Comfort Measures in Labor: Positions
In the days before hospital and medicated births, women were encouraged to move during labor. Moving in labor was a way of keeping mother and baby well oxygenated, helping to open the pelvis so baby could maneuver more easily into the birth canal, relax and stretch the perineum, and help mom to reduce pain.
With the introduction of hospital birth and medicated birth, mothers were restricted to laboring and birthing on their back in a bed. This position not only slows labor, it also significantly increases discomfort in labor and the birthing process. Laboring and birthing on your back significantly reduces the assistance of gravity. The pressure of the baby’s head against a mother’s cervix is what causes contractions to start. It also is what causes contractions to be more effective. Reducing the pressure of the baby’s head against the cervix will often cause contractions to become less effective and it slows the stretching of the cervix. This will cause labor to become longer and more painful.
What position is best?
There is no “best” position. It all depends on what mother and baby need at the moment. One good idea, however, is to use several positions. Every so often try another position. It may be the one thing that helps baby pop right into position or give you the burst of energy or relief you have been needing.
Women tend to instinctively know what position they need to get into to help baby come down. It is a good idea to become familiar with several positions prior to going into labor. Practicing them with your husband is a great way for you both to prepare for the big day and will help you be more comfortable and confident in the moment.
Keep in mind that there are some medical conditions and medications that may limit your options. For example, high blood pressure may require you to stay in a lying down or, at most, semi-sitting position. Be sure to check with your physician or midwife if you are at risk and inquire about alternative positioning. If you are restricted to bed, don’t be discouraged, there are several options that you can still try.
Standing and walking are a great way to use gravity. The walking or slow-dancing motions help to open up your pelvis, as well, making more room for baby to maneuver. Walking and dancing helps keep baby oxygenated and can also be a great distraction during contractions. This is a great opportunity for mom and dad to bond during labor as well. Keep that oxytocin flowing with eye contact, kissing, speaking sweetly to each other, gently stroking and touching, etc…
Sitting is another great way to use gravity. You can sit in a rocking chair or a birth ball that will allow you to use rocking/swaying motions to open up your pelvis, as with walking and dancing. Sitting in bed can be done even if you have had an epidural or are having complications that require you be restricted to the bed.
Sitting on the toilet is also another popular option. This will allow your perineum to relax and stretch. One idea is to sit on the toilet backwards. You can place pillows and blankets around the piping or water reservoir so you can rest your arms and head while your husband or doula massages your back.
Squatting is a great position to help open your pelvis. It is reported that squatting can increase the pelvic opening by up to fifteen percent! That is amazing! It also helps align your trunk so that baby has a better angle through the birth canal. Squatting is also great for fetal circulation.
Many hospitals these days offer squat bars that can attach to the bed. If you plan on having a hospital birth, you may want to check with your nurse to see if you will have access to this great tool.
If for some reason you are restricted to the bed for any reason or if you are tired and need to rest, side-lying is a great alternative. This position helps keep baby well oxygenated and can help if you are experiencing high blood pressure. Side-lying can also help reduce the chances of tearing or needing an episiotomy.
This position can also help slow labor that may be moving too fast. I know that sounds odd but there are times where labor can proceed faster than your body can adapt and it is better to slow things down a bit.
If you choose to use this position, you may like the assistance of a peanut ball. It is much like a birth ball but more oval or peanut-shaped than round. This is a great way to keep your legs supported and your pelvis open wide to allow baby to move down into the birth canal.
Hands and Knees
One old wives tale suggested women scrub their floors on their hands and knees to induce or speed up labor. There may have been more truth to this statement than just someone wanting clean floors. Positioning on your hands and knees helps baby get into a better position for birthing. This can be extremely helpful for mothers who are experiencing back labor.
You can also do a modified hands and knees by leaning over onto a table, chair, or bed. Another option is to use a birth ball to rest your head and arms on while on your knees.
There are many options for using positions to help bring you comfort in labor. Grab your husband and practice a few of these before going into labor and you will feel much more prepared and relaxed in labor.