What Are Good Labour and Birthing Positions?
A good labour and birth position is one that supports the physiological process of birth. And, they usually cover three different aspects:
Position allows for pelvic movement - that is movement of the sacrum, symphysis pubis and coccyx;
Uses gravity;
Is forward leaning.
Before we get into the five best positions for labour and birth lets look at these aspects in a little more detail.
Position Allows for Pelvic Movement
During labour the pelvis has to move to allow the baby to go down the birth canal. Any pressure on the sacrum limits its movement potentially causing the mother discomfort. Often we see pictures of women in labour lying propped up on their back in a supine position. It may be necessary if medical intervention is needed but can make labour feel painful and longer and does not encourage baby into an optimal birthing position. But, if a mother feels she needs to lie supported on her back for a little while it is okay to do this.
Using Gravity
Upright positions help move the baby down in the pelvis and stimulate contractions. The pressure of the baby’s head down onto the perineum helps to release prostaglandins that tell the mothers brain to release more oxytocin. The hormone oxytocin is what is required for healthy contractions. It is important that in the months and weeks leading up to birth the mother gets into positions that use gravity to help the baby engage.
Forward Leaning
These types of positions help the baby stay in the optimal birth position (head down with the baby’s spine against the mothers belly). All forward leaning positions are useful from second trimester onwards.
Are the Labour and Birth Positions Different in Each Stage of Labour
Labour and Birth is a balance of relaxation and activity. The positions are basically the same for each stage of labour. However, during 1st stage the emphasis is more on finding a way to feel relaxed in each position and on opening up the pelvis. In 2nd stage the emphasis is more on bearing down with more focus and effort. In the 3rd stage when the placenta is being born less effort is needed so relaxed positions are good. This is when it is okay to be in a more supine lying position as the baby has already been born.
What Are the Five Best Positions for Labour and Birth
In no particular order the five bes positions for labour and birth are:
Standing - rocking or leaning against something
Squatting - full squat, support squat or a standing squat
Forward kneeling - over the edge of a bed or over a ball
Forward sitting or sitting on a ball - using your thighs to support you and limiting pressure on the sacrum and coccyx)
Side lying.
Below I go into each position in more detail and how it can be used in 1st and 2nd stage of labour.
Standing
Standing is a position many mothers often like using in early labour. She can walk around or stand and sway her hips as needed or even begin to dance to help tune into the rhythm and energy of her labour. As labour progresses and contractions intensify she may want more support from her partner, a bed, a wall, or a chair to help take her weight as she bears down.
Dancing and standing squat are the two best standing positions. However, caution needs to be taken with any kind of squat in certain circumstances and it is generally not advised to squat if:
the baby is breech - it can make the baby’s bottom go further into the pelvis
there are instability issues with the symphisis pubis as squatting puts more weight onto this joint
there is any bleeding as it can put more pressure on a low lying placenta
there are any knee problems as it can stress the knee joint.
If a partner is supporting the squat they also need to be aware of their own body and any physical issues they have such as knee problems.
A standing squat is where you take your weight down slightly to a point at which your thighs are parrallel to the ground. To do this in 1st stage have your feet as far apart as feels comfortable, hold your partners hands at the wrist and as you breathe out, sink down together taking each others weight. You can even try a little side to side rocking in this position. This is the active version. To rest in this position move closer to each other so that as you sink down you can lean into each other and hug each other. Practice slow deep breathing and really letting go and relaxing.
In 2nd stage a standing squat is great as it really helps to use gravity. It is a great birthing position. The mother can either face her partner or have her back to them. It is vital her partner feels well supported and can relax without feeling any strain. They need to be able to take more weight and this can be achieved by leaning against a wall, sitting on the edge of a chair or birthing ball and their thighs can be used like a birthing stool for the mother. If you want to be in this position in between contractions try relaxing your body into your partner as much as possible.
Dancing is the same for both 1st and 2nd stage labour. You can rock and sway with each other from side to side, use movements that help the mother to circle her hips, circle around each other and take each others weight as you lean back (caution for any pelvic instability). Put on some music and dance along to it playing around with different movements and focssing on the rhythm. To rest in this position lean into each others arms and practice deep breathing slowly together.
Squating
This is the hardest position in our modern culture where people do a lot more sitting on chairs than squating. Squating in pregnancy helps:
to strengthen the pelvic floor,
the baby to engage,
opens the lower back and helps with sciatica and lower back problems,
helps with constipation.
However, follow the same cautions for a standing squat and also do not do if you have haemorrhoids or varicose veins as squats block circulation.
Is squating better for birth? Squating is a great position for giving birth as it gives the pelvis the widest diameter and uses gravity in the strongest way. You can squat on your own or do it with a partner and it is the same for 1st and 2nd stage labour.
To squat on your own you could try starting on all fours and rocking yourself into a squating position. Put books or cusions under your heels if they don’t quite reach the floor. Bring your palms together and ease your elbows against your knees. Try holding onto something if you can’t completely do it on your own.
