The Best Birthing Positions, According to Experts and Parents

From standing to hands and knees, birth experts and parents explain why the best positions to give birth don't involve lying on your back.

Many of us are used to seeing images of people giving birth in a standard "hospital" position: reclining in bed with legs up, as a doctor coaches the laboring to push from the foot of the bed. And about 68% of people give birth in that supine (on their backs) position.

But what some may not know is that there are other positions that may actually be more effective—and even more comfortable—for childbirth, such as squatting or standing. Here's what the experts and real parents say about the best birthing positions.

Why Birthing Positions Matter

Learning about different birthing positions not only offers laboring people options but can also help them feel more empowered through the birthing process, which can translate into better outcomes like lowered pain. Reproductive psychotherapist and birth doula Saleemah McNeil, CLC, MS, MFT is a believer in taking control of your labor experience. She explains that for many people, their position has a lot of influence over their level of comfort during labor.

"There are many positions more comfortable than lying on your back like a beetle," says McNeil. In fact, this supine position only became common practice when male physicians (as opposed to female midwives) began attending births because it was easier for them to inspect and "manage" the birthing process. However, this doesn't necessarily make the experience better, and lying on your back is actually working against gravity.

"Many popular positions involve standing up, working with the universe's natural pull to help your baby descend," she says. "Whereas when you're on your back, the baby's journey takes a dip. Then they go up a hill, which is the original canal." McNeil says that this can lead to tearing.

An image of a pregnant woman in the hospital.
Getty Images.

Expert-Recommended Birth Positions to Try

As a birth doula, McNeil encourages her clients to explore different positions for giving birth to find what works best for them. Here are four popular birthing positions recommended by real birthing parents and birth experts.

Standing

One key advantage of laboring in a standing position is that the upright position lets gravity do some of the work; however, standing can be exhausting, so it is helpful to have one or two people support the birthing person by holding them up from under their arms.

As a birth position, standing can encompass a few positions, including lunging and squatting or leaning onto your partner for support. Kimberly Eversly, 32, gave birth to her first two babies on her back and her third standing.

She says that the first two births were miserable, so for her third, she researched and developed a birth plan. She knew that, in case of an emergency, there would be changes, but she incorporated a pool and shower during her labor.

"I was getting massages, and I felt so relaxed, it was the easiest labor I ever had," she says. "I barely felt pain. You know when you watch on TV and women are screaming like they're dying? This was the first time I didn't scream."

Hands and knees

By Eversly's fourth pregnancy, she felt like she was a pro. This time she opted to be on her hands and knees. She says, "It was the best experience. This time I was on all fours like a dog, but on more of an incline. She just came right out." Her labor times respectively were nine hours, three hours, one hour, and less than an hour.

Squatting

Kimberly Howell, DPT, a pelvic floor specialist, says that being on your back puts you at a disadvantage when it comes to delivery. "You can't utilize your core and pelvic floor to facilitate pushing," she explains. Squatting, on the other hand, can help to expand your pelvis, and it takes advantage of gravity. There is only one place for the baby to move when you are squatting.

"Many people find that a squatting position—either active or assisted with birth partners—allows gravity and adequate muscle recruitment to play a larger role." At a hospital or birth center, a squatting position can be accomplished with a birthing bar. That said, squatting can be a physically tough position to stay in for long periods, so switching up positions may help.

Side-lying

Howell explains that lying on your side has been known to reduce the risk of perineal tearing. This is because it can open the pelvis more easily, and it gives control over pushing.

After walking around at home for as long as she could, Genelle Adrian, 33, of Columbia, Maryland, gave birth to her daughter on her side. She pushed for only 25 minutes. "I was able to do without getting any pain medication, which was really nice," says Adrian.

"The biggest thing that made it possible was having conversations with my doctor and my doula beforehand. I was really adamant about what I wanted, and though it didn't go exactly as I wanted, I stuck to my birth plan as much as I could."

Choosing the Best Birthing Position for You

Ultimately, the best birthing position for you will be the one that most closely matches your preferences while also allowing for expected and unexpected changes. If you opt to have an epidural as part of your pain management strategy, for example, standing and squatting positions won't be accessible after the epidural is placed but your birth team can help you get into other positions like side-lying.

What position you labor and deliver in will also be influenced by factors like whether there are complications that require intervention or if the baby needs to be continuously monitored. You may also find that in the throes of labor, there is a position that feels good that you hadn't considered. Listen to and honor your body in the moment and do what's best for you and your baby.

As far as the best position to give birth? Our experts and parents all agree that whatever the birthing person decides is best. No two birth experiences are the same.

Key Takeaways

Gone are the days when giving birth automatically means lying on your back. Exploring which birthing position feels the best can make your birth experience feel more empowering. Talk to your health care provider about questions and concerns about finding the best birthing position for you and your baby.

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Sources
Parents uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. A Review and Comparison of Common Maternal Positions During the Second-Stage of Labor. International Journal of Nursing Sciences. 2019.

  3. Women’s Empowerment Related to Pregnancy and Childbirth: Introduction To Special Issue. BMC Pregnancy and Childbirth. 2017.

  4. Origin of Everything | Why Do Women Give Birth Lying Down?Public Broadcasting Service (PBS). 2017.

  5. Healthy Birth Practice #5: Avoid Giving Birth on Your Back and Follow Your Body’s Urge To Push. The Journal of Perinatal Education. 2014.

  6. A Review and Comparison of Common Maternal Positions During the Second-Stage of Labor. International Journal of Nursing Science. 2019.

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