Preparing for the arrival of your little one brings with it so many questions: a home birth or hospital birth? Can I take my partner with me to the hospital? Which hospital is best to give birth in? What should I pack in my hospital bag? The list can feel endless.
But, what is often overlooked in those plans is how important upright positions and instinctive movements are during childbirth and what you should know about them.
Movement as and when you need or want to will not only help you to manage the sensations of labour better but also make your labour and birth a little shorter, less likely to need medical intervention and as such safer for you and your baby.
There are a whole range of positions you will find helpful beyond lying down on your back. These positions are collectively known as upright birthing positions because they are most commonly ones where you don’t lay on your back. Upright positions allow free movement of the bones and joints of your pelvis so that your baby can make use of the maximum amount of space so that it is easier to be born.
Upright birth positions include sitting upright-like sitting on a toilet, squatting or semi squatting, standing and variations of kneeling including ‘all fours’. These positions are instinctive movements many women will naturally use during childbirth and each one can help you and your baby to move in ways that make it easier to give birth, and to be born.
There are many other benefits to using more upright positions and movement that we don’t think get talked about nearly enough! We hope this short blog that we have put together will help you to discover the importance of upright positions during labour so that you can include them into your birth plan.
When it comes to making decisions for labour, your safety and comfort is essential; by knowing about upright birthing you’ll literally be in a better position(!) to have a safer, healthier birth.
The Upright Advantage
Upright positions during labour and birth isn’t a new or ‘alternative’ concept; for as long as there have been records of women giving birth, they have been giving birth in upright positions. There are carved images on ancient temples from Egypt to China and a long history of different types of birth stools and supports.
However, with the increase in hospital births in recent decades, it has become much more common that mothers are made to stay on a bed, usually on their backs during birth. This is not to benefit them specifically but to make it easier for those caring for them to ‘manage’ the labour and birth.
For those giving birth at home or in birth centres it is very rare to see a woman lay down on her back with her legs in the air but the majority of those giving birth in hospitals do so lying down or semi lying down with their legs placed in lithotomy (stirrups).
It is this that is a modern phenomenon that has little safety or comfort benefits for mothers in labour. But there does seem to be change happening as more mothers become increasingly knowledgeable and informed.
Reduced Labour Time
Lower Risk of Interventions
The chance of having an emergency C-section, along with other interventions like episiotomies and the use of forceps, are less common in women who are free to move instinctively and choose upright positions.
One study found that upright birthing reduced the risk of an emergency c-section by up to 29%, while also reducing the risk of unplanned medical interventions by almost a quarter. [3] [4]
Enhanced Comfort and Control
Many women report feeling more comfortable and in control of their birthing experience when they’re upright.
This sense of empowerment can lead to a more positive labour and birth experience, with women able to move freely to find the position that feels right for them they are more able to manage the sensation of labour.
Upright birth positions and encouraging free movement has even been recommended by the World Health Organisation and the Royal College of Obstetricians and Gynaecologists because of the benefits associated with them. [5] [6]
A Closer Look at the Positions
So what are upright birthing positions and what’s the logic behind them?
Well, these positions give mum the chance to move instinctively, making the most of gravity, and freeing up all of the available space in her pelvis by up to 30% compared to lying on her back. This helps the baby descend into the birth canal more easily and can potentially speed up the labour process, in some cases by up to 6 minutes! [7]
Below are just some examples of the kinds of positions that are helping mums to have safer, healthier births:
Standing and Leaning
Ideal for the early stages of labour, standing and gently leaning forward onto a support helps manage contractions while aligning the baby into a good position for birth. It is also physiologically beneficial because it allows blood flow to the uterus and frees up the movement of the joints of the pelvis.
Squatting
Squatting can be challenging for many women if you are not used to doing it and it is not a position to try to stay in for a long time.
If you do feel like squatting, remember to listen to your body and change position and move frequently.
Some studies have shown that deep squatting can increase the rates or perineal swelling and tears and subsequent blood loss. However, some women find it helpful in second stage, just don’t try to stay in a squat for a long time and move to a different position, e.g. hands and knees for the actual birth.
Sitting
Birthing stools, chairs and birth supports like the CUB are designed to offer a comfortable seated position that still benefits from gravity, providing a compromise between comfort and effectiveness. Sitting on a hospital bed is also a possibility for when mobility is restricted.
Kneeling or All Fours
Kneeling is a very instinctive position and one of the best for helping baby to move through the pelvis. Many mothers report that kneeling in different ways is one of the most comfortable positions during labour.
Similarly, variations on all-fours positions help to create space in pelvis while also making contractions more effective. If you’re considering using this position you may want to also think about using a rest or support as arms, wrists and knees can tire quickly.
Using a support like the CUB can drastically improve your ability to stay comfortable in a whole range of upright birthing positions.
Why Isn’t Everyone Doing This?
Despite the compelling benefits, many expectant mums remain unaware of the power of instinctive movement and upright birthing, or the difference it could make to your birthing experience. The findings are just too significant to ignore.
As you can probably tell, we’re passionate about upright birthing at The Parents Class and our evidence-led antenatal classes provide in-depth information on upright birthing and other cutting-edge antenatal topics to help make sure you feel confident making decisions for your best birth.
Want to read more about upright birthing? Download our FREE eBook here:
Upright birthing, by Cass McNamara – midwife of 27 years, inventor of the upright birthing support CUB, and Clinical Director at The Parents Class.
Ready to start your journey to a safer, healthier birth?
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