Pros and Cons of 11 Common Labor Positions

By Paulina G. Perez, RN, BSN, CD, LCCE, FACCEMovement and positioning in labor work magic. Movement enhances comfort by stimulating the receptors in the brain that decrease pain perception. The result is that you are able to tolerate increasingly strong contractions. When contractions become very strong, endorphins are released and pain perception decreases even more. Ultimately, your movement in response to your contractions decreases pain and facilitates labor  a win-win. Movement also helps the baby move through the pelvis, and some positions enlarge pelvic diameters.The positions shown here facilitate the normal, natural process of labor. What position should you use? Follow your body. Move freely in response to what you feel. Your body will let you know just what position is best at every point in your labor..

Standing Supported SquatSTANDING SUPPORTED SQUAT

Pros  Realigns your pelvis to increase the opening by up to 15 percentAllows you to be supported by your standing or sitting partner, the wall or a squat barTakes advantage of gravityMakes contractions feel less painful and more productiveLengthens your trunk and helps your baby line up with the angle of your pelvisMovement causes changes in your pelvic joints, helping your baby through the birth canalMay increase your urge to push in the second stage of labor  Cons  Requires a strong partner  May be tiring for both of you  ..

SITTING ON TOILET

ProsHelps relax perineumYou get used to an open-leg position and pelvic pressureUses gravity  ConsPressure from toilet seat may be uncomfortable ..

SittingSittingSITTING 
ProsGood for restingUses gravityCan be used with continuous electronic fetal monitoring  

ConsMay not be possible if you have high blood pressure   ...

SQUATTINGSquatting
ProsEncourages rapid descentUses gravityMay increase rotation of babyAllows freedom to shift your weight for comfortAllows excellent perineal accessExcellent for fetal circulationMay increase pelvis diameter by as much as 2 centimetersRequires less bearing-down effortDescent is encouraged by the positionYour thighs keep baby well aligned  

ConsOften tiringSquattingSometimes hard for health-care provider to hear fetal heart tonesMay be hard for you to assist in birth if you wish to do so...

SIDE-LYING

ProsHelps get oxygen to the babyGood resting positionHelpful if you have elevated blood pressureFine with epiduralCan make contractions more effectiveEasier for you to relax between contractions during the second stageSide LyingCan slow a birth that's moving too fastYour partner can assist in the birth by supporting your legsLowers chances of tearing or the need for episiotomyGood access to perineum  ConsMay be hard for health-care provider to access fetal heart tonesNo help from gravityIf no one can hold your legs, you must support them on your ownYou may feel too passive in this position

WALKING

ProsUses gravityContractions are often less painfulBaby is well aligned in your pelvisMay speed laborReduces backacheEncourages descent  ConsNot recommended if you have high blood pressureCannot be used with continuous electronic fetal monitoring

STANDING

ProsUses gravityHelps get oxygen to the babyContractions are more effective and less painfulMay speed laborHelps create a pushing urge  ConsPoor control at birthHard for health-care provider to see the baby

LEANING OR KNEELING FORWARD WITH SUPPORT

ProsCan help shift the baby if neededUses gravityBirth ball can be usedContractions are often less painful and more productiveBaby is well aligned in your pelvisRelieves backache  Easier for your partner to help relieve your back pain  May be more restful than standing  Good for pelvic rockingLess strain on your wrists and arms  Cons  Hard for health-care provider to help with birth

KNEE-CHEST

ProsGood for back laborAssists with rotation of baby, if neededTakes pressure off hemorrhoidsGood position to avoid tearing or episiotomyGood delivery position for large babyHelpful if fetal heart tones are low  ConsHard for your support team to maintain eye contact with youHard for you to see what's going on

SEMI-SITTING

ProsComfortableGood use of gravityGood resting positionWorks well in hospital bedsGood visibility at birth for your support teamEasy access to fetal heart tones for your health-care provider  ConsAccess to your perineum can be poorMobility of your coccyx is impairedPuts some stress on your perineum but less than when lying on your back

ON BACK WITH LEGS RAISED

ConsWorks against gravityCompresses all major vesselsTearing or need for an episiotomy is more likelyNo use of gravity to aid in birth 

LEANING OR KNEELING FORWARD WITH SUPPORT

ProsCan help shift the baby if neededUses gravityBirth ball can be usedContractions are often less painful and more productiveBaby is well aligned in your pelvisRelieves backache  Easier for your partner to help relieve your back pain  May be more restful than standing  Good for pelvic rockingLess strain on your wrists and arms  Cons  Hard for health-care provider to help with birth

KNEE-CHEST

ProsGood for back laborAssists with rotation of baby, if neededTakes pressure off hemorrhoidsGood position to avoid tearing or episiotomyGood delivery position for large babyHelpful if fetal heart tones are low  ConsHard for your support team to maintain eye contact with youHard for you to see what's going on

SEMI-SITTING

ProsComfortableGood use of gravityGood resting positionWorks well in hospital bedsGood visibility at birth for your support teamEasy access to fetal heart tones for your health-care provider  ConsAccess to your perineum can be poorMobility of your coccyx is impairedPuts some stress on your perineum but less than when lying on your back

ON BACK WITH LEGS RAISED

ConsWorks against gravityCompresses all major vesselsTearing or need for an episiotomy is more likelyNo use of gravity to aid in birth

1 Comment

Just wanted to say thanks!

April 28, 2015 12:26 PM by G

Thanks for the info!

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