Positions in Pregnancy and Birth

One of the simplest ways to make pregnancy and birth feel a little more manageable is to get comfortable with different positions.

We tend to spend a lot of our lives in a very small selection of shapes: Sitting. Standing. Lying down. Repeat.

 

But your body is capable of so much more movement than that. During pregnancy, exploring different positions can help you find ways to rest, move, stretch, strengthen and get comfortable as your body changes. And as you get closer to birth, becoming familiar with different positions means you have a whole toolbox of options to draw from during labour. There isn't one perfect position. There isn't even necessarily one position that will feel good throughout your whole pregnancy. Your body is allowed to change its mind.

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Why do Positions Matter?

 

Changing your position changes how your body is loaded and how your joints, muscles and pelvis are moving. Sometimes a small change can make a surprisingly big difference. For example, you might find that:

• Standing feels better than sitting

• Sitting feels better than standing

• Being on hands and knees takes pressure off your back

• Side-lying is the only position you want at 3am

• A supported squat feels wonderful one day and absolutely ridiculous the next

• Leaning forwards feels much more comfortable during a contraction than sitting upright

 

There is no prize for finding the one "correct" position. The useful skill is being able to move between options and notice what your body is asking for.

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Positions to Explore During Pregnancy

 

You don't need to wait until labour to start experimenting. In fact, pregnancy is a great time to become familiar with different positions when you're comfortable, well-fed and not experiencing a contraction every three minutes.

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Standing

 

Standing is one of the simplest ways to move your body. You can:

• Stand with your feet comfortably apart

• Shift your weight from one foot to the other

• Circle or gently move your pelvis

• Sway from side to side

• Lean against a wall

• Lean forwards onto a table, worktop or birth ball

• Practise gentle squats or lunges

 

Standing can also be useful in labour because it keeps you upright and mobile. The NHS recommends staying upright and gently active during early labour, as this can help your baby move down into the pelvis and help your cervix dilate.

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Sitting

 

Sitting doesn't have to mean collapsing into the sofa and staying there for six hours. You can sit:

• On a chair

• On the floor

• On a cushion

• On a birth ball

• Straddling a chair

• Supported by your partner

• With your feet on the floor or supported on a block.

 

Try moving while you sit too. Gentle pelvic rocking, circles or shifting your weight can feel lovely when you're stiff. A birth ball can be particularly useful for staying upright while resting, and can also be used for gentle movement during labour. The NHS suggests sitting, leaning and kneeling with a birth ball as options during labour.

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If you're using a birth ball

Make sure it is the right size and properly inflated, and use an anti-burst ball. Ideally, your knees should sit slightly lower than your hips when you're sitting on it. And practise before labour. The last thing you want is to meet your birth ball for the first time while you're having a contraction and discover that the two of you have very different ideas about balance.

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Hands and Knees

 

This is a wonderfully versatile position. You can use it for:

• Gentle movement

• Pelvic rocking

• Mobility

• Rest

• Taking some pressure away from your back

• Exploring different movements through your hips and pelvis

 

You can also widen or narrow your knees, move your hands forwards or backwards, or sit your bottom towards your heels to find different variations. And because your body isn't fixed in one shape, you can move continuously rather than holding a static position. Hands and knees is also an option during labour. The NHS suggests that kneeling on all fours may be helpful if you're experiencing a lot of backache.

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Kneeling

 

Kneeling gives you lots of possibilities. You might kneel:

• Upright

• Sitting back towards your heels

• With your upper body leaning forwards

• Over a birth ball

• On one knee with the other foot forwards

 

Kneeling can be particularly useful when you want to stay upright but need to take some weight off your feet. It can also be combined with movement. Try gently rocking your pelvis forwards and backwards or shifting your weight from side to side.

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Lunges and Asymmetrical Positions

 

Your pelvis isn't a rigid, fixed structure. It moves. And you don't always have to move both sides of your body in exactly the same way.

Asymmetrical positions, such as a supported lunge or having one foot raised on a low step, give you opportunities to explore movement where the two sides of your pelvis and hips are doing slightly different things.

 

You might explore these positions during pregnancy as part of your mobility practice. They're also useful to have in your movement toolbox for labour. But here's the important bit: There is no magic lunge that guarantees your baby will turn, descend or come out in a particular way. The evidence doesn't currently support recommending specific maternal positions in late pregnancy to change a baby's position.

So explore these movements because they feel useful and interesting, not because you've been told you must do them to get your baby into the "right" position.

