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Why Upright, Forward Leaning Labour Positions Work Best

Hollywood has sold us a lie when it comes to birth. So often we birthing parents laying in bed, writhing in pain and cursing all who come near them. They beg for epidurals and traumatic events almost always happen. And it get it. Pregnancy and birth is a great dramatic device to play with if you are a writer or director. But unfortunately, all this does is fuel the fires of anxiety who are pregnant and about to give birth.

The good news however, is that after 15 years of being a doula and supporting over 170 families, I can confidently tell you that Hollywood gets its wrong, 99% of the time. Labour and birth is rarely traumatic or as scary as they have made it out to be.

As a doula, I often recommend to my clients that they actually stay out of bed if they can. If they aren't tired, don't be in bed. The best positions for labour are ones that position your body in an upright and forward leaning. But why is that?

Imagine your baby inside your body. They are head down, floating in amniotic fluid. Moving from side to side, kicking, sucking their thumb, enjoying life. But while baby is not yet born, they are still on this planet and they are still governed by the rules of gravity. The back of their head and their spin are the heaviest parts of their body. And when you lay down, or recline back to be more comfortable, gravity will pull baby's body into a position where they are back to back with you.

This back to back position can cause what is called Back Labour. And I can tell you from personal experience, it sucks. Because while in labour, the discomfort you will feel with the contractions will start and stop and take a short break and start again, with back labour it will give you an undying backache that will not stop. It will be continuous and painful.

But let's say, we ignore the Hollywood version of labour and choose positions outside of the bed. Choosing standing positions that are forward leaning will allow baby's body to shift into a position where they will face your back and be in a position that will allow for labour to progress more comfortably without back labour and possibly allow the cervix to dilate more efficiently.

But what if standing isn't working for you, how about sitting, and better yet, sitting on a ball. Sitting on a birth ball allows for the birthing parent to squat without putting pressure on their knees, open up the top of the pelvis for baby to move down and still utilize gravity to have baby putting pressure on the cervix. It also allows for the support people to massage the birthing parents back or do counter pressure if it helps.

Now what if you are tired and want to rest. Then laying in bed is perfectly fine but a better choice to laying back is laying on your side. The same is true for if you choose to have an epidural. The health care workers will have you initially laying on your back with a slight wedge under your hip, but then once the epidural is giving you good coverage, I recommend laying on your side and then after about 60 to 90 minutes you flip over to your other side so that you will continue to get good coverage for the pain medication but you will also be able to keep baby in a good position as well.

Ultimately, your body will choose a position that works best for it, and it would be great to just be conscious of ones that are upright, forward leaning or side lying.

If you would like more information on comfort measures for labour, check out our online video class on comfort measures.


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