Birthing Positions

Here is a full list of birthing positions for your information:

STANDING

Advantages -- excellent for oxygenation of fetus; uses gravity; contractions more effective; contractions less painful; helps speed up a "pokey" labor; helps create good pushing urge.

Disadvantages - poor control at delivery; visualization very hard for birth attendant.

WALKING

Advantages -- uses gravity; contractions often less painful; encourages uterine contractibility; baby well-aligned in pelvis; may speed up labor; reduces backache; encourages descent.

Disadvantages -- Often not able to use if mother has high blood pressure; cannot be used with continuous electronic monitoring.

SITTING

Advantages -- Good for resting; uses gravity; can be used with continuous electronic monitoring; can be used with birth ball to encourage descent; birth ball can be used when administering epidural.

Disadvantages -- may not be able to use if mother has high blood pressure.

SITTING ON TOILET

Advantages -- Helps relax perineum; mother is used to open-leg position and pelvic pressure in this environment; uses gravity

Disadvantages -- Pressure from toilet seat may cause pain.

SEMI-SITTING

Advantages -- comfortable for mother; good use of gravity; good resting position; works well in hospital beds; good visibility at delivery for mom, dad and other present; good access to fetal heart tones.

Disadvantages -- Access to perineum can be poor; mobility of coccyx is impaired; some stress on perineum but less than lithotomic.

LITHOTOMY (on back, legs raised)

Disadvantages -- Compression of all major vessels; laceration or need for episiotomies is more likely; no use of gravity to aid this position. AVOID THIS POSITION!

SIDE-LYING

Advantages -- Good fetal oxygenation; good resting position for mother; helpful if mother has elevated blood pressure; useful if mother has epidural anesthesia; often make contractions more effective; may promote progress of labor; easier for mom to relax between contractions during second stage; allows posterior sacral movement in second stage; can slow precipitous delivery; partner may need to support leg; partner can assist in delivery; lowers chance of laceration or need for episiotomies; access to perineum is excellent.

Disadvantages -- access to fetal heart tones poor if mother is lying on same side as baby's back; no help from gravity; if no one to hold leg, mother must support own leg under knee; mother may feel too passive.

LEANING

Advantages -- Great for rotation of posterior presentation; uses gravity; can use with birth ball; contractions often less painful; contractions often more productive; baby is well-aligned in pelvis; relieves backache; facilitates use of back pressure; may be more restful than standing.

Disadvantages -- Hard for attendant if used at delivery.

KNEELING (leaning forward with support)

Advantages -- Helpful with persistent posterior presentation; assists rotation of baby; good for pelvic rocking; good for use with birth ball; less strain on wrists and arms.

SQUATTING

Advantages -- Encourages rapid descent; uses gravity; may increase rotation of baby; allows freedom to shift weight for comfort; excellent for access to perineum; excellent for fetal circulation; may increase pelvic diameter by as much as two centimeters; requires less bearing down effort; upper trunk presses down on fundus to encourage descent; thighs keep baby well-aligned.

Disadvantages -- Often tiring to mother; sometimes hard to hear fetal heart tones; may be hard for mother to assist in delivery.

HAND & KNEES

Advantages -- Good for bradycardia (low heart tones); good for back labor; useful with birth ball; assists with rotation of posterior presentation; takes pressure off hemorrhoids; best position to avoid laceration or need for episiotomies; good delivery position for large baby; excellent for shoulder dystocia

Disadvantages -- Hard to maintain eye contact with mother; hard for mother to see; baby must be passed through mother's legs; can be disorienting to inexperienced attendant.

Copyright © Paulina G. Perez, RN, BSN, LCCE, FACCE, Lamaze Parents Magazine. Permission to republish granted to Pregnancy.org, LLC.