What are my options for positions when I give birth?

There's no rule that says you must give birth lying flat on your back in a bed. You can choose to move around and into different positions throughout your baby's birth. It's your choice. Birthing positions can help you to feel in control, reduce pain and open your pelvis to help the baby come out.

You can choose the birth position that makes you most comfortable, unless there is a medical reason not to. Many people find positions naturally during their labour and birth. You may also practise some of them before you have your baby.

It is a good idea to walk, move and change positions frequently during the various stages of labour.

What positions can I use for stage 1 of labour?

Early labour

During the first stage of labour, your cervix gets thinner and dilates (opens up) to about 3cm. You may still be at home and choose to stand in the shower, sit in the bath, walk around or find another position that's comfortable for you.

Lying on your back is generally not advised in the first stage of labour because it can reduce blood supply to your baby. It could also lead to a longer labour. You can, however, rest during this early phase to conserve your energy. Choose a comfy position lying on your side or sitting with your feet up.

Keep moving and changing positions to prevent tiredness and ensure your muscles don't get too sore. You may find yourself standing upright or bent over while rocking and swaying. This is sometimes called the 'dance of labour'. This can help both you and your baby by:

• easing reducing pressure on the your pelvic area and
• encouraging your the baby to move into the correct position in the your pelvis.

Active labour

As you move into established, also known as active labour, your cervix dilates from 3cm to 10 cm. Your contractions will become more frequent and stronger.

Your maternity team will encourage you to choose your own positions during this phase of labour. They may make suggestions to help you. An upright position has many benefits, including:

• allowing your baby to move down and into the right position
• bringing on stronger contractions and potentially a shorter labour
• decreasing your need for an epidural
• giving you less severe pain or backache
• reducing the likelihood of a forceps or vacuum-assisted birth
• decreasing the chance of problems with the baby's heart rate
• helping to open your pelvis for the next stage

Here are some positions you can choose:

• kneeling, using a chair or birthing ball (yoga, or 'fit' ball) for support
• swaying or walking and holding a support person during contractions
• standing and moving in the shower to help reduce pain
• sitting or kneeling in a bath, to reduce pain and make you light, making it easier to change positions
• squatting, using a birthing stool, ball or squatting bar; this can help the flow of oxygen to your baby, reduce back pain and move the baby correctly into position
• sitting and rocking on a chair or edge of the bed
• sitting backwards on a chair, with arms resting on the chair-back
• leaning forward over the bed
• sitting on a chair leaning forward
• lunging with one foot up on a chair or footstool
• kneeling on hands and knees to help reduce back pain

If you want, your birth partner can massage you, help guide your breathing, and support you while you are in these positions.

What positions can I use for stage 2 of labour?

The second stage is when your cervix is fully dilated. This is when you push during contractions so your baby can move down and out of your vagina.

Maintaining an upright position can open your pelvis and make it more comfortable for you to push. It can also help angle or tilt the pelvis to help your baby come down and lead to a faster birth.

If you are in bed, you can still kneel or go on all fours. You can also try sitting, semi-lying down on the bed, or lying on your side with your top leg bent.

If your baby is positioned facing your back (posterior) or halfway between your back or front (lateral), being on your hands and knees can help, particularly with back pain.

What might stop me from moving or choosing my own positions?

There are a number of reasons why you may not be able to move around when you are in labour, including if you or your baby need to be monitored or you are having an assisted delivery.

• An epidural usually makes your legs feel heavy and numb so you will need to lie on the bed. However, new mobile, or 'walking', epidurals are now available to allow you to get up and move. You will need to check whether your hospital provides this.
• An electronic monitor may be placed around your abdomen to check the baby's heart rate and this may restrict your movement. Ask if your birthing facility has a mobile monitor, which will let you move around.
• If forceps or a ventouse (vacuum) is used to help your baby out of your vagina, you will need to lie on your back. You will also need to lie down for a vaginal examination or episiotomy.

How can I practise using positions for labour and birth?

It’s a good idea to practice the positions that you think you might like to use during your labour and birth. You can do this by:

• Joining an antenatal class.
• Searching for images and videos on the internet and practising at home.