We’ve all watched labour and birth on tv or in films – and 9/10 births will be happening on a hospital bed of some kind, imbedding into everyone’s mind that birth has to take place on a bed lying down on your back.
In reality, lying on your back in labour can be a real hindrance – we aren’t really made to give birth lying on our backs – in fact the more upright you are, with gravity on your side the better. During our classes we discuss in detail how different positions during different stages of labour can help and why, as well ways of adopting them whatever kind of labour you are experiencing.
During labour, if left to your own devices you’ll find you will adopt different positions to help you manage labour. This will come naturally to you depending on what the stage of labour you are in and how much energy you have at the time.
Ideally it is best to remain mobile and as upright as possible during the early stages and although it is often assumed that lying on the bed is expected, it can potentially slow labour down and be more uncomfortable during long periods. Adopting a balance between being actively mobile during labour and resting is vital to the progression and maintaining sufficient energy for the birth.
When you are mainly upright during labour, gravity helps provide pressure from baby’s head onto the cervix, encouraging strong contractions to push baby down towards the birth canal.
Upright positions include:
- Standing with legs hip width apart with hands on a table, wall or partner.
- Sitting/bouncing on a birthing ball
- Gently rocking hips from side to side.
- Kneeling over a bed or sofa
- Standing upright leaning on partner
- Being in water allows for upright labour and birth positions
During the birth of baby – often referred to as the second stage, a variety of positions can be adopted. Once again, the more upright positions tend to reduce the risk of an instrumental delivery. The pelvic outlet is wider, the uterine muscles contract effectively and pushing efforts are easier. Kneeling, squatting and on all fours are fantastic birthing positions. As well as all the benefits above, you are able to see and pick up you baby immediately after the birth.
If you have an epidural, lying on your back should be avoided. Your midwife can help you adopt a semi recumbent position or laying on your side with the use of pillows. When birthing with an epidural in situ, a more upright position can also be adopted to assist as much as possible with the descent of the baby through the pelvis.
There are also other positions which may not immediately appear to help open up the pelvis such as Knees Out Calves In – often referred to as KICO. This involves bringing your knees together and heels apart. If on your side, it will basically be turning one thigh and foot into this position. Putting the knees together opens the pelvic outlet across the narrower part of the oval shaped pelvic outlet. However, this is best used when baby is quite low in the pelvis – if baby is still high and still needs to navigate the bend of the pelvis or under the bone, then opening your knees is probably more suitable.
What is most important to remember is to listen and trust your body – trust in your ability to know what your baby and body needs you to do during labour and birth – be it resting, bouncing on a birth ball, dancing during contractions, or lying on your side. Being informed before labour starts will help you know what to try and why – and feel empowered to make choices that feel right for you.