In my experience, the closer you are to the end of your pregnancy the more you think about childbirth and how you'll make it through relatively unscathed. Thankfully, there are birthing class, online resources, and knowledgable health care providers to help us moms figure out how we want to experience childbirth and which way is best for us. That's why it's helpful to be knowledgable about the best positions for labor, regardless of whether or not you actually use them.
According to the American College of Obstetricians and Gynecologists (ACOG), research shows that each labor position has its pros and cons. For instance, a Cochrane review of studies including 5,218 women showed that most women benefit from an upright labor position and staying mobile during the first stage of labor. Standing and moving around seems to help your baby move into position, help with pain, and even shorten the duration of labor. When it comes to pushing, however, another meta-analysis showed that the lateral position, or side-lying, reduced the risk of perineal tearing, especially when compared to upright positions like standing, squatting, or sitting.
For most pregnant people there is no one position for labor that's truly the best, per se, and so it might be a good idea to try different positions during the course of your labor and delivery if you can. According to the ACOG, it's best if you see what works for you during labor and delivery and adjust accordingly. So with that in mind, and because knowledge really is power especially when you're bringing another human being into the world, here are the best positions for labor and delivery, according to the experts:
Many women choose to labor in an upright position — like kneeling, standing, or swaying — to let gravity do it's thing to help baby move into position. According to ACOG, a standing position can shorten labor by about an hour and 22 minutes. On the downside, however, is that upright positions can carry a greater risk of tearing for those people who choose to push in that position.
According to the University of Minnesota, some hospitals and birth centers even have accessories like birthing bars and stools to help pregnant women keep their balance while laboring upright. Of course, you can can also lean on your birth support person, partner, or doula for support... literally.
According to the Mayo Clinic, squatting can help ease labor pain in the first stage of labor by opening your pelvis to make room for your baby. You can squat on the bed, next to the wall, on a birthing ball, or even on the toilet. And, like other upright positions, it can help your baby descend towards the birth canal, too.
According to the Mayo Clinic, if you are tired during labor or need a break between pushes, lying on your left side is a good choice. ACOG notes that this labor position is also associated with less risk of perineal tearing during pushing. And since it doesn't involve walking, it's a great choice for women who get an epidural.
I have to admit that I thought my labor and delivery nurse was joking when she suggested I do lunges in the hallway during labor. But, according to the Mayo Clinic, lunges can be helpful in the first stage of labor to help your baby move into your birth canal and even rotate their position in your uterus to ease back labor pain.
Hands & Knees
According to University of Minnesota, getting on your hands and knees is another great choice for moms-to-be experiencing back labor. This position moves the weight of your baby away from your spine and eases pressure on your hips and lower back. Try kneeling on a mat or even on your bed and lean forward to expand your pelvis and create more room for your baby's descent. If you get tired, the Mayo Clinic suggests you try resting your upper body on a pillow or exercise ball.
More Than One Position
According to the ACOG, there's no such thing as one single "best" position for labor. Instead, most pregnant people will end up trying a variety of different positions to make it through labor and delivery. While a supine position — think reclined back with your feet in stirrups — used to be the norm for laboring women, most providers now discourage this position, as it is associated with increased risk of your or your baby's heart rate dropping. Instead, most providers will encourage women to try more than one position to find what works for them.