Your birth, your choice.Here’s our expert guide tosome of the best positions for when you’re inactive labour…
Picture the scene: a pregnant woman giving birth while lying flat on her back in a hospital bed. It’s one we’ve seen a million times before in films and TV dramas but if you’re watching having given birth yourself, chances are you’ll shudder at this ‘traditional’ anti-gravity labour position! Thankfully, the reality is totally different. Instead, you can be up and about, and in pretty much any position that works for you, during active labour and while giving birth. ‘You’re the birth boss,’ says midwife and author Marie Louise, ‘and you decide whatever position is comfortable for you when giving birth to your baby. I always tell mums who haven’t had an epidural to listen to their body you’ll find you naturally get into positions that help your baby come through the pelvis with ease. It’s a bit like when you’ve got trapped wind and you move to try and relieve it it’s a natural and instinctive movement to help make yourself feel better. And it’s very similar in labour: your body will often tell you to get into a different position, and that will help relieve pressure on your back, or help your baby to come through.’
Here are Marie’s top tips for what positions work well, and at which points of labour, to help you find the one that works best for you…
Lie on your side
If you’ve been in labour for a while, chances are you’ll be feeling very tired. But the good news is there’s a position for that! ‘Some women who have had longer labours and are quite tired don’t have the energy to sit and rock on a birth ball,’ says Marie. ‘Instead, try lying on your side. Not only does your baby get more blood flow compared to when you’re on your back, it also means you’re able to open up your pelvis fully and encourage your baby to come through ready for birth.’
Get gravity on your side and encourage your baby tomove down your birth canal bywalking up the stairs.This can really help as your body transitions from the latent phase to active labour. ‘It’s all about making sure you are as mobile as possible,’ says Marie, who suggests taking the stairs as you head into the labour ward or birth suite, if you can. ‘That rocking-ofthe-pelvis motion can help get your baby’s head right down, and put more pressure on the cervix. This in turn will help your cervix dilate.’ Get your birth partner to walk with you.
If you can’t face the stairs, simply standing, walking, or swaying will help your baby move lower. ‘Walking is a part of active birth and maintaining movement,’ says Marie. ‘One way to imagine it is if you need to get a ring off your finger you wouldn’t pull it straight off, you’d twist it slightly from side to side. You’d also manoevre your finger. It’s a very similar thing with baby’s head coming through your pelvis. Rather than expecting her to come straight out, she needs a bit of swaying and motion in order to navigate her way down through the pelvis and to come out with ease.’
Hug it out!
Placing your arms around your birth partner’s neck is a lovely, comforting labour position that will also help you breathe easier. Face your birth partner and put your arms around the back of his neck for stability. Then, if you can, move slowly together and slightly bend your knees. ‘This position helps create more space in your upper body, which will help you breathe and feel more calm,’ says Marie. ‘It’s almost like a cuddle position, and can be really comforting during labour.’
Get on all fours
Going on your hands and knees is a popular position, no matter what stage oflabour you’re in,fromthe latent phase to actually giving birth. ‘This position can be a nice release for your back,’ says Marie. ‘It also opens up the pelvis, and this helps the smallest part of the baby’s head come first, which allows the cervix to slowly stretch and open.’
Take a seat
A good labour position for when you’re tiredis sitting on a birthing ball. ‘This enables you to open up your pelvis,’ says Marie. ‘Sitting on the hospital bed can be quite uncomfortable for your lower back, bottom and perineum, as the beds are firm. A birth ball is much softer, so will be a lot more comfortable. This is also a good position if you have symphysis pubis dysfunction (SPD) , and can give you a real feeling of relief during labour by taking the pressure off your back.’ Another benefit is that you can rock slightly and encourage your baby to move lower and lower.’ Make sure the ball is the right size for you, advises Marie.
Squat with support
This position works with gravity and gets your birth partner involved. Marie says: ‘Ask him to stand behind you and hold you gently underneath your arms or, if you prefer, get him to put his arms loosely around your waist to support you. When you’re comfortable, go into a gentle squat.’ Alternatively, ask your birth partner to put his hands underneath your hands as you squat, so you’ve got something to push against. ‘That touch and connection can really help you,’ says Marie. ‘It’s about creating an environment where you feel empowered and in control. It’s a fantastic way of ensuring you feel physically and mentally supported.’ If you’re alone as you do your squat, use a table to lean on, or have your back against the wall.
If your arms get tired from being on your hands and knees, then try kneeling and use your birthing ball for support. ‘There are lots of different kneeling positions to get into,’ says Marie. ‘One that is really effective is when you kneel down with your legs open and put your arms over the top of the ball. It’s similar to being on all fours, but you’re not having to support your body as much, so you’re not using as much energy. The ball is nicely taking the weight for you. It’s quite comforting like a big hug!’.
Prop your legs up
‘Labour is like a marathon,’ says Marie. And that means pacing yourself ready for active labour this is when you are having three contractions or more in a 10-minute period and your cervix is 4cm dilated. Marie recommends conserving as much energy as possible during the latent phase. ‘A good position is lying on your side with your legs propped up and your pelvis a little bit open. This is good for you and your baby, as she receives more blood flow when you are on your side.’
Four of the best labour positions if…
You have back pain
This is incredibly common during labour, but there are lots of ways to relieve it. ‘You can minimise the pressure on your back by lying on your side or sitting on a birth ball. This means you’ll be in an upright, forward and open (UFO) position, which will be more comfortable for you,’ says Marie. ‘But listen to your body you will naturally get into different positions until you find one that is comfortable. A supported squat can also be quite nice, as there is no pressure surrounding the pelvis. The least pressure you have on your lower back when you have back pain, the better.’
You have an epidural
Having an epidural doesn’t mean you have to lie flat on the hospital bed. Marie recommends lying on your side and asking your birth partner or midwife to hold the inside of your knee with one hand and the inside of your ankle with the other. ‘They need to hold your leg just above your hip, which gives your baby a nice amount of room. I’ve witnessed some great births in this position.’
Another option is to let the epidural wear off slightly and allow a bit of sensation to return. Marie says, ‘If a woman is able to feel her legs and lift them up with ease, I put the side of the bed up, lift the back of the bed slightly, and get them onto all fours and leaning over the bed, still with the epidural and monitors. This helps them to push better; enables them to move around a bit, which is good in birth; and can also feel more empowering, because they are then having an active birth while also benefitting from pain relief.’
You are being monitored or are high risk
Keeping up momentum is important, and you can do this even if you’re being monitored. Marie says, ‘Ask your midwife to put your bed up really high. Now lean forward over it, resting your chin and forearms on the bed, so you’re in a UFO position. You can then rock and sway, and that motion helps the baby come down into the pelvis.’
Your baby is back-to-back
If your baby is in an occiput posterior (OP) position when the back of her head is against your back different positions can encourage her to turn. Marie says, ‘Avoid slouching back on a hospital bed, instead, make sure you keep your knees lower than your hips. If you’re tired, you could lie on your side with a peanut ball between your legs, to give your baby room to turn.’