The journey out from the womb seems like such a short distance, but in reality, navigating the passage through the pelvis is a long journey for a baby! Your muscles, tissue, and bones guide the baby’s positioning throughout labour and birth, and as the baby descends actually assist in signalling when to rotate its head or shoulders or extend to flex its neck. You can help your baby along the way by changing your positions for labour frequently.
Changing your position during childbirth helps make use of gravity and productive, restful positions to increase the regularity and strength of your contractions. Every time you move your body into a new position during labour, the sensation and intensity of contractions changes. I recommend trying any new position for at least 3 contractions before moving on to a new one, as moving too frequently from one position to the next doesn’t give you time to settle into the new position and can even make things feel worse! Also remember, restful or restorative positions can be helpful in maintaining your energy levels throughout your labour. The trick is in finding the balance between active, upright and restful.
Suggested Positions and Movement
Walking or Stair Climbing
Walk at a comfortable pace. Walk both at home and at the hospital. Don’t be afraid to explore the outside – especially in early labour. Occasionally climb a flight of stairs if possible. Walking and stair climbing encourages the baby to drop down into the pelvis. It helps to rotate the baby’s head into the best position for birth and can help relieve back pain. Breathing slowly. . . relax–especially when you are no longer able to walk or talk without pausing during contractions.
Standing and Leaning Forward
Lean against your partner or the wall for support. This position has all the advantages of gravity but allows you to rest. For added rest, you can even sit in between contractions on a chair or a birth ball. Your partner can give you a back rub or apply back pressure. This position can also be used at the bedside if you require electronic fetal monitoring!
This is a beautiful, intimate way to connect with your partner and assist with the progress of labour. In this position you maintain a supported upright position while encouraging rotation of your baby’s head as it molds to your pelvis. Stand facing one another and embrace your partner around their neck. Let your head rest on their chest or shoulder. They can support you by placing their arms around your trunk and pressing their clasped hands into your lower back if desired. Think “Grade 7 High School Dance” – and sway from side to side. Turn the lights low, put on some music and let the magic happen all over again!
If you are really motivated to move your baby into a better position try lunge-ing. Place one foot on a secure chair seat, with the knee and foot out to the side. Bend the raised knee and hip and slowly lean in the direction of the raised foot. Have your partner help you with your balance while you lunge sideways during contractions and hold for 5 seconds. This is a particularly good position if you are experiencing back pain as it widens one side of the pelvis to allow the baby’s head to rotate into a better position.
Sitting on a Birth Ball
Sit upright on a birth ball rotating your hips from back to back or side to side or gently bounce. Your partner can stand behind you to help you balance and support you by massaging or applying pressure to your back. Sitting upright on a birth ball utilises gravity while allowing you to rest – including relaxing your pelvic floor muscles. This position combines the benefit of gravity and a relaxed pelvic floor with the movement of your hips to assist in the rotation of your baby.
Sitting Leaning Forward with Support
Sitting on a ball or backwards on a chair can allow you to rest into pillows in between contractions. These positions free up the partner to really work on your back if you need or appreciate massage or pressure. This position is easily adapted for electronic fetal monitoring if required.
Birth has a rhythm: contractions are followed by rest. You cope with pain by breathing in a steady rhythm. Finding your own rhythm in movement by sitting and rocking in a rocking chair or on a ball can also assist you in coping with the intensity of contractions and encourage progress.
Hands and Knees
In a hands and knees position, gravity can pull the weight of the baby’s back forward into the curve of your belly, assisting in the rotation of the head into an “anterior” or optimal position for birthing your baby. Rotation can be further encouraged by adding movements such as rocking, circles or lungeing forward. Hands and knees can be hard on knees and wrists if done for prolonged periods of time, so be sure to add comforts such as pillows under knees or modifying the position by leaning over a ball or the back of a birth bed.
Lying on your side can be the most restful position in labour. Liberally support your body with pillows under your head, belly, back and/or between your legs. This position maximizes rest – some women even briefly fall asleep between contractions. It is particularly important if you have been upright and walking for a long time. Lying on your side can provide additional relief as it has the added benefit of taking pressure off painful hemorrhoids and lowering blood pressure.
Moving your baby through your pelvis can be likened to putting a cork back into a bottle. The cork (your baby!) may seem too big and impossible to fit especially if you were to just try to force the cork straight in. However, move the bottle (your pelvis) around the cork (your baby) and it will make its way through much easier.