(Q6 on my birth plan - positions for labour)
(Q9 I would like to be in the following position to give birth:)
I sat in a hospital waiting room during my first pregnancy, waiting to see someone when a couple came in looking for labour ward. Her waters had broken and they were trying to find out where to go. They waited for the receptionist, and while doing so, were looking at the posters on the wall. The one just beside me had a whole variety of labour positions depicted in pictures. The woman said to her partner, “Hey, look here. You can have the baby in all these positions. You don’t have to lie down.”
My jaw dropped.
I’m sorry if this sounds judgemental, but I struggle to fathom how you can get to that point in one of the biggest occasions in your life and not know something as simple as labour positions. Especially when your position during labour can have such a huge impact on your experience of childbirth.
Humans are the only mammals that try to give birth on their backs. It’s illogical as it defies gravity.
In The Business of Being Born, Michael Odent, the reknown doctor from France, explains why doctors want women on their backs – it makes their job of observing and interfering much easier. He shows, in the video, the best position for a woman, which has him low down –hard on his back, but better for the labouring woman.
In reality, the best position for a labouring woman is the one she’s comfortable in. I spent most of my pregnancy with Ameli practicing squatting so I could give birth in that position. When it came down to it though, I found having my back out of the water to be excruciating and ended up delivering in the pool, sitting bolt upright. An illogical position, but a perfect one for me. Below are a few suggestions for the best positions to labour in. The links go to videos with detailed instructions on each position. (Some videos are linked more than once.) I’ve also collaborated with Joni Rae from Kitchen Witch who has drawn up two beautiful printable pages for you to print out and keep with your birth plan to remind yourself of the different positions when the time comes. Feel free to print and share them, but please remember to attribute them to her. There are two of the same of each, with different spellings of labour/labor. Choose whichever you prefer!
IF the link on the images don’t work, please use these below:
First stage/Early Labour
- Side lying – especially with a pillow between your knees, helps open the pelvis. (After 44 hours of labour and progressing only to 4cm, two hours in this position saw me go from 4 to 8cm and my daughter was born an hour later.)
- Leaning forward – useful for taking the weight of the baby off your back
- Rocking, swaying and rhythmic motion – slow dance with your partner to help you relax and release the birthing hormones. Alternatively, there’s been great things said about gentle belly dancing during labour. Another option is sitting on a birth ball and doing figure of eights with your hips.
- To progress labour, staying active is helpful. For example, climb stairs, go for a walk, do lunges – these are useful to have practiced in late pregnancy so as not to be exhausted with sore muscles! Walking uses gravity and contractions are often less painful. It may speed up labour, reduce backache and encourages descent.
Back labour Back labour generally inspires fear. Everyone accepts widely that it is more painful, although that’s not a given. For me, it was. I couldn’t lie down, and if I wasn’t submerged in water, I found it excruciating. This time I want to be prepared with more back labour defences! (I also have always had back pain during periods, so have always anticipated back labour in childbirth.) The idea with these positions is to keep the baby away from the spine, taking the pressure and weight off the spine. These positions can also help baby move from a posterior position.
- Over the birth ball or bed – helpful if baby stays back to back, and good for pelvic rocking(tilt) which helps with pain relief.
- Pelvic Tilt
- Straddle a chair
- Leaning against a wall is great for rotating a posterior presentation, and the contractions are often more productive.
- Sofa or raised hospital bed
Positions for pushing
- Semi-sitting – Good for resting, uses gravity – this is how I gave birth, as it was the most comfortable position for me.
- Side-lying – you’ll probably need someone holding your leg up for this one. This is good for fetal oxygenation. This position may promote progress of labour (I went from 4-8cm in two hours in this position – after 44 hours at 4cm)
- Hands and knees – this is a popular home birth position, also useful because mothers often deliver their own babies in this position. This position is also good if there’s low heart tones, and takes pressure off of haemorrhoids. This is apparently a good position for delivering a large baby, and excellent for shoulder dystocia.
- Back of hospital bed or sofa – similar to hands and knees, but with support
- Birth ball – again, similar to the above
- Squatting – this one takes strong legs and practice, but is great for shortening the birth canal and also for delivering your baby into your own hands. Also increases pelvic diameter by up to two centimeters.
- Dangle – is pretty much identical to squatting, with the difference being that someone else (and strong!) supports your weight. This is similar to a birthing stool, except your centre of support is different. (There has been mention of dangling putting too much pressure on the perineum, so do what’s comfortable.)
Sources: Lavender T and Mlay R. Position in the second stage of labour for women without epidural anaesthesia: RHL commentary (last revised: 15 December 2006). The WHO Reproductive Health Library; Geneva: World Health Organization. Copyright © Paulina G. Perez, RN, BSN, LCCE, FACCE, Lamaze Parents Magazine. Positions for Labor and Birth – Transition to Parenthood Images: Joni Rae from Kitchen Witch