"When you change the way you view birth, the way you birth will change."
When you imagine the process of giving birth, what do you picture in your mind?
Perhaps you think of your own birth experience and are flooded with happy memories of meeting your bub for the first time. Or maybe you think of what Hollywood portrays to us- a woman laying on her back, with her feet up in stirrups, pushing a baby out into the world.
Think of an elephant- can you imagine a female elephant laying on her back, pushing a baby elephant out. No, she stands in a field as her newborns stumble to the ground.
According to research coming out of the US, 68% of people who had vaginal births in US hospitals report they pushed lying on their backs (1). However, back labour isn't often a position women instinctively give birth in. According to one home-based midwife, the majority of her pregnant patients spontaneously choose the hands-and-knees position(1). A European study of nearly 3,000 people who had planned home births found that the majority (65%) gave birth in non-back-lying positions (2).
So why is back lying labour so common? It is thought that most people giving birth are encouraged to push in this position because it is more convenient for the care provider during labour (1).
As a chiropractor, I have two golden rules for positions during labour.
There is no one ideal position to give birth in
The position that feels best to you and baby, that makes you feel empowered and as comfortable as possible, is the best position for you.
With that in mind, I want to discuss why giving birth on your back may not be the optimal birthing position.
If we look at the pelvis, there are two passageways the baby must move through during labour–the pelvic inlet and the pelvic outlet.
For the baby to make its way out, the sacrum and coccyx need space to get out of the way and quite frankly, laying on your back isn't the optimal position for this to happen.
Also, in back labour, what we typically see is the legs are wide open, which makes the pelvic outlet smaller.
Now, try this, place your hands on your sit bones and bring your knees apart. Notice what happens. Now put your knees together with your ankles apart, and you should notice that your sit bones are now further apart. Pretty cool, huh?
Here are three (non-back-lying) positions that you can use during the pushing stage of labour that allows for the optimal opening of the pelvis.
Side-lying with peanut ball- Laying on your side with a peanut ball between your legs, place your feet so they are wider apart than your knees, as this will help with opening the pelvic outlet. This side-lying position also allows the coccyx to get out of the way.
Hands and knees- you can use a pelvic tilt in this position to get movement in the pelvis. Make sure to give your hands and knees a break. You can also lean over a birth ball for a variation of this position.
Squat- During the push phase of labour, we want to focus on opening the outlet, so when you squat, you want to make sure your but is sticking out as this helps lift the tailbone. Also, in this position, you are working with gravity to help bring the baby down.
These are all positions to have in your tool belt to feel empowered to make choices for your labour. And you might think now that you want to give birth on your hands and knees, but it might change on the day of your delivery. Listen to your body and what feels best.
We hope that by providing you with this information, you will feel full of confidence entering your birth and have minimal fear.
To find out more about birthing positions and breathing for birth, here at Balanced for Life, we highly recommend the Calm Birth course with Kat, where you'll get to practice these positions with your partners, so you're prepared for anything on your due day.
Edqvist, M., Blix, E., Hegaard, H. K., et al. (2016). "Perineal injuries and birth positions among 2992 women with a low-risk pregnancy who opted for a home birth." BMC Pregnancy Childbirth 16(1): 196.