Why not labour in bed?
It is only usual for women to labour and give birth lying down in the affluent countries of the West. If you think about it, lying down really doesn't make much sense. If the mother is upright, gravity pushes the baby's head down onto the cervix (neck of the womb) to help the cervix dilate and then assists the baby's progress through the pelvis. And many women find that lying down, even for just a few minutes while you have an internal examination, can be very uncomfortable. Research, though limited, has shown that women who remain mobile during labour have shorter labours and fewer drugs for pain relief than those who take to their beds.
Best positions for labour
When your labour starts, you'll probably feel quite restless. You'll want to be moving around and keeping busy. Just take care that you don't get over-tired before your labour is properly underway. Make yourself have little rests, in a chair or lying down. If your contractions start at night, try to stay in bed and relax for as long as possible. As contractions get stronger, you'll need to concentrate on them, focussing on what is happening to your body and your baby, and practising your breathing and relaxation exercises. Now is the time to choose a position that you find best helps you to cope with your contractions. You could: • Lean onto a work surface or the back of a chair • Put your arms round your partner's neck or waist and lean on him/her • Lean onto the bed in the delivery room (with the height adjusted for your comfort) or a window-sill • Kneel on a large cushion or pillow on the floor and lean forwards onto the seat of a chair • Sit astride a chair, resting on a pillow placed across the top • Sit on the toilet, leaning forwards, or sit astride, leaning onto the cistern • Go onto all fours • Kneel on one leg with the other bent. Don't forget to rock your hips backwards and forwards or in a circle to help your baby through your pelvis and to comfort yourself.
Changing position
All of these are useful positions for making your contractions efficient, and helping you feel in control. If you find you want to change position as your labour progresses, you may need to ask your birth companion and/or midwife to help you. Their job is to keep you mobile and make you comfy with pillows and cushions wherever you choose to be. When you are in very strong labour, you will probably find that you don't want to move around a great deal. You'll need all your strength simply to cope with each contraction as it comes along. Don't worry: you will naturally find the position that suits you best. Just keep rocking, leaning forwards during contractions and straightening up in between. If you feel it helps you cope, ask your birth companion or midwife to massage your back with each contraction. If you get really tired and bed seems like the best place to be, lie down on your left hand side - rather than propped up on your back, which stops your pelvis being able to open effectively. Lying on your left side is much better for your baby than lying on your back because he gets more oxygen, and the contractions are still effective in this position. If you feel rested after a little while, push yourself up with your hands into a sitting position and get up again.
It is only usual for women to labour and give birth lying down in the affluent countries of the West. If you think about it, lying down really doesn't make much sense. If the mother is upright, gravity pushes the baby's head down onto the cervix (neck of the womb) to help the cervix dilate and then assists the baby's progress through the pelvis. And many women find that lying down, even for just a few minutes while you have an internal examination, can be very uncomfortable. Research, though limited, has shown that women who remain mobile during labour have shorter labours and fewer drugs for pain relief than those who take to their beds.
Best positions for labour
When your labour starts, you'll probably feel quite restless. You'll want to be moving around and keeping busy. Just take care that you don't get over-tired before your labour is properly underway. Make yourself have little rests, in a chair or lying down. If your contractions start at night, try to stay in bed and relax for as long as possible. As contractions get stronger, you'll need to concentrate on them, focussing on what is happening to your body and your baby, and practising your breathing and relaxation exercises. Now is the time to choose a position that you find best helps you to cope with your contractions. You could: • Lean onto a work surface or the back of a chair • Put your arms round your partner's neck or waist and lean on him/her • Lean onto the bed in the delivery room (with the height adjusted for your comfort) or a window-sill • Kneel on a large cushion or pillow on the floor and lean forwards onto the seat of a chair • Sit astride a chair, resting on a pillow placed across the top • Sit on the toilet, leaning forwards, or sit astride, leaning onto the cistern • Go onto all fours • Kneel on one leg with the other bent. Don't forget to rock your hips backwards and forwards or in a circle to help your baby through your pelvis and to comfort yourself.
Changing position
All of these are useful positions for making your contractions efficient, and helping you feel in control. If you find you want to change position as your labour progresses, you may need to ask your birth companion and/or midwife to help you. Their job is to keep you mobile and make you comfy with pillows and cushions wherever you choose to be. When you are in very strong labour, you will probably find that you don't want to move around a great deal. You'll need all your strength simply to cope with each contraction as it comes along. Don't worry: you will naturally find the position that suits you best. Just keep rocking, leaning forwards during contractions and straightening up in between. If you feel it helps you cope, ask your birth companion or midwife to massage your back with each contraction. If you get really tired and bed seems like the best place to be, lie down on your left hand side - rather than propped up on your back, which stops your pelvis being able to open effectively. Lying on your left side is much better for your baby than lying on your back because he gets more oxygen, and the contractions are still effective in this position. If you feel rested after a little while, push yourself up with your hands into a sitting position and get up again.
