Women use a variety of positions in labour and if allowed to, your body will instinctively guide you at the time.
Moving around is the best thing you can do while in labour and you will find that different positions can help ease the labour pain. Here are a few ideas:
Standing and walking
Being mobile during your labour gives you a sense of being actively involved and in control. Walking uses gravity and makes contractions more efficient by increasing uterine contractibility. Being mobile and upright aligns the baby better within the pelvis (the bony part of the birth passage). Back pressure will also be reduced.
Contractions in the upright position (especially standing) are usually stronger and longer and further apart and perceived to be less painful by most women. They also seem to be more effective.
Because upright positions use gravity, the baby descends and cervical pressure is increased evenly and usually less painfully than if you were recumbent.
Remaining upright does not mean that you need to stand alone or that you need to stand all the time. Leaning against a windowsill, wall or your labour partner is a wonderful way to deal with your contractions.
You should not stand unsupported, but should have most of your weight against something. You may enjoy being held or rocked by another person or having your lower back massaged. This is a good position if you want to rest but still remain upright.
Sitting or semi-sitting
If a mother experiences some complications during labour, sitting is good for resting and still engages the use of gravity. Sit as upright as possible, even if you are attached to a foetal heart monitor or drip. The coccyx can still move back if you are sitting fully upright.
Hands and knees
Many women instinctively adopt the all-fours position, especially if they feel pain in their backs. Use chairs, bean bags, balls or continental pillows to make yourself more comfortable. This will take all the pressure off your back as your belly hangs away from the nerves and blood vessels supplying the uterus.
This is a fantastic position for a woman experiencing most of her pain in her back. If you wish to give birth in this position you are less likely to need an episiotomy or to tear. This is also a good birthing position for a mother delivering a large baby.
In the squatting position your pelvis is open to its widest and the angle of the baby’s descent is maximal in relation to the shape of the pelvic canal and the force of gravity. If this hurts your knees and tires your thighs, sit on a low stool or back-to-front on a chair, with your knees wide open in a supported squat position.
A birthing ball is a wonderful aid in getting the pelvis to open to maximum. Squatting tends to make contractions stronger so you may wish to squat between contractions and stand or kneel during contractions.
Lying down and lithotomy (on back with legs raised)
It may be appropriate at certain times during your labour to lie down. If your labour is progressing well, you may be most comfortable lying on your side, supported with cushions. While this position will not hinder labour, it may not help labour either.
When you lie on your back, the heavy uterus presses down on the major blood vessels that lie behind it. This means that you will feel more pain. You will also be lying on the spine, which causes pressure on the major nerves sending strong pain messages up to your brain. Being off your back allows the coccyx to move back and out of the way. Avoid lying on your back as much possible.
Why remaining in an active position during labour is better
A woman who lies in bed during her labour is at a distinct disadvantage, both physiologically and psychologically. She loses most of the advantages of gravity and is more likely to be treated like a patient and to become more dependent on the people around her, handing responsibility for her wellbeing over to them.
Being up and about and remaining mobile will keep up a good circulation as she takes charge for what happens to her body, her baby and her labour.