More than One Birthing Position
It’s not always like you see in the movies. TV shows and movies like to show women giving birth lying flat on their backs in a bed with their knees bent and apart in a rather undignified position, but midwives and even doctors in other cultures outside the Western World, have known for hundreds of years that other positions have the advantage of helping labor progress and reducing pain.
So let’s take a look at what your options are and what the various advantages and disadvantages are.
Birthing Position #1 – Standing
Giving birth standing up provides good oxygen levels for the baby and takes advantage of gravity, which allows contractions to be more effective. If your labor is progressing slowly, standing can help move it along. Standing also creates a good pushing “urge”. Obvious disadvantages are that delivery is difficult to control, and it is difficult for the doctor, midwife or nurse to see what’s going on.
Birthing Position #2 – Walking
You may not feel like walking when in labor, but walking can actually help make contractions less painful, enables better use of the contracting muscles, and keeps the baby ideally aligned in the pelvis. Walking has been known to speed up labor, reduce backache associated with labor and allows the baby to more easily position himself/herself in the birth canal. If you suffer from high blood pressure or otherwise require continuous monitoring, then walking may not be an option.
Birthing Position #3 – Sitting (Chair or Toilet)
Either sitting positions have the advantage of using gravity in helping the progress of the baby through the birth canal and are okay if continuous monitoring is necessary. A birth ball can also be used, which is helpful to encouraging the baby down and in the event of an epidural. A birthing chair allows a mother to rest where her back and hip/thigh area are supported. The toilet option puts the mother in a more relaxed position. It is a more comfortable position because the mother is already used to having her legs open and feeling pressure. The only caution is that the birthing chair option may not be advisable for women with high blood pressure.
Birthing Position #4 – Semi-Sitting
Semi-sitting is where a mother is on a bed, but the head of the bed is raised to the point where she’s practically sitting up. This is the position that most hospitals use now as a matter of course. This position is very comfortable for most laboring mothers, allows good use of gravity and rest in between contractions. It allows mom and dad and attendants a good view of what’s happening and it is easy to monitor fetal heart rate. Disadvantages are increased stress on the perineum (the part of the body from the vulva back to the anus) and tailbone because the mother is actually resting her weight on it.
Birthing Position #5 – Lithotomy (On the back with legs in the air)
This is the position we’re most accustomed to seeing on TV and it is the one that has been used for most hospital births since the late 1700s, but it is, in fact, the worst position for giving birth. It compresses all major blood vessels, increases the level of pain, and often requires an episiotomy to create more space, which the other more “gravity-based” positions allow. Compressed major blood vessels interfere with circulation and lower maternal blood pressure, which in turn lowers oxygen saturation levels as much as 91 percent in babies, decreases fetal heart rate “or contribute to other forms of fetal distress, including cord compression, which may lead to continuous or internal fetal monitoring, increased risk of shoulder dystocia/problems with fetal presentation, or a prolonged pushing phase.” (GivingBirthNaturally.com)
Birthing Position #6 – Lying on your side
There are many advantages to this position. There is good oxygen supply for the fetus. It is a resting position for the mother. For those moms who have an epidural, side-lying makes contractions more effective, and it is safe for those with high blood pressure. It allows easier movement of the baby along the base of the spine and tailbone, and is probably the best position to avoid an episiotomy and tears. It allows good partner participation.
Birthing Position #7 – Leaning
Leaning forward over a birthing ball, against the bed or back of a chair allows for rotation if a baby is facing forward (posterior position) instead of facing backward. This position allows takes full advantage of gravity, and makes contractions more productive and less painful, and relieves back pressure. It also offers the advantage of being more restful than a standing position.
Birthing Position #8 – Kneeling
This is a variation of leaning because to use this position requires leaning forward with support, either by a person or the back of the bed. This position often helps the baby to turn if he/she is presenting posteriorly. It allows for pelvic rocking which helps alleviate pain and helps moms focus during contractions and babies to move down the birth canal.
Birthing Position #9 – Squatting
This is another position that uses gravity and encourages the baby to turn. The mother can shift her weight to alleviate pain and to rest. It allows excellent fetal circulation and actually increases “pelvic diameter by as much as two centimeters.” (Pregnancy.org) There is less effort required of the mother when bearing down, and the position of the mother’s thighs keeps the baby where he/she should be. However, mothers may tire using this position.
Birthing Position #10 – Hands and Knees
This is a good birthing position if there are low heart tones. It relieves back labor pain and also assists in rotating a baby presenting posteriorly. This position is the “best position to avoid laceration or need for episiotomies.” (Pregnancy.org) This is the best position for birthing larger babies, or where a baby’s shoulder may get stuck after the head passes. (shoulder dystocia)
Darlene Oakley is a freelance writer for EmpowHER.com.
Positions for Labor. Mother’s Advocate. Web. Apr 16, 2012.
Birthing Positions. Pregnancy.org. Web. Apr 16, 2012.
Effective Birthing Positions. University of Minnesota. Web. Apr 16, 2012.
Positions for labour. BabyCentre. Web. Apr 16, 2012.