To squat with your partner stand and face each other making sure your arms are fully extended and your back is straight. Have your legs hip width apart. As you breathe out sink down into the full squat position. Once you are down stay for as long as you feel comfortable leaving enough energy to come up.
With practice squating can be a comfortable position to rest in between contractions. This can be achieved by taking your weight forward and into your hands so that you are leaning on the floor or you could lean back and rest against a wall or your partner.
Forward Kneeling
Being on all fours is a great labour and birth position for everyone although some caution should be taken for mothers with carpal tunnel. This position can be adapted to be leaning over a ball, bed, bean bag or chair to take the strain off the wrists. This is a great position to:
help get the baby into the anterior position and turn the baby if it is breech
take the weight off the lower back and pelvis
helps to strengthen the abdominal muscles.
Forward kneeling is a position many mothers feel comfortable with for a lot of labour and is a good position for the partner to give some massage in. In both stages to make this an active position the mother can try rocking and circling her hips. If there are no pelvic issues then one leg can also be in more of a lunge position as you rock and circle around. To make it a resting position in between contractions it is much easier to lean over something like a ball, a chair or your partner using padding to make it as comfortable as possible and then just really rest the weight of the body into this position.
In 2nd stage it can be helpful to move from all fours to leaning your elbows on the floor while your bum is up high to:
help a posterior baby turn;
slow labour down if it is progessing too quickly - some mothers can find a quick labour traumatic as they don’t have time to get into the rhythm and everything is over before they’ve gotten into it;
to take the edge off the intensity of labour and give the mother a short rest
to prevent the mother from bearing down before the cervix is fully dilated - if you bear down on a cervix that is not fully dilated you can cause it to swell and then it won’t open any more (I have personal experience with this);
help the baby get into a better position if the mother is bearing down and nothing is happening
Sitting
You can’t give birth siting but it is a good position for resting in during 1st stage and transition. It is important though not to sit with pressure on your sacrum, that is, leaning back. It is better to sit on a ball or the wrong way around on a chair or on your partners thighs facing towards one another. Practice relaxation breathing techniques such as breathing in to the count of four and breathing out to the count of 8 and doing visualisations of the baby moving deeper and deeper into the birth canal.
Side Lying
This is the most restful and great for relaxation. it is the least active position. It doesn’t use gravity or promote movement. It is much better than lying on your back and is good for 2nd stage if nothing else is working.
In 1st stage lie down on the side that is most comfortable placing cushions where you feel you need them - under the top leg, between the knees, under the chest and abdomen. Your partner can snuggle in behind you, putting their hands on your abdomen and you can practice breathing together.
In 2nd stage the mother may prop herself up on one arm. The partner can be at her feet and the mother can push her feet against him to help her bear down.
Exploring Labour and Birth Positions in Pregnancy
The best positions that support labour and birth are the same ones many women find comfortable at the end of pregnancy, particularly forward leaning. It is helpful to practice these positions in the weeks leading up to labour, incorporating them into a daily routine. It can be supportive for the partner to practice these positions with you as then you can then find positions that are comfortable for both of you. Practice for as long as feels comfortable.
Negotiating Positions if Medical Intervention is Required
Often women are placed in positions more convenient for the care provider when there is medical intervention. If the woman is uncomfortable her partner may need to negotiate alterations for comfort. Be aware of pelvic instability issues.
Supporting a Woman to Labour in Water
Labour and birth positions are essentially the same in water. For any woman with pelvic instability issues labouring in water is much better if she can get in and out of the pool without aggravation. Squating positions are easier as the water is supportive. Lying supine can be restful and the sacrum is not compressed so doesn’t increase pressure on the back or encourage the baby to move into a posterior position. Partners can also get into the pool with the mother and do some acupressure on the sacrum and gentle stroking of the abdomen.
Practicing breathing and positions in a swimming pool is helpful to feel comfortable in different position and moving from one to the other.
Labour and birth can be a wonderful and empowering experience for a woman. Being prepared for your birth is more important than just focussing on the birth. Being prepared helps the baby get into the most optimal position for labour and ensures that a mother may have the most natural, smooth and healthy delivery possible for her and her baby.
At Soul Body Shiatsu we specialise in helping pregnant mothers be birth ready. We value helping mothes to feel supported as supported mothers are relaxed mothers. And, a relaxed mother is more likely to have a healthy, smooth delivery and recover well. We incorporate exercises/positions, breathwork and visualisations for labour in all our pregnancy shiatsu massage treatments. Each treatment is tailored specifically to a pregnant mothers needs. From 36 weeks a mother can book in for a Birth Preparation Shiatsu Massage. This is a unique treatment to ensure a mothers body is completely ready for labour.
To book a Pregnancy Shiatsu Massage or Birth Preparation Massage Click Here or contact us on 0403 550 695.