Birth positions

Childbirth involves several phases during which the contractions differ in nature. The contractions can be extremely painful and you may have to use trial and error to find the most comfortable position for you. Upright positions are particularly good, because gravity can help the baby work their way down through the tight, slightly curved birth canal. Not sitting still and changing positions regularly can be a great help along the way.

Which position is best for giving birth?

No single position is better than any other, because we are all different. But in general, upright positions make it easier for the baby on their journey, as does changing between a few different positions. Your midwife will also be very helpful here – midwives are familiar with all the different positions, and will encourage you to change often, and know how a position will impact your baby’s journey into the world. Ask questions and ask for help!

Common positions that you might change between include: (H2)

• Walking, standing or leaning against a person, wall, or chair.
• Walking quickly with a walker.
• Sitting on a ball and rocking your pelvis.
• Sitting on a birthing stool.
• Being on all fours, sitting up, lying on your side, or leaning over a pouf, a bed, or a chair.
• Placing your hands on your hips, bending slightly forward and rocking back and forth through the contractions.
• Taking a shower or bath during a contraction. Some maternity wards have baths with water at a comfy temperature. The heat can help you relax and can move the process along. Your stress hormones fall – which also has a good pain-relieving effect during the contractions.

Let gravity help you out during labour!

There are several recognised benefits to maintaining an upright position for much of a contraction:

• The work of the uterus is more effective.
• It releases endorphins, the body’s own morphine, making pain easier to handle.
• Breathing is easier, which provides more oxygen to both mother and baby.
• It gives you more power and prevents the formation of lactic acid.
• Reduced risks of nausea and a drop in blood pressure.
•  It enhances your sense of control over what’s going on.

Think about being heavy, soft and malleable – like a ragdoll – during the active phase. Being in motion makes it easier for the baby, which is working down into the pelvis.

Birth positions that reduce the risk of tearing

In the next phase, the pushing phase, the midwife will probably recommend an upright position in which it is possible to monitor the perineum to avoid tearing. But how you give birth is up to you: standing, squatting, or another choice. Let your midwife guide you and try to see what feels good. Different positions create different conditions: being on your knees, on all fours, on your side, or on a birthing stool all permit mobility in your pelvis and can offer a more controlled pushing phase.

It is always important for the midwife to have a good view during the last phase, as the baby’s head starts to appear, to assess whether the process is moving too quickly – you don’t have to rush to push out the entire baby in one contraction. Instead, birth the head first, and then – during the next contraction or in between contractions – to the rest of the body. The risk of vaginal tearing can be reduced with birth positions that give the midwife a good view, control, and the ability to guide and offer manual perineal protection, with one hand on the perineum and one on the baby’s head. This often leads to a calmer, more controlled birthing process.

If you need vacuum extraction to help at the end, the midwife will make sure you are in a good position for the midwife and doctor to help the baby come out as smoothly as possible while avoiding significant tearing. And as we said, let the midwife give suggestions and guide you, in case a position doesn’t quite feel good or natural.

Please note that all information above is based on Swedish recommendations.