Birthing Positions - does it really matter?

What do you think the following stats have in common?*

• 23% less likely to have a forceps or vacuum-assisted delivery
• 21% less likely to have an episiotomy
• 54% less likely to have abnormal fetal heart rate patterns

These are the comparable statistics for women who birth in an upright position v non-upright positions. They are pretty blooming powerful stats right?! You are also more likely to have a shorter labour and less likely to have a c-section. So why, despite these benefits, do so many women opt to lie down on their back to give birth? 

Giving birth lying flat on a bed or in a lying down position is actually quite a modern trend. If you were around a few hundred years ago, then you would most likely be squatting, on your hands and knees, or sitting on some form of a birthing stool. Have a look below at some of the super cool carvings, sculptures, and drawings of women throughout history, giving birth. My favourite is the South Indian carving below in the middle. Notice that the mama is the biggest and therefore most powerful. She's supported in a standing Squat position.

So what has changed? Have women's bodies dramatically changed so much that lying down is best? Ehhh no. The main reason is that by lying down, you are in the easiest and most convenient position for birthing attendants to monitor you, and also because it is ingrained deeply into our psyche due to a plethora of media portrayals. 

Let's look a little further into the ideal upright positions for birth. Firstly 'upright' means anything from standing, sitting, squatting, kneeling to being on all fours. Any form of upright position will allow mama to move around freely, letting gravity do the work, but also it promotes a great blood supply for herself and also to her baby. When you are free to move around, you'll notice that your body will often automatically get into the most comfortable positions naturally. When you lie down, those instinctive positional changes like rocking and tilting side to side, are totally inhibited. It is the combination of gravity and these movements which help the baby descend into the pelvic canal and therefore speed up your labour.  You might want to be supported during labour and sometimes as you go towards what I call the business end of labour, it's satisfying to hang off something or someone for extra support, both physically and mentally. 

1. Squatting - this is a pretty awesome position as it reduces pain in the back, and allows baby to rotate perfectly into a lovely birthing position. 
2. Standing upright - this allows the baby to press down onto the cervix, the pelvic floor and ligaments, thus increasing oxytocin delivery, and therefore allowing the natural process of dilation to occur more smoothly. You can also lean forward onto the raised bed, which can help baby tuck its chin, which will also lead to more efficient contractions.  
3. Hand & Knees position - awesome for any form of back pain, and particularly beneficial for women who are experiencing 'back to back' labour, where baby is lying with their little back, against their mother's back. This can often lead to a constant feeling of pressure for mama which can be very challenging to manage. So ladies if you are experiencing back pain during labour, get onto the hands and knees!
4. Seated positions - any form of sitting can also be fabulous, but you should make sure that your knees are dropped lower than your hips for optimal positioning. Leaning forward in a seated position can also help reduce back pain, and like on the hands & knees, it gives the birthing partner access to apply pressure around the low back and sacrum. 

If you are interested in having an upright / Active Birth, ensure you talk to your midwife or caregiver during your next antenatal appointment. Please do not wait until you are in labour to explore this!

I cover an abundance of birthing positions and an enormous amount of other birthing tips for an awesome birth in the Active Birthing Workshop and Full Prenatal Online Program with NurtureMamas.com. 

Big love ladies,

Helen x 

_{* Gupta, J. K., G. J. Hofmeyr, et al. (2012). “Position in the second stage of labour for women without epidural anaesthesia.”}

_{Helen Plass works with women and their birthing partners to achieve a comfortable, healthy & happy journey into Pregnancy, Birth and Motherhood. She has built a successful business in Dublin, Ireland, as a Yoga Instructor, specializing in Pre- & Post-natal health and fitness, Active Birthing workshops, Baby Massage and Mama & Baby Yoga classes. She is known for her very practical & non-judgmental approach to pregnancy and the crazy times of motherhood! Helen has trained in the UK and Ireland, and is mega proud of coming first in her Yoga Teacher Training (she’s a bit of a swot) at the gorgeous Samadhi Studios in Dublin. She’s a proud wife, mama to two energetic little boys, former corporate marketing professional, keen runner and lover of all things related to sport…and is an avid supporter of Irish Rugby.}

_{When she’s not becoming all teary and emotional with messages from her clients about their gorgeous births, you can find her walking along the rocks and beach with her boys, cheering on the sidelines of football and rugby pitches, experimenting with essential oils, baking and preparing meals for the non-stop eating men in her life…and in general just trying to keep it all together. Check out all her communication at NurtureMamas.com, and if you are in Ireland, her local business Mumandbaby.ie}