How to find the best birthing positions during labour

Hello Mumli Mamas, 

Today I’m sharing some insight into helping your baby navigate that amazing pelvis of yours. Yep, we’re talking birth positions! 

Now, we’ve ALL seen the movies. A red-faced woman lying on her back, legs akimbo, breathless and panting as a doctor crouches between her knees saying, “One more push!” But while the bed does sometimes have its place, as a midwife I can tell you it’s also worth talking about the benefits of getting OFF the bed, and the impact mobility can have on your labour.

How birthing positions can affect labour

First, a little bit of background to help us understand why position choice can play such a big role.

In order for your cervix to dilate, your baby to engage in the pelvis and your uterus to push them through the vaginal canal, you need contractions. Without them, the cervix cannot move out of the way to allow bub to pass through, and the stronger, more rhythmic those contractions are, the more effectively they can do their job. Positions play a HUGE role in making your contractions as efficient as possible. When we adopt upright positions, the weight of your baby’s head presses on the cervix with each contraction, which aids dilation and triggers a hormonal response that causes more contractions… and so the cycle continues. 

This means gravity is your friend! 

The other major reason why certain positions can improve labour is that the female coccyx (tailbone) is flexible, unlike a male coccyx, which is fixed. This allows the pelvis to expand during childbirth, allowing your small (but rather large in this moment) human to pass through. Basically, mother nature has us covered (what a doll). However, when we lay on our backs, or sit flat on our bottom, the coccyx is unable to move as intended, and the opening of the pelvis narrows. 

So, it’s no surprise that research consistently demonstrates that the use of upright positions improves the strength and regularity of contractions, helps babies adopt more optimal positions within the pelvis AND shortens the length of labor overall, including the time spent pushing. 

One study which used magnetic resonance imaging (MRI) demonstrated that in comparison to back-lying positions, the dimensions of the pelvic outlet became wider when on all fours, squatting or kneeling (Gupta et al. 2017). Another big benefit to birthing OFF your back is a reduced risk of perineal trauma. Research suggests that you’re the least likely to tear if you birth in an all-fours or side-lying position (Royal College of Obstetricians and Gynaecologist, 2021). 

With this in mind, what are some positions worth trying?

Finding the right birthing position

During labour, you may find that remaining upright and mobile not only helps things progress, but is also a great way to work with pain. You can try: 

  • Standing 
  • Standing and leaning (e.g. over a bench or against the wall) 
  • Swaying
  • Sitting on a fit ball rocking/rolling hips (the flexible nature of fit balls are preferable to sitting on a firm surface like a chair or bed) 
  • Kneeling either on the bed or a mat on the floor
  • All fours positions
  • Forward lunges

What if you have an epidural?

All is not lost! Lying on your side is a great option, as it takes pressure off your back and can allow for pelvic expansion. This can also be helpful if you’re bed-bound or are simply tired and need a rest from being upright. Either way, ask your midwife about something called the ‘peanut ball’. This nifty birth tool sits between your knees in a way that supports the pelvis to widen, even while laying down.

Your midwife is there to support you in labour and will no doubt encourage the use of movement and different positions. However if you like what you’re reading, it’s a great idea to include your intention to remain mobile in your birth plan. Remember, it’s all about what feels right for you at the time, so listen to your body and move in a way that feels good for you.

Read next: Ways to induce labour naturally: what actually works?


Expert author: Beth Ryan

Beth Ryan is a registered midwife with a Master’s degree in Public Health. You can find out more about her by following her on Instagram here.

Gupta, J. K., Sood, A., Hofmeyr, G. J., et al. (2017). “Position in the second stage of labour for women without epidural anaesthesia.” Cochrane Database Syst Rev 5: CD002006.

Royal College of Obstetricians and Gynaecologists (2021) Reducing your risk of perineal tears.

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