11 Common Labor Positions: the Pros and Cons
By Paulina G. Perez, RN, BSN, CD
Research shows that moving freely in labor improves your sense of control, decreases the need for pain medication, and may reduce the length of your labor.
Download the 8 Key Labor Positions Proven to Help Labor Progress infographic and pack it in your hospital bag or save it on your phone.
Maintaining Freedom of Movement
Movement and positioning in labor work magic. Movement enhances comfort by stimulating the receptors in the brain that decrease pain perception. 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.
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.
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.
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
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
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
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
- 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
- Works 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 labor 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 labor 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
Checklist for place of birth
- Safe place to walk
- Smart phone or 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
- Policy for respecting women’s choices for labor support