Updated: Dec 3, 2020
Last week we talked about how epidurals can make it harder to work with your body and how using position changes during labor can help you cope with the experience, but many of you were left thinking, “Okay… well what positions should I be using…? I really didn’t think I’d be doing yoga in labor." Don’t worry!! MOST positions do not require yoga-like flexibility.
Labor positions are always interesting to discuss in my opinion and I’m super excited to be here with you today to chat about this! For those of you who are new here, I’m Jaimie and I’m a nurse, doula, and lactation consultant who empowers women to birth and breastfeed with confidence. I’m here to answer all of your pregnancy, birth, and breastfeeding related questions! If you ever have a question, you can submit it on my social medias, blog comments, youtube, or shoot me an email and I will add your question to my list of topics to educate Mama Bears about!
Now, Back to business...In the media, we’re assaulted with a few basic images of labor/birth positions: bouncing on a labor ball or laying on your back in bed. The truth is, there are so many other positions and variations thereof. You might be hoping I will provide you with a list of positions to use in labor and when to use them… but it’s not quite that simple… I can’t give you a fool proof labor position guide because every woman and every birth is unique! What I can do is tell you how different positions can be helpful to your labor experience! Honestly, if you’re in tune with your body, your body will tell you what position to get into. But if you find yourself curling up in the fetal position as a go-to and desiring an alternative, you might like to have the Birth Partner Pocket Guide handy so your support person can encourage you into a new position if you’re feeling stuck.
Standing is effective at allowing the pelvis to open while utilizing gravity to help your baby descend. Many women will find they want to lean over a counter top, sway back and forth, use their partner as support in a “slow dancing” position, or simply pace back and forth.
Of course a variation of standing is squatting. Many women will find themselves going into a squat during the peak of a contraction. Often times holding onto a rope/sheet, counter top, or partner for leverage. An alternative to squatting (just like in the gym!) is lunging! If you’re doing lunges, be sure to keep it symmetrical! Whatever you do on the left, make sure you do on the right! You don’t want to misalign your pelvis in the middle of labor. If you want to squat but have an epidural, ask your nurses to drop the bed and bring you a squat bar, while it's not quite the same, it can help simulate the position!
Sometimes a laboring mother who is working hard needs to rest… sidelying with pelvis being supported in an open position using a peanut ball or pillows can help to allow baby to descend while resting between contractions. While we are listing this with other "unmedicated laboring positions" this can absolutely be done with medication also.
Hands and knees:
Hands and knees can be a great position at many different times, particularly if your baby is in a bit of a funky position. Hands and knees with the butt higher up and chest closer to the bed can move the baby out of the pelvis and allow them to adjust to a better position.
I also frequently find mothers favoring this position as they get closer to transition.
This is a great position for counter pressure, hip squeezes, and massage (although they can absolutely be done in any position). Occasionally mothers with epidurals have enough mobility to use this position!
Toilet Sitting / Birth Stool: Toilet sitting and birth stools work similarly in that they get you into a position that is familiar and supports an open pelvis. Additionally, muscle memory tends to be at play when toilet sitting because your body is conditioned to relax and open when you sit on the toilet to have a bowel movement. Similarly, toilet sitting is notorious for opening the pelvis and dilating the cervix.
So I think the birth ball might be the most misunderstood tool for labor. Many people talk about bouncing on their ball to start labor and I really have just never understood that. Instead, use your ball to rock back and forth through contractions, do a figure 8 with your hips, or just support good posture while focusing on contracting. They’re much more moveable and comfortable than a rigid chair. You can sit upright, you can sit next to a bed leaning over and holding on, you can kneel over your birth ball… Check out this video on using your birth ball.
The sidelying release is a technique coined by Spinning Babies that I have personally seen make a significant difference in labor progress. This technique requires two support people. Mom will lay on her side with a straight spine, One helper will ensure mom’s back stays straight while the other stands in front of mom and supports her in bringing the top leg over the side of the bed to dangle. Mom should feel a stretch in her hip, but should not experience pain. Be sure to repeat on the other side! Remember to keep it symmetrical. I encourage you to read the description on the spinning babies website to properly learn this technique. This position is able to be used in mothers with or without epidurals!
At the end of the day, like I said before, your body will tell you where and how to move... but sometimes you can feel a little lost like you're not sure. This is when your partner can come in handy by reminding you of positions to support your baby's descent.
Do you have a favorite position you plan to utilize for your labor?
Jaimie Zaki is an LPN, Certified Doula, Birth Photographer, and IBCLC (International Board Certified Lactation Consultant). Jaimie is an Air Force Wife and cesarean, VBAC, and HomeBirth Mama. Jaimie is dedicated to supporting women through pregnancy, birth, and breastfeeding. Jaimie empowers women to use their Mama Bear Roar and Birth and Breastfeed with Confidence!