeling

• Lying on your side

• Sitting on a yoga ball

• Sitting on a toilet

Most people feel very restless during labor, and sitting may be especially uncomfortable when you’re in active labor. Many people even refuse to sit on their bottoms on the car ride to the hospital and may end up kneeling instead. But even if sitting is very uncomfortable, a yoga ball might feel better because it is softer and puts less pressure on the swollen area. And the toilet seat has a hole in the center which also can feel different from sitting on a normal seat. The toilet even has a nickname that birth workers use – “The Dilation Station”. Lying down on your back might not feel all that comfortable while you’re in labor, but lying on your side might feel OK. The most important thing to remember is that what is normally comfortable for you, might not be comfortable in labor, so listen to your body and change your positions! You can get as creative as you need to, and change is good.

Peanut Balls

Peanut balls are provided by hospitals as a comfort measure as well as for their ability to help people with epidurals change their positions. These are a great tool for helping you be more comfortable in reclined positions so you can get some rest, even during contractions.

Pushing Positions

Pushing might be a little different. Once your cervix is fully dilated, the pushing stage officially begins. Most people feel different when this happens, and may find they need to do some adjusting of their position… or not. Evidence shows that there really isn’t one right way to push a baby out. Most people are lying down when they push their babies out, and that might be what feels best. If it doesn’t, that makes sense. Research shows that most people are more comfortable in an upright position, and that more upright positions tend to produce better outcomes.

What seems to be the key is that the best position is one you choose because it feels most right for you at that moment. Research hasn’t been able to pinpoint one most right position, however, there is a lot of evidence that being in the Lithotomy position as shown below, may be associated with an increased risk for tearing and for fetal distress. It also isn’t a position that most people would choose for themselves. So even though this position might look familiar and has been very common for a long time, it is now being encouraged less.

What About With An Epidural?

If you have an epidural, you shouldn’t be feeling uncomfortable. Epidurals block pain, so your position isn’t as important as it relates to pain. However, changing positions is also important for ensuring that your labor progresses normally and as quickly as possible. If you stay on your back in the same position for long periods of time, it can make it harder for your baby to rotate and descend. You may not have big complications, but it may take longer. Longer time spent laboring and pushing, and a lot of time spent on your back, can also cause a baby to experience stress. Peanut balls are a great solution for changing positions when you have an epidural. In some cases, you might have more sensation and ability to move with an epidural, and you can change positions yourself. A great tip is to use the hospital provided squat bar to help lift and shift yourself.

Remember that whether you have an epidural or not, your position matters. Let your body lead the way when you can, and give yourself or ask a partner to give you regular reminders to check your position. Sometimes labor can consume all of your mental energy and you might get “stuck” doing something that isn’t working for you anymore. Changing positions is a simple and powerful way to stay involved in the progress of your labor and will probably make you feel better in the process.