When women give birth in the movies, they are generally portrayed one way: lying down, in bed. But research shows that moving freely in labor improves a woman's sense of control, decreases her need for pain medication, and may reduce the length of her labor. Sometimes it is hard to move in labor due to routine procedures or lack of support and space. A recent US study found that 71 percent of laboring women did not walk at all during active labor. Instead, women often labor in bed propped up with pillows. Many women who have labored this way say next time they want to be more upright. This following list provides steps you can take to increase the chance that you will be able to maintain freedom of movement during labor.
- Choose a care provider and your birth place carefully to make sure you will be encouraged and supported to move and change positions. Find a care provider who will support you in choosing the positions that work best for you. When choosing a birth setting, look for birth balls, rocking chairs, squatting bars, and tubs.
- No matter where you give birth, stay home until you are in active labor, when contractions are five minutes apart and last about one minute. If your cervix is not dilated more than 4 centimeters when you arrive at your birth setting, consider going home or for a walk until your cervix dilates more. It's often easier to move and respond to your labor at home. You can rock, slowdance, walk, or sit on your birth ball. Listen to your body and rest when needed.
- Once at the birth setting, request that your care provider not use any unnecessary intervention that may make it harder to move around. This will mean that continuous monitoring of the baby's heart rate (continuous EFM) and intravenous lines (IVs), are only used when needed for medical reasons. If there is a medical reason for these, tell your care provider that you want to maintain as much freedom of movement as possible. There may be ways to minimize the effect of these interventions on your ability to move freely.
- Arrange to have continuous support in labor from a professional labor assistant (a doula) or a close friend or family member who makes you feel safe and confident. Ask them to remind you to try different positions or activities in labor.
- Consider the impact that pain medications will have on your ability to freely move during labor. All pain medications make it hard to stand or walk in labor. It is usually impossible when an epidural is used. You may hear about a walking epidural but this usually just allows you to move your legs in bed or walk short distances. Pain medications often lead to the need for other interventions, such as IVs and continuous electronic fetal monitoring, which restrict movement. Choose to birth at a place that provides easy access to a tub. Using water in labor decreases the need for pain medication. If you want an epidural in labor as a pain coping technique, wait until labor has progressed and you have already used lots of movement to help the baby rotate and move down in the pelvis. Encourage your support team to learn about ways to support a woman with an epidural and encourage movement compatible with epidural use.
- Attend a childbirth class that focuses on active labor, giving you and your partner plenty of movement and position options. Keep a list of the positions that you like best and bring it with you as a reminder in labor. Practice positions and movements before your labor begins, so you and your partner feel comfortable and confident using them.
Quick checklist for place of birth
- Safe place to walk
- iPod, smart phone, other MP3 player for dancing music
- A tub
- Birth ball
- Rocking chair
- Squatting bar
- Telemetry (portable device used for continuous fetal monitoring)
- Policy for intermittent auscultation (heart rate monitoring)
- Policy for respecting women's choices for labor support
For more information on the importance of maintaining movement during labor, check out the Lamaze Health Birth Practice video all about walking, moving, and changing positions during labor.