If your car stalled at the bottom of a hill, you certainly wouldn’t try to push it uphill. So why does it make sense to fight gravity by lying down during labor? This is just one reason why the standard hospital labor position—semi- or fully reclining—is not ideal. For one thing, when you’re lying on your back, your uterus compresses major blood vessels, potentially depriving the baby of oxygen and making you feel dizzy or queasy. “Most women feel better when they are not lying on their back during labor,” says certified nurse-midwife Katy Dawley, Ph.D., C.N.M., director of the Institute of Midwifery at Philadelphia University in Pennsylvania. In addition, when you’re reclining, the baby’s head puts pressure on pelvic nerves in your sacrum, increasing pain during contractions. Remaining upright and leaning forward reduces this pressure while allowing the baby’s head to constantly bear down on your cervix. As a result, dilation tends to occur more quickly.
“Lying on your side, standing, sitting, walking, rocking—anything that keeps you active can help decrease pain and speed up labor,” says Dawley. Just be aware that a prenatal visit is the time to discuss with your doctor or midwife the different positions you think you’d like to try. “In the throes of labor, you’re not going to be able to advocate for yourself,” she explains.
Seven soothing labor positions
Here’s another reason to be open to the possibilities: Fetal heart monitoring during labor can help determine which positions you can sustain without impairing circulation to the baby, so it’s best to have a repertoire available. Some options:
1. Get on all fours This position eases back pain and helps the baby rotate into the optimal position for delivery—facedown. (When the baby is faceup, the result is the dreaded “back labor.”)
2. Lean forward This can help make uterine contractions more effective in bringing the baby down. Drape your chest over a table, bed, countertop, pillow or exercise ball (see “Get on the [Birthing] Ball,”).
3. Lie on your left side This may increase blood flow to your baby and can help reduce back pain. Support your belly and legs with pillows.
4. Lunge Place one foot on a sturdy chair or footstool and lean into that foot during contractions.
5. Rock Sit on an exercise ball, the edge of the bed or a chair and gently rock back and forth.
6. Sit and lean Sitting in a chair, prop up one foot and lean forward into it during contractions.
7. Sway Put your arms around your partner’s neck and sway back and forth; pretend you’re slow dancing.
Ready, set, push! While the position may be less convenient for hospital personnel, squatting is especially effective when you’re ready to push. In fact, squatting is sometimes called the “midwife’s forceps” because of its ability to work with, not against, gravity, enlarge the pelvic opening and speed the pushing phase of labor.