Positions for birth is a subject you have probably read quite a lot about already. The positions you adopt during the different stages of labor will influence your experience of giving birth and may affect whether you have any tears or problems as a result of your baby’s birth.
The best positions for the end of labor and for giving birth can be broken into several categories.
Standing Upright or walking
Standing upright is one of the great positions for birth if you're feeling strong and want to be on your feet. Being upright allows for the maximum amount of gravity to aid you and the baby in his descent through the birth canal. You may feel like swaying from side-to-side, or learning forward at the same time. Follow what your body is telling you.
Some women want to lean on their partners or a familiar piece of furniture. If you’re planning a home birth, think about which furniture is a comfortable height for you to lean on. Maybe a high-backed chair.
All-fours or Kneeling:
This is one of my personal favorite positions for birth. When I was a newly qualified midwife I cared for a first time mom while she birthed her 10lb 4oz baby girl! She was comfy in the all-fours position, leaning on a pile of 5 pillows. Her legs and feet were well apart and she could just relax into the pillows between contractions. She was so calm and in control, the baby just slipped out without much effort. No-one could believe the birth weight, so we checked it twice!
I was fortunate enough to be on duty when she came in for her next birth. She chose the same position and had a gorgeous baby boy who weighed 11lb 2oz. No problems.
MIDWIVE’S TIP: ask your birth attendant to place a rolled up hand towel under your feet and another behind your bent knees when using this position. The towels help your feet and legs to relax and be comfy if you’re in this position for a long time.
Side-lying or lateral positions can be great too. Midwives often recommend left lateral as one of the best positions for birth. This is similar to the position pictured on the Sleep page. Right-side lying is not quite as good unless fetal monitoring indicates that your baby prefers this side.
This position for birth is good if you’re feeling tired and need to lie down. It allows your contractions to remain strong and powerful, yet doesn’t restrict the movement of the baby down the birth canal. Your pelvic bones are free to move and open as necessary, giving the maximum opening for birth. Either you or one of your care givers can support your right leg when you need to raise it. Just put your hand behind your bent knee. Let you pelvic muscles relax as much as possible.
I have often used this as one of the positions for birth as it helps speed up labor for some women. Maybe it’s because you can relax more once lying down.
Squatting or Semi-Sitting
Throughout history we find images of women squatting to give birth. Obviously squatting or semi-sitting allows your pelvis to be fully open. You’re also leaning forward slightly or being upright which aids gravity.
Some women want to lean on their partners or have their partner support them from behind, with their arms under the woman's armpits. When doing this the partner can be sitting on a low chair or stool and the mom on a pillow or on the floor, depending where she feels happy.
The problem with squatting can be that your legs get tired quickly if you’re not used to this position. In some cultures women squat daily in their normal routines and don’t have any problems as their leg muscles are extremely strong. If this isn’t you, then alternate squatting with other positions like standing.
This is a mixture between standing and squatting. A few modern Birth Centres have these ropes attached to the ceiling. I have seen historical books with pictures of Native women holding on to ropes and alternating between squatting during contractions and standing up between contractions.
It has the advantage of both with something strong to hold onto, opening up your pelvis more and using gravity to aid birth.
Supine or Back-Lying
This was introduced by men and the medical profession as it is more convenient for doctors, obstetricians and other assistants to observe what is happening during a birth. It isn’t an instinctive birthing position. In fact it’s probably the worst way to try and give birth. In this position you are working against gravity and expecting your baby to go ‘uphill’ before he can get out! It’s so much harder for all concerned, except the observers.
If your caregiver is asking you to lie on your back please ask them what their reason is and tell them that you’d rather try a more upright position.
Again this is not a recommended way to give birth. Lithotomy means having your feet or legs in stirrups, being flat on your back, with your buttocks at the edge of a delivery table. Often it means that you are in hospital, with an IV drip in, urinary catheter insitu, continuous fetal monitoring straps around your abdomen and unable to move.
Lithotomy is thought to be necessary when suction Ventouse delivery is required or when forceps are being used. It opens your hips to the widest capacity. It has a similar effect to squatting but instead of your back being upright, your back is on the bed.
As always follow your instincts and keep changing positions so that you’re relaxed and comfy and feel in control. Active birth means movement and movement helps your baby to move down and out.
All of these positions (except walking and lithotomy) can be adopted in a birthing pool if you’ve chosen to go for a Waterbirth. As Anne Frye says about positions for birth in her book, "An ideal birth position allows the mother's sacrum and coccyx the freedom to rotate backward, the rest of the pelvis room to open to optimal dimensions to allow for birth, and contractions to remain strong and close together. She (the mother) should choose the position that best enhances the quality of her contractions and her ability to push."
Reference: Anne Frye (2004) Holistic Midwifery: A Comprehensive Textbook for Midwives in Homebirth Practice, Vol. 2: Care of the Mother and Baby from the Onset of Labor Through the First Hours After Birth. Labrys Press.