Positions for backache labours
If you have backache in between as well as during contractions, your baby might be in a posterior position. You'll find labour very hard to cope with unless you get the weight of the baby off your spine. To do this, take up an all-fours position with pillows under your knees and hands to keep yourself comfortable. If you find that the blood is rushing to your head, try resting your head, shoulders and forearms on a birth ball so that your head isn't hanging down. (Go to the Active Birth Centre website for more details).
Positions for pushing
Your baby will find it easier to be born if you are in an upright position because you will be able to bear down more efficiently. The combination of the muscular action of the womb, your pushing efforts and gravity is a powerful one. If the midwife prefers you to give birth on the bed, kneel on the mattress and lean against a large pile of pillows placed at the top end. Or put your arms round your partner's neck as he stands at the bedside. If your midwife is happy for you to give birth on the floor, try kneeling. When the time comes for your baby's head to be born, all fours is an excellent position. Because gravity is not so effective in this position, your baby's head is able to emerge very gently from the vagina, reducing your risk of tearing. The squatting position has also been shown to increase the outlet through the pelvis compared to lying in a supine position, so it is a good one to try if you have been pushing for a while without much progress.
What about birthing stools?
A birthing chair or stool does help you to keep upright while you're pushing. They've certainly been used for centuries in all parts of the world. Some research shows that they tend to lead to the mother losing more blood, perhaps because the pressure from the chair on her bottom and thighs makes the blood pool there. However, other experts think the apparently increased blood loss is simply due to the fact that it's easier to collect and measure the blood when the woman is sitting on a stool!.
Positions for not pushing
Just occasionally, the neck of the womb doesn't open up evenly, leaving a "lip" of cervix round your baby's head. You may feel ready to push but your midwife will ask you not to until your cervix is fully dilated. It can be incredibly difficult not to push when nature is telling you to. Try going into a knee-chest position with your face on the floor and your bottom in the air and "panting" through your contractions. It's not elegant, but it does tip the baby off the cervix and should reduce your desire to push. If you simply have to push - go for it! There isn't any research to say that if you really feel you have to push, you shouldn't do so.
What if I have an epidural?
You'll have to stay in bed if the epidural has made you completely numb from the waist downwards. If you have some sensation left and can still move around a little, try sitting in a chair with your knees wide apart and leaning forward with every contraction. If you have to stay in bed, make sure that you have sufficient pillows in the small of your back to push you over onto your side. When you're ready to push, stay on your left side and ask your partner to hold your top leg up with each contraction. Avoid lying flat on your back - in this position, your baby's oxygen supply is reduced.
Birth PositionsWe are going to cover some of the birth positions you might want to try during labor. One of the most common positions is the semi-sitting position. If you are giving birth at a hospital this may be the only position that will be suggested to you; however, there are many different positions you can try. Be sure to let your doctor or hospital staff know if you would like to try your own birth positions.
Here are some common birth positions.
- Semi-sitting: The semi-sitting position is a comfortable position for mom. There is some use of gravity with this position. It is a convenient position for hospital staff and can be used in a hospital bed. This is also a good position for moms that have an epidural.
Lithotomy position: This position, not as popular as it used to be, has mom lying on her back with her buttocks close to the edge of the bed and her legs in stirrups. - The lithotomy position used to be the standard position for childbirth and in some hospitals it still is. However, this is not the best position for giving birth. Mom is working against gravity. Tearing is more common, as well as the need for episiotomies. Also with mom lying on her back all of the major blood vessels are compressed. As you know from earlier in your pregnancy, lying on your back for too long can decrease circulation to your heart and baby.
- Standing or leaning: Standing or leaning position uses gravity to help baby descend in the birth canal. Using this position along with walking may help speed up labor. Leaning against something may make this position more comfortable. You can also have your partner massage your back using this position which may help ease some of the pain or comfort you during contractions. This position may be more challenging for hospital staff. Because you are standing, it is difficult to check your progress or to see baby’s head crowning, for example. If you are giving birth at a hospital, your doctor or midwife may prefer this position for labor but not for actual birth.
- Sitting or sitting backwards in a chair: Sitting, sitting backwards, or sitting on the toilet can be good positions to use during labor. The sitting position works with gravity and is comfortable for mom. Sitting on the toilet is also good. Sitting on the toilet is familiar to mom and may feel more natural to mom. Mom can also use a birth ball in this position and her partner can massage her back to help comfort her while she is sitting.
- Squatting: Squatting also uses gravity. Squatting is a natural position and it helps to open your pelvis as you squat. With your pelvis more open, it may be easier to push baby out. Squatting requires some balance and may be easier to do with support. If you get tired using this position you can rotate to the leaning/standing position to rest.
- Kneeling on all fours: This position is comfortable for mom. This position is good for back labor as it takes pressure off of your back. You may also be moved to this position if your baby has bradycardia (low heart rate) because this position increases placental and umbilical blood flow. This is also a good position for delivering a big baby
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