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What are the best positions for labour?
When your , you'll probably feel restless and want to move around and keep busy. Just take care that you don't get over-tired before your labour is properly under way.
Have short rests in a chair, or lying down. If your contractions start at night, try to stay in bed and relax for as long as possible.
As your contractions get stronger, concentrate on them. Focus on what's happening to your body and your baby, and practise your and exercises.
Now is the time to find the positions and movements that help you to cope with your contractions. Your should encourage and help you to keep moving around and find comfortable positions, preferably ones that are upright.
You may think that you'll be most comfortable lying on the bed. But keeping as upright as possible will help:
- you to cope with your contractions
- you and your baby to cope better during labour
You'll be able to keep moving by shifting your weight from one foot to another, or by rocking your pelvis. Some positions make it easier for your birth partner to massage your back, or breathe with you through the contractions. You could:
- Lean on a work surface, or on the back of a chair.
- Put your arms around your partner's neck or waist, and lean on him.
- Lean on the bed, with the height adjusted for your comfort, or on a window-sill.
- Kneel on a large cushion or pillow on the floor, and lean forwards on to the seat of a chair.
- Sit astride a chair, resting on a pillow placed across the top.
- Sit on the toilet, leaning forwards, or sit astride, leaning on to the cistern.
- Go on to all fours.
- Kneel on one leg, with the other leg bent..
Your hospital or birth centre is likely to have posters that show positions for you to try.
Why choose not to labour in bed?
If you are upright, gravity can help to push your baby's head down on to your cervix (neck of the womb) to help it open. This helps your baby's progress through your pelvis.
Lying down in labour may cause:
- More painful contractions, making an epidural more likely.
- A longer labour, as contractions may be less effective.
- A higher chance of having a caesarean.
- A greater likelihood that your baby will need to go to special care.
- A narrower passage through the pelvis for your baby.
Even so, many women in the UK do give birth while on a bed.
How likely you are to move around and try different positions also depends on the facilities that are available to you, and the support you get.
Some units and birth centres offer mats, beanbags, birth balls, and grab rails or ropes that support you to move around in labour. Ask a midwife what is available locally, as it could affect .
How should I change positions in labour?
Upright positions help to make your contractions efficient, and you to feel in control. When you are in very strong labour, you probably won't want to move around a great deal. You'll need all your strength just to cope with each contraction.
If you want to change position as your labour progresses, your or midwife can help. She will help to keep you comfortable with pillows and cushions, whatever your position.
Keep rocking, straightening up and leaning forwards during contractions. Your birth partner or midwife could with each contraction, if it helps. Try to keep your shoulders relaxed, as this helps to relax all the muscles supporting your back.
If you get really tired, and bed feels like the best place to be, use pillows or wedges so you can lie on your side. Or adopt a semi-prone lunge position with pillows under your knee.
Contractions can be more painful if you lie on your back, so you'll need to balance your need for rest with how you're coping.
If you feel rested after a little while, push yourself up with your hands into a sitting position, and get into a comfortable upright position again.
Which positions are best for backache in labour?
If you have backache between, as well as during, contractions, your baby may be in a . Getting the weight of your baby off your spine may help.
To do this, go on all fours, with pillows under your knees and hands. This can reduce back pain, and may help your baby to get into a better position.
You may find that your arms and wrists get tired, or that the blood rushes to your head. Resting your head, shoulders and forearms on a birth ball, the seat of a chair, or your partner's lap, may help.
Which positions are best for pushing?
The following positions help your womb's (uterus) muscles to work and use gravity to open your pelvis:
- On all fours, on your hands and knees.
- Leaning forward in a supported standing, kneeling, or sitting position.
- A squatting position.
- Lying on your side, or in a semi-prone position.
- A semi-sitting position.
If you're on the bed, lying on your back is the least helpful position. Being propped up or on your side, rather than being on your back, or on your back with your legs in stirrups, will reduce your likelihood of:
- Needing .
- Having .
- Your baby's heart rate being affected while you're pushing.
However, being on a bed in a sitting or lying position does increase your risk of during the birth, and of having a second-degree tear.
If your midwife prefers you to give birth on the bed, or you want to be on the bed, you can still choose to adopt a comfortable upright position. Try kneeling on the mattress, or leaning against a large pile of pillows placed at the top end. Or put your arms around your partner's neck as he stands at the bedside.
If you're too tired to be upright, lying on your side is a good option. Similar to upright positions, it provides a roomy exit route for your baby through your pelvis.
If your midwife is happy for you to give birth on the floor, try a supported, kneeling position. When the time comes for your baby's head to be born, leaning forward on all fours may reduce your risk of tearing, as your baby's head may emerge more gently from your vagina.
Bear in mind that other factors, such as whether or not you have had a baby before, and the care you receive, may be more important than the position you're in.
Should I use a birthing stool?
A birthing chair or stool helps keep you upright while you're pushing. Though using these has been linked to losing more blood during birth, it could just be because it's easier to collect and measure the blood when a woman is sitting on a stool.
When compared with lying on your back in labour, using a birthing stool reduces your risk of having an episiotomy.
Which positions are good for not pushing?
Occasionally, you may feel like pushing, but your midwife will ask you not to. This may happen if:
- Your cervix is not fully dilated.
- Your cervix hasn't opened up evenly, leaving a "lip" of cervix round your baby's head.
It can be difficult not to push when your body is telling you to. You could try lying down on your left side, or going into an all-fours or a knee-to-chest position, with your face on the floor, and your bottom in the air. This should tip your baby off your cervix, and reduce your desire to push.
Some experts recommend "pant, pant, blow" breathing as a way of suppressing the urge to push. Or you could try "grunt pushes" that satisfy the urge to push with a brief grunt. However, if you really have to push, your midwife will work with you.
Which positions can I try if I have an epidural?
You'll need to stay in bed if the has made you completely numb from the waist down. Try not to lie flat on your back. In this position, your baby's oxygen supply is reduced. Your midwife should help you to get comfortable in a sideways or semi-reclining position, using pillows or wedges. You could ask your partner to hold your loose leg up with each contraction.
If you have some sensation left, and can still move around a little, your midwife may encourage you to keep mobile and as upright as you can. You may even be able to sit in a chair, with your knees wide apart, and lean forward with every contraction.
