Labor Positions

Labor Positions

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Position Statement

The pros and cons of 11 common labor positions

By Paulina G. Perez, RN, BSN, CD, LCCE, FACCELabor Positions

Movement and positioning in labor work magic. Movement enhances comfort by stimulating the receptors in the brain that decrease pain perception. The result is that you are able to tolerate increasingly strong contractions. When contractions become very strong, endorphins are released and pain perception decreases even more. Ultimately, your movement in response to your contractions decreases pain and facilitates labor – a win-win. Movement also helps the baby move through the pelvis, and some positions enlarge pelvic diameters.

The positions shown here facilitate the normal, natural process of labor. What position should you use? Follow your body. Move freely in response to what you feel. Your body will let you know just what position is best at every point in your labor.

STANDING SUPPORTED SQUAT

Pros

  • Realigns your pelvis to increase the opening by up to 15 percent
  • Allows you to be supported by your standing or sitting partner, the wall or a squat bar
  • Takes advantage of gravity
  • Makes contractions feel less painful and more productive
  • Lengthens your trunk and helps your baby line up with the angle of your pelvis
  • Movement causes changes in your pelvic joints, helping your baby through the birth canal
  • May increase your urge to push in the second stage of labor

Cons

  • Requires a strong partner
  • May be tiring for both of you
  • Possible increased blood loss

SITTING ON TOILET

Pros

  • Helps relax perineum
  • You get used to an open-leg position and pelvic pressure
  • Uses gravity

Cons

  • Pressure from toilet seat may be uncomfortable

SITTING

Pros

  • Good for resting
  • Uses gravity
  • Can be used with continuous electronic fetal monitoring

Cons

  • May not be possible if you have high blood pressure

WALKING

Pros

  • Uses gravity
  • Contractions are often less painful
  • Baby is well aligned in your pelvis
  • May speed labor
  • Reduces backache
  • Encourages descent

Cons

  • Not recommended if you have high blood pressure
  • Can only be used with continuous electronic fetal monitoring if telemetry unit is available 

SQUATTING

Pros

  • Encourages rapid descent
  • Uses gravity
  • May increase rotation of baby
  • Allows freedom to shift your weight for comfort
  • Allows excellent perineal access
  • Excellent for fetal circulation
  • May increase pelvis diameter by as much as 2 centimeters
  • Requires less bearing-down effort 
  • Descent is encouraged by the position
  • Your thighs keep baby well aligned

Cons

  • Often tiring
  • Sometimes hard for health-care provider to hear fetal heart tones
  • May be hard for you to assist in birth if you wish to do so
  • Possible increased blood loss

SIDE-LYING

Pros

  • Helps get oxygen to the baby
  • Good resting position
  • Helpful if you have elevated blood pressure
  • Fine with epidural
  • Can make contractions more effective
  • Easier for you to relax between contractions during the second stage
  • Can slow a birth that’s moving too fast
  • Your partner can assist in the birth by supporting your legs
  • Lowers chances of tearing or the need for episiotomy
  • Good access to perineum

Cons

  • May be hard for health-care provider to access fetal heart tones
  • No help from gravity
  • If no one can hold your legs, you must support them on your own
  • You may feel too passive in this position

STANDING

Pros

  • Uses gravity
  • Helps get oxygen to the baby
  • Contractions are more effective and less painful
  • May speed labor
  • Helps create a pushing urge

Cons

  • Poor control at birth
  • Hard for health-care provider to see the baby

LEANING OR KNEELING FORWARD WITH SUPPORT

Pros

  • Can help shift the baby if needed
  • Uses gravity
  • Birth ball can be used
  • Contractions are often less painful and more productive
  • Baby is well aligned in your pelvis
  • Relieves backache
  • Easier for your partner to help relieve your back pain
  • May be more restful than standing
  • Good for pelvic rocking
  • Less strain on your wrists and arms

Cons

  • Hard for health-care provider to help with birth

KNEE-CHEST

Pros

  • Good for back labor
  • Assists with rotation of baby, if needed
  • Takes pressure off hemorrhoids
  • Good position to avoid tearing or episiotomy
  • Good delivery position for large baby
  • Helpful if fetal heart tones are low

Cons

  • Hard for your support team to maintain eye contact with you
  • Hard for you to see what’s going on

SEMI-SITTING

Pros

  • Comfortable
  • Good use of gravity
  • Good resting position
  • Works well in hospital beds
  • Good visibility at birth for your support team
  • Easy access to fetal heart tones for your health-care provider

Cons

  • Access to your perineum can be poor
  • Mobility of your coccyx is impaired
  • Puts some stress on your perineum but less than when lying on your back

ON BACK WITH LEGS RAISED

Cons

  • Works against gravity
  • Compresses all major vessels
  • Episiotomy is more likely
  • Makes the pelvic outlet smaller
  • Greater risk of instrument-assisted delivery

Additional important information:

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