Advice on the different labour positions you can try during an active birth.
In Western cultures most women expect to labour and birth lying down on their backs with their legs akimbo. While this 'cultural norm' conforms to the image of a labouring woman typically portrayed in the media, there are a range of alternate birthing positions that are actually much more beneficial for you and your baby.
By taking a more active approach to labour and moving from one position to another as your comfort dictates you are able to exert more control over your baby's passage into the world and will be better able to deal with the contractions and discomfort you are experiencing. This is because changing position during labour alters the size and shape of your pelvic opening, helping to rotate your baby into an optimum position for birth and facilitate his or her movement through the birth canal. In fact, research has shown that, in general, women who remain mobile experience more effective contractions, shorter labours and are less likely to need pain relief or any form of clinical intervention.
Some of the positions you may like to try are....
Standing up - Standing upright and moving around can be particularly beneficial in positioning your baby during the first stage of labour. Try gently walking around (making sure you take plenty of rests to conserve energy for later on) or standing still and swaying your hips to and fro or in a circle. Lean forward either against your partner (with your arms around their shoulders or hips) or against a chair or work surface during contractions as this will help you to feel supported and enable you to breathe through them. Generally any upright position helps labour to progress as gravity is able to lend a helping hand, facilitating baby's descent and increasing dilation of the cervix, it is also much easier to bear down and push effectively when in an upright position.
Sitting - Sitting upright either on a birthing ball (this allows you to continue with a comforting rocking movement), against a chair (facing forward or sitting astride) or on the toilet (this can be a good position for those who find it difficult to completely relax their pelvic floor otherwise) allows you to bear down effectively while providing you with some support.
Squatting - Leaning with your back resting against your partner or a bed or a chair (so that you can use your arms to take some of the weight) and squatting down really helps to open the pelvis and makes pushing though your contractions more effective. This position can be used to encourage the later stages of labour to progress more quickly.
Kneeling - Kneeling either on your bed or on a pile of cushions on the floor while leaning forward onto a birthing ball, your partner or a chair can provide a comfortable, supported upright position. This can feel especially good when you are experiencing very strong contractions as you can remain active and move you hips back and forth, or bear down, without putting too much pressure on the legs. Kneeling also allows for more concentrated pushing with less exposure than if you were in a squatting position.
All fours - Kneeling on all fours can be a good position to adopt if you are tired and need a break or need to slow the progression of labour. It is also a very soothing position if you are experiencing intense back ache as the weight of your baby is taken away from your spine. Some see this as the optimum position to deliver baby's head as it slows movement through the birth canal and as such reduces the risk of tearing. Leaning forward on your forearms with your bottom tilted towards the sky will help you resist the urge to push during contractions (you may be asked to do this for a number of reasons at some point during labour) as it allows gravity to work in the opposite direction for a little bit.
Lying down - There may be times during labour when you want to lie down, this is perfectly fine and you should listen to your body. However, try lying on your left hand side in the 'recovery position', resting forward with your back, upper leg and arms supported by pillows. This position is favourable to lying on your back as your pelvis still remains open allowing your baby to get more oxygen and a clear passage - your partner should lift and support your upper leg during contractions to widen the pelvic canal further.
During labour it is important that you adopt whichever position makes you feel comfortable, in control and supported. It can be best to practice these different positions with your partner in conjunction with your breathing and relaxation exercises as you progress through your pregnancy. This will help make adopting them second nature when the time comes to put them into practice.
N.b. A completely active labour is not possible if you have had an epidural or if your doctor has advised otherwise.
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