Advantages and disadvantages of various positions you might try during childbirth.
Fortunately we've left behind the days of the laboring-on-her-back, heavily sedated mother-to-be, totally dissociated from the natural workings of her own body and missing out on the joy of giving birth.
Today women can learn how to use their bodies to minimize discomfort and speed the progress of labor. Trying a variety of positions during labor and birth can help you to find what works best for you. Here is what you need to know about the various labor and birth positions.
Standing
Walking
Sitting
Sitting on Toilet
Semi-Sitting
Lithotomy
Side-Lying
Leaning
Kneeling, Leaning Forward with Support
Squatting
Hands and Knees
Standing
Advantages
Excellent for oxygenation of fetus
Uses gravity
Contractions are more effective and less painful
Helps speed up labor
Helps create pushing urge
Disadvantages
Poor control of delivery
Visualization very hard for birth attendant
Walking
Advantages
Uses gravity
Contractions often less painful
Encourages uterine contractility
Baby well-aligned in pelvis
May speed up labor
Reduces backache
Encourages descent
Disadvantages
Often mother can't use if she has high blood pressure
Can't be used with continuous electronic fetal monitoring
Sitting
Advantages
Good for resting
Uses gravity
Can be used with continuous electronic monitoring
Can be used with birth ball to encourage descent
Disadvantages
Possibly can't be used if mother has high blood pressure
Sitting on Toilet
Advantages
Helps relax perineum
Mother accustomed to open-leg position and pelvic pressure in this environment
Uses gravity
Disadvantages
Pressure from toilet seat can cause pain
Semi-Sitting
Advantages
Comfortable for mother
Good use of gravity
Good resting position
Works well in hospital beds
Good visibility at delivery for mom, dad and others present
Good access to FHTs (Fetal Heart Tones)
Disadvantages
Access to perineum can be poor
Mobility of coccyx is impaired
Some stress on perineum, but less than lithotomy
Lithotomy
(on back, legs raised -- avoid this position!)
Disadvantages
Compression of all major vessels
Laceration or need for episiotomy is more likely
No use of gravity to aid delivery
Side-Lying
Advantages
Good fetal oxygenation
Good resting position for mother
Helpful if mother has elevated blood pressure
Useful if mother has epidural anesthesia
Often makes contractions more effective
May promote progress of labor
Easier for mom to relax between contractions during second stage
Allows posterior sacral movement in second stage
Can slow precipitous delivery
Partner may need to support leg
Partner can assist in delivery
Lowers chance of laceration or need for episiotomy
Access to perineum is excellent
Disadvantages
Access to FHTs poor if mother is lying on same side as baby’s back
No help from gravity
Mother must support her leg under knee if no one is there to hold leg
Mother may feel too passive
Leaning
Advantages
Great for rotation of posterior presentation
Uses gravity
Contractions often less painful
Contractions often more productive
Baby is well-aligned in pelvis
Relieves backache
Facilitates use of back pressure
May be more restful than standing
Disadvantages
Hard for attendant if used at delivery
Kneeling, Leaning Forward with Support
Advantages
Helpful with persistent posterior presentation
Assists rotation of baby
Good for pelvic rocking
Good for use with birth ball
Less strain on wrists and arms
Squatting
Advantages
Encourages rapid descent
Uses gravity
May increase rotation of baby
Allows freedom to shift weight for comfort
Excellent for access to the perineum
Excellent for fetal circulation
May increase pelvis diameter by as much as two centimeters
Requires less bearing-down effort
Upper trunk presses on fundus to encourage descent
Thighs keep baby well-aligned
Disadvantages
Often tiring to mother
Sometimes hard to hear FHTs
May be hard for mother to assist
Hands and Knees
Advantages
Good for bradycardia (low heart tones)
Good for back labor
Useful with birth ball
Assists with rotation of posterior presentation
Takes pressure off hemorrhoids
Best position to avoid laceration or need for episiotomy
Good delivery position for large baby
Excellent for shoulder dystocia
Disadvantages
Hard to maintain eye contact with mother
Hard for mother to see
Baby must be passed through mother’s legs
Can be disorienting to inexperienced attendant.
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