How will I know when to go to the hospital - AlphaBirth

Birth preferences: positions for labour and birth

When we think about births we have seen on TV or in films, it usually looks something like this:

Birth preferences: labour and birth positions - AlphaBirth

Image courtesy of

The bed is usually the centre of all the action! The reality is, unless you’ve had an epidural, the bed is the last place you should be. Often, it’s the presence of it in the room in the first place that makes people – women, partners, healthcare providers – gravitate towards it. It’s there, so why wouldn’t you use it, right?

The bed in your delivery suite can be a great tool to support you, but not by lying on it! A 2013 Cochrane Review found that the first stage of labour, when your cervix is dilating from 0-10cm, may be approximately one hour and twenty minutes shorter for women who are upright or are walking around. It also found that when women who were upright and mobile during labour were compared to women who laboured lying down in a bed, their risk of Caesarean birth was reduced, they were less like to use epidural as a method of pain relief and their babies had a lesser chance of being admitted to the neonatal unit.

Another Cochrane Review, this one published in 2012, recommended that women should be encouraged to give birth in comfortable positions, which are usually upright. It found that women who give birth on their backs were more likely to have an instrumental delivery (using forceps or vacuum), more likely to require an episiotomy but had less blood loss.

So the evidence shows that for both labouring and giving birth, being upright and mobile is preferable for improved outcomes for both mothers and babies.

Now that we’ve looked at the science, what about the instinctual? When labour begins naturally and women are progressing well at their own pace and without intervention, they usually find that their body adopts the position they find most comfortable all by itself. Some women find that they really like being on all fours, or sitting on their birth ball. Others like to walk around or use the bed to lean forward on if they are kneeling, for example. Many women love being in water, either in a birth pool, a deep bath or a shower. If you are feeling comfortable and safe, with all that lovely oxytocin flowing in your body, you will find that you will instinctually move into positions that work best for you. This applies not only when you are labouring but also when you are delivering your baby. You might find the very last place you want to be is on your back.

Take a look a this infographic that you may have seen on social media to see why:

birth preferences: labour and birth positions - AlphaBirth

So what are the best positions to use? Only you will know yourself when labour begins. You might like the idea of a few positions and then discover on the day that you’d actually prefer something completely different! The National Childbirth Trust (NCT) in the UK have produced these excellent posters to give you some ideas to try.

It’s a good idea to include a sentence in your birth preferences along the lines:

I prefer to labour and birth in any position that I find comfortable

This will help your midwife on the day know the type of birth that you have prepared for and she will be able to support you as you try different positions during your labour and birth.

More support and comfort measures for both you and your birth partner to use during labour are covered in depth at my GentleBirth weekend workshops. Take a look at dates coming up for rest of 2014 and reserve your place now.

Other posts in my birth preferences series:

Do I need birth preferences?

Birth preferences: what about vaginal exams?

© Sylda Dwyer, AlphaBirth 2014.  Unauthorised use and/or duplication of this material without express and written permission from the owner is strictly prohibited.