What’s the Best (and worst) Position for Birth?
The short answer to this question is easy - whatever position you’re comfortable in is the best position to birth your baby.
Research tells us that an upright position is the best for birthing. This is really for a couple of reasons: gravity, more blood flow and oxygen to your baby, better contractions, and helping your baby pass through your pelvis.
Movies and television typically depict labor in a position similar to the one pictured. Lithotomy position, or flat on your back with your hips and knees flexed and open is what we all think of when we think of birth positions because that’s the one we’ve all seen. This is actually one of the worst positions to give birth in. Here’s why - in pregnancy, the ligaments and joints in your pelvis are loosening thanks to the hormone relaxin. Your sacrum and your tailbone actually flex as your baby moves through your pelvis, allowing more space for baby’s head to come through the birth canal. If you’re laying flat on your back, you’re limiting the space that your baby can use to navigate your pelvis. As you can imagine, the whole process is more difficult in that position - space is limited, contractions aren’t as productive, and we’re working against gravity.
If you have an epidural placed, you’re not going to be able to get into some upright positions, but there are still ways to assist you into a better birthing position and get you off of your sacrum and tailbone.
Ok, so what are some good upright positions?
Hands and Knees / All Fours
Squatting
Side-Lying
Standing and Leaning on Your Support Person
Kneeling
Sitting
What makes these positions good positions to give birth in? Research tells us the following about upright birth positions:
less painful than lithotomy (back lying) position
less use of vacuum/forceps
better fetal heart rate patterns
likely to shorten the pushing stage of labor
may lessen the use of synthetic oxytocin (Pitocin)
less likely to require episiotomy
greater satisfaction with the childbirth experience
TL;DR - The best birth position is an upright birth position. The worst is lying on your back. Ultimately the best position to give birth is whatever position you feel comfortable in.
For more info on the evidence on birthing positions, head over to
https://evidencebasedbirth.com/evidence-birthing-positions/