Positions for Labour

July 20, 2008

First Stage

On the following pages are some suggestions for positions you may find useful during labour. Experiment with these in pregnancy to find those that seem most comfortable, but be prepared to try them all again when labour is underway. In choosing the most comfortable position, remember:

• The woman should be as fully supported as possible, using people, pillows, bean bags or furniture, to allow her to fully relax.

• Knees should be bent to avoid tiredness in the legs and to make pelvic rocking easier.

• Her feet should be apart to give a wide base for support, and to encourage ‘open’ positions.

• Be creative in your adaption of available furniture in the hospital. If you need extra pillows or a stool or chair, request these.

• Once a comfortable position is found, use it until she signals that it is no longer helping her relax. Change positions only as she indicates, unless you are positioning for a specific purpose, such as to help the baby turn from posterior or to encourage the baby to move down further in the pelvis.

	Some women find asymmetrical positions help ease pressure points.
	It is easy to rest if you are well supported by pillows or a bean bag.
	Sitting on a birth ball makes it easy to rock your pelvis.

Using Water and Heat

Warm water is very soothing in labour and effective at easing pain. Showers are quickly available, provide freedom of movement can be as hot as required and have a spray that can be localised to particular sore spots. Hand held showers work best.

Deep baths or pools take time to fill and must be no hotter than 37 degrees Celsius. They provide freedom of movement if large enough and enable a deep sense of calm which can lower anxiety and pain. They are safe to use after the membranes have broken and water births are safe for the baby.

Using hand towels wrung out in hot water and applied to local sore areas are very effective for relieving pain and provide a good alternative if a shower or bath is not available. A fresh towel will need to be applied for every contraction. Use a bucket of very hot water to heat the towels and use rubber gloves when wringing them out.

Hot packs can be made from small cloth bags of grains such as wheat or rice (heat in a microwave after dampening the fabric cover). Alternatively, gel filled plastic packs heated in near boiling water work well. Apply the hot pack to areas of localised pain.

	Standing or sitting in the shower will help ease much of the pain, especially towards the end of the first stage.
	Lying or kneeling in a bath or pool encourages faster dilation.
	Use well wrung-out hot, wet towels draped over the buttocks for lower back pain.

Second Stage

In second stage, a woman needs to be able to brace her body to push effectively. She will seek something to grip and will prefer to be upright with her legs planted firmly on a floor mat and good support from her partner or other helpers. Furniture can also be used as a source of support.

	A mirror is useful to enable the father and caregivers to see the baby’s progress towards birth. Women usually have their eyes tightly closed at this time!
	Sitting on the toilet often helps early pushing contractions become more coordinated.
	Leaning against a wall makes it easier to support a woman in a deep squat.
	Leaning forward helps reduce the effect of gravity during birth. This is useful if the labour is very fast.
	A birth stool can be a comfortable support during the birth.

These pages are copyrighted and have been reproduced here with the expressed permission of Birth International and the author Andrea Robertson. For more information on these topics and other related issues about pregnancy and birth, please see www.birthinternational.com