POSITIONS IN LABOUR
Have
you ever watched a woman give birth on TV or in a movie? The woman is usually
lying on her back, being coached to push, struggling and screaming in pain. If
that is the image you have in your mind of birthing your baby, it will
undoubtedly make you anxious and nervous about childbirth. But it doesn’t have
to be that way. There are plenty of positions you can use during labour to ease
discomfort and to give birth to your baby in the most natural way possible, as
women have been doing for generations.
During labour, the uterus, which is essentially a large muscle, contracts which helps the cervix open up and pushes the baby out into the world. Let’s begin with the stages of labour - did you know you go through three distinct stages of labour during childbirth?
● The 1st is the
Latent Stage when contractions begin and the cervix thins and begins to
dilate. This usually begins with lower abdominal and lower back pain. You will
experience mild, irregular contractions.
● The 2nd is Active labour where your cervix is 4cm dilated or more. Then the cervix becomes fully dilated (at 10 cm), pushing and finally, childbirth. The contractions become stronger and come every 2-3 minutes.
● The 3rd stage is the Expulsion of the placenta.
The best positions to labour and birth in are those in which gravity assists you in helping your baby descend and you instinctively feel comfortable and confident about giving birth.
The day you go into labour is not the day to think about what positions you would like to try. It should be the day you choose between the variety of positions to best support you. This is made much easier if you make a birth plan in advance (link here) about how you would like to give birth. Having a supportive partner and/or a Doula will make you feel supported during childbirth.
What positions can you use during
labour?
Unless your pregnancy is high-risk or there are any other complications, there is no need to be flat on your back. All the positions given below use gravity to open up your pelvis to help your baby move down into the birth canal and make the Transition Period, where you are pushing your baby out, a lot easier.
You may experience back labour or the Occiput Posterior position, where the back of your baby’s head is against your tailbone. Several of these positions will help in greatly reducing discomfort on your back.
- Standing or walking: It will be easier to
walk early on in your labour and then you can stand and sway while holding
your partner (or doula) or against a solid surface like a wall.
The swaying and rocking (even hip rotations) move the pelvis, encouraging the baby to descend. This is a great position to return to between other positions. Forward leaning while standing can also help with back labour.
- Squatting: Practice squats regularly during pregnancy, with your doctor’s go-ahead, to get some practice in this stance. This is most useful in the later stages of labour or when you are giving birth..Use a birthing stool, take the support of a birthing bar (if your hospital has one), or a wall to help you squat. A supported squat can also be created by squatting against a birthing ball.
- Kneeling: Use a birthing ball, a chair, a pile of pillows or even the hospital bed and lean against that as you kneel. This is another forward-leaning position that helps relieve the discomfort of back labour.
- Lying on your side: If you are tired or feel the urge to lie down, try lying on your left side rather than your back, to avoid compromising blood flow to the baby. This position is not gravity-friendly, but is a good neutral position to labour in.
- Hands and knees: Going on all fours on your hospital bed is another great position for the later stages of labour. It takes the pressure of the back during back labour and provides a better position for your baby to rotate. Swaying your hips or arching back and forth may make you feel more comfortable.
- Lunging with one leg up one a stool or chair: This is a great asymmetric position to open up your pelvis and reduce pressure on your back. Do this only with your partner or Doula supporting you and alternate legs to prevent yourself from getting too exhausted. Climbing stairs and even sitting with one leg up and your hips open also creates the asymmetrical position like a lunge.
- Sitting on a birthing ball: This is a great way to get some rest while reducing pelvic pressure and back pain. Sitting on an anti-slip birthing ball, with your partner holding the ball stable, gently bounce, rotate or rock back and forth can be really beneficial in the early stages of labour, before the cervix is fully dilated. Make sure your feet are fully flat on the floor.
- Sitting on a chair: You can straddle a chair and lean against it. You can also sit at the edge of the chair and rock back and forth or just sit on the chair leaning forward, with your legs open, while having your partner or Doula massage your back. These will all make back labour and lower back discomfort bearable.
These positions help because:
● Your baby moves downwards and
even rotates if needed
● Labour may potentially be
shorter
● The need for an epidural
reduces
● Discomfort in the pelvis and
back reduce
● The pelvis opens for an easy
labour
● The risk of a
forceps-assisted birth reduces
● The risk of episiotomies
reduces
● The risk of the baby having
an abnormal heart rate reduces
● There is less use of
synthetic induction or augmentation of labour
● The chance of C-section reduces
Ask your partner or Doula for support in any position you need or to massage your lower back to ease any discomfort you may be feeling. Remember to stay flexible - a position you may have envisioned might not work for you in the moment, really focus on your body’s needs and use or change positions as needed. Balance any movements with periods of rest and use breathing or relaxation techniques to ease you through labour and childbirth.
