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Birth Position – Overview and Recommendations

A birth position refers to the body posture a woman adopts during labour and the pushing stage. Choosing the right position can positively influence the progress of labour and reduce discomfort.

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Things worth knowing about "Birth Position"

A birth position refers to the body posture a woman adopts during labour and the pushing stage. Choosing the right position can positively influence the progress of labour and reduce discomfort.

What Is a Birth Position?

A birth position refers to the posture a woman adopts during childbirth, particularly during the first (dilation) and second (expulsive) stages of labour. The choice of birth position is highly individual and can significantly affect the duration of labour, pain levels, and overall birth outcomes. Modern obstetric practice encourages freedom of movement and free choice of position, as different postures offer distinct advantages.

Common Birth Positions

Upright Positions

Standing or walking: Promotes contractions through the effect of gravity and may help shorten the duration of labour.
Squatting (birthing stool): Widens the pelvic outlet and makes optimal use of gravity.
Kneeling: Relieves back pressure and is particularly helpful for women experiencing back pain during labour.
Sitting: Allows rest between contractions while still benefiting from a degree of gravitational support.

Reclining and Lateral Positions

Side-lying (lateral position): Gentle on the perineum, reduces pressure on the vena cava, and is well-suited for prolonged labour or when an epidural anaesthesia is in place.
Supine position (lithotomy position): Historically common as it provides easy access for the birth attendant, but is now less recommended as it may inhibit contractions and compress the major blood vessels.
Hands-and-knees (all-fours): Particularly helpful for occipito-posterior presentations (baby facing forward) and for relieving back pain.

Benefits of Freedom of Movement

Research indicates that upright birth positions offer several advantages:

Shorter second stage of labour
Reduced risk of episiotomy (surgical cut to the perineum)
Less pain due to the natural effect of gravity
Improved blood circulation for both mother and baby
Greater sense of control and well-being for the birthing person

Factors Influencing the Choice of Position

The choice of birth position depends on a range of factors, including:

Personal preference and comfort of the birthing person
Progress and intensity of labour
Use of epidural anaesthesia, which may limit mobility
Medical indications or complications requiring specific monitoring
Available equipment in the delivery room (e.g., birthing pool, birthing stool, support bar)

Water Birth

Water birth is a special form of delivery in which part or all of the birth takes place in a warm water pool or tub. The warm water has a relaxing effect, can help reduce pain, and increases the freedom of movement for the labouring person.

Recommendations from Medical Organisations

The World Health Organization (WHO) and leading obstetric bodies recommend that women should be free to adopt whatever position they find most comfortable during labour and birth, provided there are no medical contraindications. Midwives and obstetricians play a crucial role in informing and supporting birthing people in exercising this choice.

References

World Health Organization (WHO): Intrapartum care for a positive childbirth experience. WHO Guidelines (2018). Available at: https://www.who.int/publications/i/item/9789241550215
Lawrence A. et al.: Maternal positions and mobility during first stage labour. Cochrane Database of Systematic Reviews, 2013. DOI: 10.1002/14651858.CD003934.pub3
Gupta J.K. et al.: Position in the second stage of labour for women without epidural anaesthesia. Cochrane Database of Systematic Reviews, 2017. DOI: 10.1002/14651858.CD002006.pub4

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