Positions for active labour

The positions you use for labour and birth can increase your chances of achieving a wonderful birth. They have the power to make you feel more comfortable, shorten your labour and decrease your need for birth interventions. You can practice these positions throughout your pregnancy so you are ready to use them in active labour.



What is active labour
Active labour follows early labour. At this stage your contractions will become stronger, longer and closer together and will cause your cervix to dilate from 4-7cm. When you move to the transition stage your cervix will further dilate from 7-10cm and contractions can last for 60-90 seconds. Often this is the time women feel the urge to push, ask to ‘go home’ or to stop. This is a completely normal reaction - and is actually a very good sign that your baby is nearly here! It’s also a great time for your birth partner to remind you that you are doing a wonderful job and that you definitely CAN do it!

Best position for active labour
These birth positions can be used for both early and active labour. Every birthing women is different so try to think of the list below as ideas to trial. You can go with whatever increases your comfort level and works for you. One thing you will notice is that most of the suggested positions have you in an upright position. This is because in birth gravity is your friend. By placing yourself upright, rather than lying down, you help your body and uterus move your baby downwards. In western cultures women birthing in hospital settings have been encouraged to lie down during labour and birth. However, evidence has shown that this positioning leads to increased risk of assisted delivery and episiotomy. We were only really ever encouraged to get on our backs on the bed to make it easier for Dr's backs. ARGH!

By staying upright you can:

  • Lessen back pain
  • Help your baby move downward and into the right position
  • Reduce the likelihood of needing an epidural or other intervention
  • Open and relax your pelvis
  • Increase blood flow and stabilise your baby’s heart rate

Forward Lean
In this position you are standing up or on your knees and leaning forward onto a chair, bed, bench or your birth partner. While in this position your baby’s head is pressing against your cervix. This releases hormones to stimulate contractions, which further dilates the cervix, making it easier for your baby to pass through.

If your labour slows down, changing positions or going for a gentle walk can help. Walking and other movement can release muscle tension and provide a great distraction from the pain. It can also work to increase the size and improve the position of your pelvis. As your contractions intensify you will probably find that your ability to walk around lessens and you’ll want to find a more stationary upright position. At this stage you could try leaning against or sitting in a chair in the shower. The warm water can be a great pain reliever!

Side Lying
The side lying position is great for protecting your perineum and is often used to stabilise a baby’s heart rate. This is because it takes pressure off organs such as the uterus or kidneys that may be pressing on the umbilical cord. For best results you can place yourself in the foetal position on your side when resting or have your birth partner or midwife slightly lift or support one of your bent legs as you push. Peanut balls can be a great aid to help stabilise the legs.

Hands and knees
I love this one as it can really help to ease lower back pain. You can place yourself on hands and knees on the floor (if it’s soft enough), on a bed, over a birth ball or even in the bath. This position helps to take pressure off the perineum as the pelvic outlet stays open. A slight variation of this position is to place yourself on your knees but lean up against a wall or your birth partner if more comfortable.

In this position you can choose to sit on a chair forward or straddling the chair backwards. You could also sit on a stool or birth ball. Apart from when you are sitting forward facing in a chair, the other sitting options provide easy access for a partner to massage your back and hips. Sitting with legs apart also helps to improve blood flow to your placenta, uterus and baby. For even greater blood flow you can try sitting on a birth ball and slowly moving your hips from left to right.

When it comes to the pushing stage it’s a good idea to move out of the sitting position. Choosing a side lying or other upright position that will protect the perineum as you push will improve your comfort level and reduce the risk of tearing.

Just like other upright and side lying positions, squatting takes pressure of your tail bone and allows the pelvis to expand. This position is also great because gravity is on your side and your legs are already widened, which helps move your baby downward. You need to be reasonably fit to sustain this position but using props or a birth partner to hold you up and lean on can help. A couple of options include squatting between the legs of your partner, with your back to them, and resting your arms on their knees, or facing forward and hanging onto a stable chair or object. Some women also like to squat over the toilet as they can rest on the seat whenever they need a break. Sitting on te toilet is associated with releasing and letting go- so it's a great tool. Also you can close the door to get some privacy.

Finding the right positions for you as you move through the stages of labour and birth can have a positive impact on your birth experience. Getting educated and including some ideas about birth positions in your birth plan is good way to start preparing for a wonderful birth.

If you would like to find out more about my birthing programs and how I can help you plan for an amazing birth, please get in touch. I would love to hear from you.



If you would like to learn more about the birthing process and how you can plan for an amazing birth you can check out my range of programs. I also love connecting with mums to be and birth partners so please feel free to get in touch you have any questions.