There is no right or wrong, best or worst position to give birth. It depends on where you're comfortable and what's happening. Most women do well lying on their side during labor. Others may feel better walking around or taking a shower. Listen to your body to find the position that works best for you and helps labor progress. Always remember that whatever position you're in there are options:
- On your back. This is the most commonly used position because it gives your provider plenty of space during delivery. But, being on your back may cause your uterus to press against a major blood vessel, reducing blood supply to the placenta. For extra comfort and support, put a pillow under one side of your hips and tilt your abdomen slightly. Or, sit in a semi-reclining position with your head and shoulders elevated, with legs on the stirrups as you pull on the back of your legs.
- On Your Side. This takes pressure off your perineum. It also keeps your uterus off a major blood vessel which allows blood flow to your uterus and your baby. Have your partner hold your upper leg to widen the pelvic outlet and support the weight of the baby.
- On your hands and knees. This may ease back pains and give a poorly positioned baby a chance to turn around. It may help a baby in stress because it increases blood flow to the uterus and the placenta. This position can be difficult if you have an epidural, as you may not be able to move your legs well enough to support yourself.
Upright positions include:
- Sitting during early labor. Makes your uterus move forward. This takes pressure off your diaphragm and improves the blood supply to the contracting muscles. Try a birthing chair, stool, or birthing ball.
- Standing or walking during labor. Helps widen your pelvic opening and lets gravity do its job by pressing the baby's head against your cervix. Use a wall or ask to lean on your labor coach during contractions.
- Squatting during delivery. Opens your pelvis even wider so the baby has more room to move down into the birth canal. Use a bed with a squatting bar or two extra bodies to help support you and stay in this position.
- Kneeling during delivery. Lets you maintain an upright position without straining your back. Just kneel on a pillow, lean forward against your bed, a chair, or a wall, and rest your arms and upper body on or against the prop.
Remember that upright positions can be difficult if you have an epidural, because your legs may be too numb to support you or balance in an upright position.
It's important to breathe through each contraction and keep an open mind. If you have to be restricted to bed because of medical equipment, anesthesia or fetal monitoring, stay focused on your goal: your baby. And whether you're lying down or standing up, changing positions is key.
John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
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