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Labor Positions
Your choice of body position in labor can affect your experience immensely. Learning about your options ahead of the big event can enable you to select positions that you find most comfortable, and may facilitate the process of labor.

In the first stage of labor, being upright lets gravity work in your favor. This may help your cervix to dilate faster and your baby to descend through the birth canal, shortening the length of your labor. You may also feel a greater sense of control when you are upright, and you'll be able to change positions fairly easily. Another option is laboring in water, which can be very soothing. Reclining in a well-cleaned tub of warm water may feel relaxing during the first stage of labor, or you can try standing or sitting in a warm shower. (Note: you should not be immersed in a bathtub if your bag of water has already broken.) If you find that being in water slows down your contractions, you may want to follow this with walking to try and encourage your labor along.

The following positions may be tried with your health provider's permission. Be familiar with your options. Once you're in labor you can see which positions feel the best to you.

  • Walking/Standing—Walking and being upright in early labor can help your labor to progress and allows your baby's head to press against the cervix. Contractions may feel less painful. It can feel good to move around in early labor, but watch for fatigue.
  • Leaning—Leaning forward against your partner or a wall may help you during strong contractions. Deep and slow breathing is helpful, too. Sometimes it's easier to kneel rather than stand. Use a mattress or a pillow under your knees, and lean against your partner or a large surface. It may feel good to be massaged in this position.
  • Sitting—Reclining in bed with your back against your partner can feel soothing for both of you, as long as your partner has adequate back support. You may like sitting on a cushioned rocking chair or an exercise ball, as well. This will give your legs a break from standing, and can allow you to get some rest.
  • Hands and knees—Being on all fours is especially good for back labor, taking the pressure of the baby off of your back. Leaning over an exercise ball can help in the same way, and may be easier on your arms. Both positions can provide some relief from the fatigue of standing.
  • Squatting—This is an excellent option for the second stage of labor (the pushing stage). This position allows your pelvic bones to widen slightly, creating more room for the birth. You can sit on a small stool or cushion, or you may know someone who can lend you a special birthing chair. Squatting can be tiring on your legs, and you may require physical support from another person, so it's good to practice squatting with assistance ahead of your labor.

  • Leg flexion while lying on your back or side—One of my favorite positions for the actual delivery is similar to the squatting position, but you lay on your back or side. This position is especially good if you have an epidural, an anesthetic that prevents you from walking or being upright. As you flex your thighs you will increase the diameter of your birth canal, which makes more room for the delivery itself. Holding your knees with your hands and pulling them towards your shoulders as you bear down can help your pushing efforts to be more effective.
  • If you are taking a childbirth preparation class, you will be introduced to some of the above positions. Find out which positions are comfortable for you, and try several positions as labor progresses. You may wish to have some props with you at the birth: extra cushions or pillows, a comfortable stool, or an exercise ball. Don't worry about memorizing the above list; your birthing attendant will be familiar with these positions and can help you find the ones that feel the best for you.
Laura E. Stachel M.D. Obstetrician & Gynecologist