Pros and Cons of 11 Common Labor Positions

By Paulina G. Perez, RN, BSN, CD, LCCE, FACCE

Movement and positioning in labor work magic. Movement enhances comfort by stimulating the receptors in the brain that decrease pain perception. The result is that you are able to tolerate increasingly strong contractions. When contractions become very strong, endorphins are released and pain perception decreases even more. Ultimately, your movement in response to your contractions decreases pain and facilitates labor – a win-win. Movement also helps the baby move through the pelvis, and some positions enlarge pelvic diameters.

The positions shown here facilitate the normal, natural process of labor. What position should you use? Follow your body. Move freely in response to what you feel. Your body will let you know just what position is best at every point in your labor.
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Standing Supported SquatSTANDING SUPPORTED SQUAT

Pros
  Realigns your pelvis to increase the opening by up to 15 percent
 Allows you to be supported by your standing or sitting partner, the wall or a squat bar
 Takes advantage of gravity
 Makes contractions feel less painful and more productive
 Lengthens your trunk and helps your baby line up with the angle of your pelvis
 Movement causes changes in your pelvic joints, helping your baby through the birth canal
 May increase your urge to push in the second stage of labor  

Cons
  Requires a strong partner
  May be tiring for both of you  
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SITTING ON TOILET

Pros
 Helps relax perineum
 You get used to an open-leg position and pelvic pressure
 Uses gravity  

Cons
 Pressure from toilet seat may be uncomfortable 
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SittingSittingSITTING
 
Pros
 Good for resting
 Uses gravity
 Can be used with continuous electronic fetal monitoring  

Cons
 May not be possible if you have high blood pressure   
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SQUATTINGSquatting
Pros
 Encourages rapid descent
 Uses gravity
 May increase rotation of baby
 Allows freedom to shift your weight for comfort
 Allows excellent perineal access
 Excellent for fetal circulation
 May increase pelvis diameter by as much as 2 centimeters
 Requires less bearing-down effort
 Descent is encouraged by the position
 Your thighs keep baby well aligned  

Cons
 Often tiringSquatting
 Sometimes hard for health-care provider to hear fetal heart tones
 May be hard for you to assist in birth if you wish to do so
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SIDE-LYING

Pros
 Helps get oxygen to the baby
 Good resting position
 Helpful if you have elevated blood pressure
 Fine with epidural
 Can make contractions more effective
 Easier for you to relax between contractions during the second stageSide Lying
 Can slow a birth that’s moving too fast
 Your partner can assist in the birth by supporting your legs
 Lowers chances of tearing or the need for episiotomy
 Good access to perineum  

Cons
 May be hard for health-care provider to access fetal heart tones
 No help from gravity
 If no one can hold your legs, you must support them on your own
 You may feel too passive in this position

WALKING

Pros
 Uses gravity
 Contractions are often less painful
 Baby is well aligned in your pelvis
 May speed labor
 Reduces backache
 Encourages descent  

Cons
 Not recommended if you have high blood pressure
 Cannot be used with continuous electronic fetal monitoring

STANDING

Pros
 Uses gravity
 Helps get oxygen to the baby
 Contractions are more effective and less painful
 May speed labor
 Helps create a pushing urge  

Cons
 Poor control at birth
 Hard for health-care provider to see the baby

LEANING OR KNEELING FORWARD WITH SUPPORT

Pros
 Can help shift the baby if needed
 Uses gravity
 Birth ball can be used
 Contractions are often less painful and more productive
 Baby is well aligned in your pelvis
 Relieves backache
  Easier for your partner to help relieve your back pain
  May be more restful than standing
  Good for pelvic rocking
 Less strain on your wrists and arms  

Cons
  Hard for health-care provider to help with birth

KNEE-CHEST

Pros
 Good for back labor
 Assists with rotation of baby, if needed
 Takes pressure off hemorrhoids
 Good position to avoid tearing or episiotomy
 Good delivery position for large baby
 Helpful if fetal heart tones are low  

Cons
 Hard for your support team to maintain eye contact with you
 Hard for you to see what’s going on

SEMI-SITTING

Pros
 Comfortable
 Good use of gravity
 Good resting position
 Works well in hospital beds
 Good visibility at birth for your support team
 Easy access to fetal heart tones for your health-care provider  

Cons
 Access to your perineum can be poor
 Mobility of your coccyx is impaired
 Puts some stress on your perineum but less than when lying on your back

ON BACK WITH LEGS RAISED

Cons
 Works against gravity
 Compresses all major vessels
 Tearing or need for an episiotomy is more likely
 No use of gravity to aid in birth 

LEANING OR KNEELING FORWARD WITH SUPPORT

Pros
 Can help shift the baby if needed
 Uses gravity
 Birth ball can be used
 Contractions are often less painful and more productive
 Baby is well aligned in your pelvis
 Relieves backache
  Easier for your partner to help relieve your back pain
  May be more restful than standing
  Good for pelvic rocking
 Less strain on your wrists and arms  

Cons
  Hard for health-care provider to help with birth

KNEE-CHEST

Pros
 Good for back labor
 Assists with rotation of baby, if needed
 Takes pressure off hemorrhoids
 Good position to avoid tearing or episiotomy
 Good delivery position for large baby
 Helpful if fetal heart tones are low  

Cons
 Hard for your support team to maintain eye contact with you
 Hard for you to see what’s going on

SEMI-SITTING

Pros
 Comfortable
 Good use of gravity
 Good resting position
 Works well in hospital beds
 Good visibility at birth for your support team
 Easy access to fetal heart tones for your health-care provider  

Cons
 Access to your perineum can be poor
 Mobility of your coccyx is impaired
 Puts some stress on your perineum but less than when lying on your back

ON BACK WITH LEGS RAISED

Cons
 Works against gravity
 Compresses all major vessels
 Tearing or need for an episiotomy is more likely
 No use of gravity to aid in birth

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Comments

  1. Judith says:

    I disagree with the statement that you cannot walk when cont EFM is needed. a good hospital will have a telemetry unit that allows mobility and cont monitoring. similar with sidelying in no one is there to support your legs. if you are speaking of hospital settings, you can attach stirrups so she can rest her leg in it.

  2. Avatar of Cara Terreri Cara Terreri says:

    Thanks for your input Judith. Perhaps we should amend this to read that some hospitals may have a cordless device to allow for movement and walking. I agree with you that a “good” hospital will have more options, but unfortunately there are many hospitals out there that have a long way to go to catch up.

  3. I actually wish to book mark this specific post, “Pros and Cons
    of 11 Common Labor Positions — Giving Birth with Confidence” on my personal
    webpage. Would you care in case I reallydo? Thank you ,Estella

  4. Cyrena says:

    thanks for this informative article. i printed it for future reference, as i’ll be having my little one pretty soon. i would have loved to see more pictures of these positions, but i liked that you offered both pros and cons.

Trackbacks/Pingbacks

  1. [...] Pros and Cons of 11 Common Labor Positions. This great post is exactly what its title suggests!  Only one of the 11 positions has no pros — and unfortunately, it’s the most common one in hospital settings!  (Paulina G. Perez, RN, BSN, CD, LCCE, FACCE; Giving Birth With Confidence) [...]

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