The best positions for labor are the ones that help you stay focused on breathing, relaxing, and bringing your new baby into your world. Those positions will change as labor progresses, and you may change for each contraction. Knowing some great positions for labor that many women have used gives you options to roll with labor demands.
Some positions for labor require that you have good control over your body, so you’ll need to plan your birth accordingly. If your birth plan states that you want to walk or stand or squat during labor, you’ll also need to avoid an epidural, or have a walking one. Be sure your final birth plan listed on your hospital bag checklist clearly tells your birth team about this preference.
Many women assume that with a vaginal birth, the hours of labor and delivery are spent in bed, on their backs (supine) or slightly elevated (semi-supine).
It’s also the go-to position for the high numbers of women who receive epidurals or medications that compromise their muscle strength or balance, which then requires them to stay in bed.
Given that the epidural rate in the US has risen to 60%, it means vast numbers of women assume this is the best labor position simply because it’s the most common.
This common position works perfectly for attendants and doctors when they examine you or deliver your baby, but it’s not so great for you.
For every part of the birthing process, the supine or semi-supine position is the least effective.
According to research, blood vessels in your abdomen are compressed by your heavy uterus, which can inhibit blood flow to both uterus and placenta. This position can affect contractions, making them weak or irregular. It can slow cervical opening, prolong labor, and inhibit baby’s ability to descend.
Being supine decreases your pelvic outlet because it tilts your sacrum forward. This position creates an “uphill” orientation that makes you work against gravity. As well, it’s easy for the femoral nerve to get compressed, causing muscle weakness or numbness.
All of this can make you feel like you don’t have control.
But that doesn’t have to be the case.
Upright and moving positions decrease labor time and work with gravity to bring baby down through the birth canal. If the hospital allows, some women with epidurals can use the upright positions, especially with assistance from a partner, doula, or care provider.
10 Positions for labor if you don’t have medication or an epidural
1. Kneeling against and/or sitting on a birthing ball
Helps open your pelvis and works beautifully with gravity.
You can hug the ball or drape over it (as much as your stomach allows). Use it to apply a bit of counter pressure to your abdomen, if that feels good.
This is a great position to ease back pain. It also allows you to sit up between contractions then go back to the ball during them. As well, you can sit on the ball for support or comfort and still work with gravity.
If you don’t have a ball but kneeling sounds good, your partner/doula can sit in a sturdy chair. Put a good pillow on the floor to kneel on and rest your arms on your partner/doula’s lap.
2. Walking and swaying
Moving as much as possible, especially in the early stage of labor, really helps promote effective contractions that bring baby down the birth canal.
Walk between contractions then use the wall, your doula, or your partner to lean against during contractions.
Or, if your helper is strong, you can wrap your arms around their neck and hang or squat a little. Just don’t ask them to do this for long because it takes strength and stamina.
Can be soothing. Sitting at the edge of a hard chair, rock your pelvis and torso back and forth.
The movement stimulates your circulation, helps ease back pain, and keeps your pelvic opening as wide as possible.
4. Leaning forward
Can be done by sitting backwards in a hard chair, facing the back support. Drape your arms around it to straighten out your back.
You can do the same by standing and using your partner/doula or even the wall to support you. When you stand like this, you open your entire birth channel and create as much room as possible for baby.
Place one foot on a reasonably high surface like a chair seat, footstool, stair step, or even a suitcase. Any secure object will work as long as it won’t slide and is the right height for you.
6. Sitting with one leg up on an ottoman or chair
Can be refreshing because of its asymmetry and effective because it uses gravity.
You may need to put a pillow or folded blanket under your outstretched knee to support it.
An excellent position for giving baby the biggest opening through which to come, and for getting the most out of gravity.
Squat during contractions and stand—if you want—between them.
Use your partner, doula, or sturdy chair to help you get up and down from squatting, especially as labor progresses and your strength or balance changes.
8. Hands and knees
Almost always makes your back feel better. It helps open the birth canal and promotes circulation to baby so she gets a lot of good oxygen on her journey.
You can do this on the floor or in bed, and if your arms get tired simply change to putting your forearms on the ground, putting your shoulders on pillows on the floor, or use the bed.
This position also allows you to sway side to side or flex and extend your back. It gives your birth helpers easy access to your hips to apply counter-pressure.
9. Sitting on the toilet, birthing stool, or birth chair
Gives you the comfort of sitting with the pelvic opening and gravity advantages of being upright.
Though it’s not upright, laying on your side with pillows between your legs is a wonderful way to rest and still promote your birth canal being as open as possible. In the side lay position your sacrum isn’t pushed into the pelvic opening, so doesn’t decrease it.
5 Positions for labor if you have medication or epidural
Once you’ve received pain medication of any kind, your body control is less predictable so you have to be careful of relying on muscle function or strength.
Some hospitals offer walking epidurals that allow you to move around, which helps labor progress faster and decreases pain. Even with a full epidural that keeps you in bed, movement and changing positions is usually possible.
Promotes pelvic openness by not pushing your sacrum into the pelvic outlet.
When medication or epidural prevents you from getting out of bed, this is a better choice than semi-sitting or completely supine.
Use pillows between your knees for comfort and to keep pelvic opening as big as possible.
May take some help from partner, doula, or care team to get into if your muscles or sensations are weakened by medication.
Raise the top of your hospital bed and kneel facing that, with your arms either draped over the top or up against it.
This excellent position works with gravity and keeps baby’s passageway through the birth canal open. Some women even push in this position.
3. Hands and knees
Another great position that can easily be done in bed, but make sure you’re secure enough to move into or out of it.
Be sure you have help or support once your medication kicks in.
4. Sitting on the edge of the bed
May be controversial so check with your care attendants.
If you can sit on the edge of the bed, you’re working with gravity and can rock forward and back during contractions. Make sure someone is in front of you in case medication makes your muscles too weak to hold you upright.
The most common position. It’s very secure but doesn’t work well with either gravity or anatomy to keep the pelvic outlet open.
As you plan your birth, knowing good positions for labor and pushing gives you and your partner a chance to play with them ahead of time and see which feel best to you. You never know what will happen in labor, but having a trove of positions to choose from will help you work best with what labor gives you.
 Bucklin BA, Hawkins JL, Anderson JR, Ullrich FA. Obstetric anesthesia workforce survey: twenty-year update. Anesthesiology. 2005 Sep; 103(3):645-53.
 Lupe PJ, Gross TL. Maternal upright posture and mobility in labor–a review. Obstet Gynecol. 1986 May; 67(5):727-34.
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This new resource for pregnant families is a compilation of top tips and advice from more than 20 nationally-recognized experts in the field including renowned pediatrician, Dr. Alan Greene and GraceFull Birthing founder, midwife Elizabeth Bachner. These trusted experts offer thoughtful guidance for whatever type of birthing experience parents want, in whichever setting they choose.
Published: December 26, 2017 | By SP Turgon, Certified Labor Doula | Reviewed by: The Best Ever Baby Expert Team | Last reviewed: December, 2017