1. Squatting. You may wonder why you should squat when you could belying comfortably on your side in bed. Squatting benefits mother and baby. It widens the pelvic openings, relieves back pain, speeds the progress of labor, relaxes perineal muscles so that they are less likely to tear, improves oxygen supply to the baby, and even facilitates delivery of the placenta. If you have practiced squatting a lot during pregnancy, it will be easier during labor. If you try squatting down right now, you can probably feel where your upper leg bones, the femora, are attached to your pelvic bones. When you squat, the leg bones actually act like levers to widen your pelvic outlet by twenty to thirty percent. Squatting gives your baby a straighter route through a wider passage, creating the easiest path for moving baby through your pelvis. (Women who have short second stages will choose not to squat.)
2. Kneeling. Kneeling is helpful to ease overwhelming contractions, relieve back pain, or turn a posterior baby. It is also a position that helps you improvise, and can lead to the kneel-squat, kneeling on all fours, or the knee-chest position.
3. Sitting. The sitting position widens the pelvis, but not as much as squatting does. The most labor-efficient position is sit-squatting on a low stool. Alternatives are to sit astride a toilet seat, chair, or a birth ball you may have practiced on. If you must stay in bed because you’ve had a pain medication, you can sit astride the birthing bed.
4. Standing and leaning. Since your labor is likely to progress more quickly and efficiently if you walk a lot, you may find yourself upright during an intense contraction. Try stopping and leaning against the wall or your birth partner, or resting your head against pillows on a table.
5. Side-lying. Even though moving and being upright helps your labor progress, it is not humanly possible to be upright during your whole labor. Your hard-working body will need some rest, and if you don’t get it, it may stop doing its job so well. Best to be upright, in varying positions, during active labor contractions, but to rest as much as possible during early labor and between contractions. Lie on your left side. Support your body with at least five pillows: one or two under your head, one supporting your top knee, one behind your back, and another under the bulge.