Understanding Your Birthing Position Options
When you think about what giving birth is going to look like, I think the picture that may pop into your head first is what we’ve seen in the movies…a panicked woman who BARELY made it to the hospital on time, laying in a hospital bed with her knees up towards her chest, directly on her back while screaming at her husband and doctor between contractions. What an image, right??
And maybe that was your experience, which is totally fine! But, that doesn’t have to be your experience if you have a different image in your head for what you would like your birthing experience to look like.
One of the pieces that may be lacking in the type of birthing experience you want, is just simply knowing what your options even are. If your birthing position options are never really discussed with you by your medical providers, how would you know what to try when the time comes and then be able to advocate for yourself, if needed?? So, let’s talk about it!
Let’s first start with the positions that may be an option for you if you go the non-epidural route.
Standing
All fours
Squatting
Assisted lunge
Upright sitting
Supported kneeling
Sidelying
Lithotomy position (on your back)
And many other variances to all of these positions!
I think it’s fairly well understood that if you are unmedicated and without an epidural, you may have more options for positioning; however, what’s not well understood is that you STILL have options and you are STILL in control even if you choose to have an epidural.
Here are some examples of positions that may be an option for you if you go the epidural route.
Lithotomy position (on your back)
Sidelying
Assisted hands and knees
Upright sitting
Semi-sitting
Semi-prone
Assisted kneeling
Supported squat
And many other variances to all of these positions!
A few examples of some of these…
So, what exactly is the big deal and why all the controversy over birthing positions??
Birthing on your back is one of the most common positions because it is a safe and effective position to be in to allow your doctor the easiest position to be able to see and access if needed. This does not mean that it is the only position that will allow your doctor the ability to see and access, but it is the easiest for them. But, let’s remember…your birth experience is about YOU and BABY. It is just as important for you to feel comfortable and safe in order to allow you the ability to give birth. If you feel comfortable on your back and that feels right to you, then go for it! And here are a few tips for birthing on your back if you do go that route. But, if it doesn’t, don’t be afraid to speak up. Giving birth is an extremely vulnerable, exhausting and primal activity…being able to get into the position that feels right to you can help with that vulnerability and allow you to be able to do what you need to do!
The alternative to birthing on your back would be to promote a more upright position. Although more research needs to be done, the idea behind birthing in an upright position is to allow gravity to assist you. Gravity helping you out can be a HUGE benefit when it comes time to pushing the baby out, but according to the research, it may also lead to a higher rate of second degree perineal tearing. Again, the studies out there aren’t completely clear on this and could definitely benefit from further research. As far as some potential benefits of birthing in an upright position, check out the following: (*)
Less pressure on the abdominal aorta (better blood flow to baby)
For baby to get into a better position - check out this saved highlight reel for more on this!
So the uterus can contract stronger and more efficiently
So the pelvic outlet can become wider
So, if birthing on your back allows the easiest access for your doctor, you may be wondering if an upright position will keep your doctor from doing what needs to be done…in short, no, it shouldn’t. If your doctor is on board with a patient-led birthing experience, then your doctor will have no problem maneuvering, adjusting and putting in a little extra effort to get into the position necessary to be of assistance to you and your baby. Also, it’s been studied that a more “hands off” approach may actually lead to less overall trauma, such as the need for an instrument assisted delivery or an episiotomy…that seems to go hand-in-hand with the primary responsibility of “do no harm” that all medical professionals stand by, right? (*)
Here’s what it comes down to. There needs to be more research on this topic. The more research we have, the more we, as women, can educate ourselves as well as allow for doctors and medical professionals to be able to help guide and educate their pregnant patients as they get closer to the big day! But for now, here are a few tips to take away from this if you’re wondering what your birthing position options are…
Talk to your doctor! Start asking questions at your prenatal appointments and see what they have to say about birthing positions as well as potential hospital policies around the topic.
Do your own research - like this blog you’re currently reading, for example :) If you don’t like what options were given to you, don’t settle. Research for yourself and advocate for you and your baby…it likely won’t be the first time you may have to do that, so what better time to start than now?!
Seek an alternative opinion. This may look like speaking with a different doctor or medical professional, checking out a different hospital, looking into a midwife option, home birth, birthing centers or seeking advice from a pelvic floor PT!
And also, if labor prep is something you are looking for support with, my Mind Body Core - Prenatal Program has a full Labor Prep Program that is included in my Prenatal Program or can be purchased separately as it’s own program! Check it out by clicking below.
You’ve got this, mama!
Doc Lizzie
*(Gupta et al., 2017), (Thies-Lagergren, 2013), (Yu Zang et al., 2020)