Common delivery scene: Woman, lying on her back, screaming, swearing and sweating profusely as she pushes her baby into the world.
Less common, but more pleasant scene: Woman, sitting up, silent, serene and sweating profusely as she breathes her baby into the world.
Why is the first scene – far less pleasant than the second – the more common one, the one always pictured in movies and TV shows? After all, there is more than one way to give birth, ways that are far more comfortable and relaxing for mother and baby. Lying on your back in labour may seem like the most obvious position; however, taking this position can cause contractions to slow down and become more painful, and, as your body is working against gravity, to make your labour a lot longer than necessary.
Assuming your personal choice and circumstances allow for a natural labour, there are five main positions you might consider.
“ After all, there is more than one way to give birth, ways that are far more comfortable and relaxing for mother and baby. ”
When you’re in labour, think of gravity and the man who got you into this situation as your best friends. Choose a position that allows gravity and your partner to help and support you through what can be one of your most amazing experiences ever. Try standing up. When you stand, gravity encourages labour to progress by easing your baby’s head down into the cervix and then into the pelvis. Contractions are said to be more manageable and less painful as a result. The upright position also allows your partner to help you with your labour, be it by massaging your back, allowing you to lean on him for support and comfort, or breathing with you through your contractions.
Take a walk
Walking during the early stages of labour is beneficial to both mother and baby. Not only does it allow you to feel more in control, but the movement also helps your baby pass more comfortably through your pelvis.
As labour progresses, walking may become increasingly difficult. But it is still possible to remain standing, with your partner’s support, and rhythmically rock back and forth.
Sitting down – on a birth ball, facing the tank on the toilet, or on the edge of the bed – allows gravity to play its part whilst allowing you to relax. Your weight is supported without too much pressure being placed on your perineum, and rocking back and forth or in a circular motion whilst sitting encourages baby to find a comfortable way through the pelvis. Again, these upright positions allow your partner to massage your back with each contraction.
Squatting is a fantastic position to help open up the pelvis. This is not the easiest of positions, so you need your birthing partner to hold and support you for this one.
Get on all fours
Down on your hands and knees, or elbows and knees, allows your pelvis to expand and prevents excessive pressure on the perineum. This position is ideal if your baby is in a posterior position and your back is aching. It reduces pressure on your spine and, combined with rocking back and forth, may help get your baby into a better position for birth. This is also a good position for delivery as it allows your baby to emerge gently, reducing the risk of tearing. Once again, this position allows your birthing partner to massage your back and provide comfort.
Rest on your side
There may come a point when you just want to get into bed and lie down, especially during a long labour. It is preferable to use one or a combination of the above positions in the early stages of labour to allow your trusted friend, gravity, to help you. Lying down, preferably on your side to avoid the disadvantages of the horizontal position, is a comforting position to be in when you’re tired or in active labour.
Lying on your side also reduces pain and discomfort by limiting the amount of pressure on your perineum, and allows your partner to massage and comfort you.
Your ability to change positions and find one or a combination that work best for you are dependent on many factors, including your choice to have an epidural and how your labour is progressing. Speak to your midwife to establish your options based on your individual circumstances.
Hulda Thorey, co-owner of maternity and early childhood organisation Annerley, is a midwife who offers antenatal clinics and classes and breathing classes, and helps prepare couples for their birth.
“One of the biggest challenges you come across when choosing a position is the fact that, in hospitals, it has long been traditional to expect women to lie/half-sit in bed when giving birth. This is partly because it is easier for the midwives and obstetricians to see the perineum and manage the actual birth,” Hulda says.
She continues, “Nowadays, this is slowly becoming an unacceptable demand since research shows that this does not always improve the quality of the birth, or give any better birth outcomes. So, slowly, the choices of positions are becoming slightly more available. But women’s biggest challenge to finding a good position for birth is still, in my opinion, the professional staff’s resistance in supporting them to do so. If you intend to use any of the positions that make sense to your body and may aid the process of normal birthing, you will have to lead this yourself and be very well-prepared before going into labour. This way, you will have the confidence to follow your own body’s lead, instead of expecting others to tell you what to do.”
She concludes, “Having said this, there are a few doctors and midwives who are happy to assist and support different positions and movement during labour and this all comes down to communicating with them beforehand as well as while you are in labour.”