Labour – Birthing Positions

Standing

Advantages

 

• Excellent for oxygenation of fetus
• Uses gravity
• Contractions are more effective and less painful
• Helps speed up labor
• Helps create pushing urge

 

Disadvantages

• Poor control of delivery
• Visualization very hard for birth attendant

 

 

Walking

Advantages

 

• Uses gravity
• Contractions often less painful
• Encourages uterine contractility
• Baby well-aligned in pelvis
• May speed up labor
• Reduces backache
• Encourages descent

 

Disadvantages

• Often mother can’t use if she has high blood pressure
• Can’t be used with continuous electronic fetal monitoring

 

 

Sitting

Advantages

 

• Good for resting
• Uses gravity
• Can be used with continuous electronic monitoring
• Can be used with birth ball to encourage descent

 

Disadvantages

• Possibly can’t be used if mother has high blood pressure

 

 

Sitting on Toilet

Advantages

 

• Helps relax perineum
• Mother accustomed to open-leg position and pelvic pressure in this environment
• Uses gravity

 

Disadvantages

• Pressure from toilet seat can cause pain

 

 

Semi-Sitting

Advantages

 

• Comfortable for mother
• Good use of gravity
• Good resting position
• Works well in hospital beds
• Good visibility at delivery for mom, dad and others present
• Good access to FHTs (Fetal Heart Tones)

 

Disadvantages

• Access to perineum can be poor
• Mobility of coccyx is impaired
• Some stress on perineum, but less than lithotomy

 

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Lithotomy

(on back, legs raised — avoid this position!)

Disadvantages

• Compression of all major vessels
• Laceration or need for episiotomy is more likely
• No use of gravity to aid delivery

 

 

Side-Lying

Advantages

 

• Good fetal oxygenation
• Good resting position for mother
• Helpful if mother has elevated blood pressure
• Useful if mother has epidural anesthesia
• Often makes contractions more effective
• May promote progress of labor
• Easier for mom to relax between contractions during second stage
• Allows posterior sacral movement in second stage
• Can slow precipitous delivery
• Partner may need to support leg
• Partner can assist in delivery
• Lowers chance of laceration or need for episiotomy
• Access to perineum is excellent

 

Disadvantages

• Access to FHTs poor if mother is lying on same side as baby’s back
• No help from gravity
• Mother must support her leg under knee if no one is there to hold leg
• Mother may feel too passive

 

 

Leaning

Advantages

 

• Great for rotation of posterior presentation
• Uses gravity
• Contractions often less painful
• Contractions often more productive
• Baby is well-aligned in pelvis
• Relieves backache
• Facilitates use of back pressure
• May be more restful than standing

 

Disadvantages

• Hard for attendant if used at delivery

 

 

Kneeling, Leaning Forward with Support

Advantages

 

• Helpful with persistent posterior presentation
• Assists rotation of baby
• Good for pelvic rocking
• Good for use with birth ball
• Less strain on wrists and arms

 

 

 

Squatting

Advantages

 

• Encourages rapid descent
• Uses gravity
• May increase rotation of baby
• Allows freedom to shift weight for comfort
• Excellent for access to the perineum
• Excellent for fetal circulation
• May increase pelvis diameter by as much as two centimetres
• Requires less bearing-down effort
• Upper trunk presses on fundus to encourage descent
• Thighs keep baby well-aligned

 

Disadvantages

• Often tiring to mother
• Sometimes hard to hear FHTs
• May be hard for mother to assist in delivery

Hands and Knees

Can be disorienting to inexperienced attendant.