Midwife Tracy Donegan gives advice on the best labour positions to help you through.
Changing positions during labour can help to ease your baby’s journey into the world and also makes the process a lot more comfortable for mum too.
Everything you need to know about labour positions
There is an old Jamaican midwife’s saying, “the baby will not be born until the mother opens her back”. In other words when mum is upright, the pelvis opens and we make the exit for baby about 30% larger. It makes sense to make baby’s exit as easy as possible. Being upright and mobile in active labour (6cm) means mum is maximising the use of gravity and optimising blood flow to that amazing muscle doing all the work. You’re also providing lots of oxygen for your baby. Being on the bed reduces oxygen to your baby, the uterus and can make labour more painful and more challenging for your baby, especially in the pushing stage as your baby is having to move uphill against gravity to get under the pubic arch (think of the bend in a welly boot) and how your foot has to be angled in a certain way to get it in.
Trust your body’s intuition
Often mums ask which is the best position to labour in and I tell them “your baby and body will tell you”…. Just like when you get uncomfortable sitting in one position too long….or in bed at night…you don’t need anyone to instruct you on what feels best – there’s very little thinking involved you just do what feels rig ht and shift your position. Being upright also means we’re ‘hacking our hormones’ to reduce stress hormones and increase testosterone (associated with confidence). Being upright means mums feel more in control. Sometimes, monitoring can make being mobile more challenging for staff but that’s their worry, not yours yours – staff almost always facilitate monitoring while mum sits on the ball or stands.
If baby has moved into a less than optimal position and you’re experiencing back labour, the knee the knee chest (all fours) position is great. Being on all fours means your partner can apply counter pressure on your lower back if you are experiencing back labour. Forward-leaning versions can also help if mum is healthy and well – www.spinningbabies.com has some great videos to encourage baby into a more optimal position.
Pushing position – whatever is easiest
When it comes to pushing, choose whatever position feels best for you, but your partner may need to facilitate with staff for positions other than on your back in the bed. Squatting sounds ideal, but most mums haven’t had a lot of practice training those muscles to support you. A birth stool can be really helpful if this position feels good for you and if there’s no birth stool available getting into a supported squat position between your partners knees is amazing.
The peanut ball
Mums can still change position even with an epidural and the use of a little known magical labour tool call the ‘peanut ball’. With a light epidural, mums can even give birth upright leaning over the back of the bed. At the moment only the Coombe uses the peanut ball – but you can purchase them online and bring it with you if you are planning on having an epidural.
For mums with pelvic girdle pain be sure to let the staff know especially if you have an epidural to protect your pelvis from any damage in labour as you won’t feel if your legs are overextended.
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