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Squatting

 

Squatting is a natural human movement that gives you another option for changing the way you load your hips, legs and pelvis. You don't need to be able to do a deep, unsupported yoga squat. You can use:

• A wall

• A chair

• A sofa

• A partner

• A birth ball

• A support bar

 

You can also practise partial squats rather than going all the way down. As your pregnancy progresses, your squat may naturally become wider or shallower. That's fine. A movement doesn't stop being useful simply because it looks different from the version you could do before pregnancy. Squatting is also one option for birth. The NHS lists squatting alongside standing, kneeling, sitting and side-lying as positions you may choose during the second stage of labour.

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Forward-leaning Positions

 

Sometimes your body simply wants to lean forwards. You might lean over:

• A table

• The back of a chair

• A kitchen worktop

• A birth ball

• The raised head of a bed

• Your partner

 

This can be a lovely position for resting while still being upright. It can also give your partner something useful to do. Massage your lower back. Apply pressure. Hold your hands. Or simply provide something sturdy to lean on while you sway. You don't need to look elegant.

The position that makes you think "oh, that's better" wins.

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Side-lying

 

Not every useful position is upright. Side-lying can be wonderfully restful during pregnancy, particularly when you are tired or simply need to get off your feet. You can make it more comfortable with:

• A pillow between your knees

• A pillow supporting your bump

• A pillow behind your back

• A bolster or cushion under your top leg

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Side-lying is also a useful position to know for labour and birth. It can be particularly helpful if you're tired, need to rest between contractions or want to change position without being fully upright. RCOG information on assisted vaginal birth notes that upright positions or lying on your side after full dilation may reduce the need for an assisted vaginal birth.

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What About Lying on your Back?

 

You don't need to be frightened if you find yourself lying on your back. However, the NHS advises avoiding exercise that involves lying flat on your back for prolonged periods, particularly after 16 weeks, because the weight of the uterus can affect blood flow and make you feel faint. There are lots of alternatives.

You can:

• Prop yourself up

• Lie on your side

• Use an inclined position

• Move onto hands and knees

• Use a seated position

 

And, as always, listen to how you feel. If lying on your back makes you dizzy, breathless, nauseous or uncomfortable, change position.

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Positions During Labour

 

This is where all that experimenting during pregnancy can become really useful. When labour begins, you don't necessarily need to find the perfect position. Instead, think: What feels good right now?

 

You might want to:

 

Stand

Walk around. Sway. Lean against something. Move your hips. Hold onto your partner.

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Sit

On a chair. On a birth ball. On the edge of the bed. Supported by your partner.

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Kneel

Upright. Leaning forwards. Over a ball. On one knee.

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Get onto hands and knees

Rock your pelvis. Move your hips. Rest your head. Let your partner massage your back.

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Squat

Supported. Holding onto your partner. Using a birth stool or other support.

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Lie on your side

Rest. Sleep if you can. Change sides. Use pillows for support.

 

The NHS recommends a range of positions for labour and says your midwife can help you find a comfortable position for birth.

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Is Upright Always Better?

 

You'll often hear that upright positions are "best" for birth. There's some good evidence that being upright and mobile during the first stage of labour can be beneficial, including potentially shortening the first stage of labour. But best isn't the same as mandatory.

 

Sometimes you will want to stand. Sometimes you'll want to kneel. Sometimes you'll want to sit. Sometimes you'll desperately want to lie down. And there may be times when your clinical circumstances mean that your options are more limited. The aim isn't to force yourself to remain upright because somebody told you that lying down is bad. The aim is to have options.

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What if I Have an Epidural?

 

Having an epidural doesn't necessarily mean that you're stuck in one position. Exactly what you can do will depend on your individual circumstances, the type of epidural you have, your mobility and your maternity unit's policies. You may still be able to change position with support. Side-lying can be particularly useful, and some units may have additional positioning equipment such as peanut balls.

Your midwife can help you understand what's possible for you. And if you're planning an epidural, this is a great question to ask during pregnancy: "What positions will I be able to use if I have an epidural?" Knowing your options before labour means you're not trying to work them out in the middle of it.

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What about Birth Positions and Tearing?

 

You may have heard that certain positions are supposed to prevent tearing. The reality is more nuanced. There are a number of factors that influence perineal trauma, and there isn't one position that guarantees you won't tear.

 

The RCOG OASI Care Bundle specifically supports discussing birth positions and movement during labour as part of informed decision-making, rather than prescribing one position for everyone. Your maternity team can talk you through the options available to you and any recommendations that are particularly relevant to your circumstances.

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Can Positions Turn my Baby?

 

This is one of the biggest questions people have. You'll find plenty of advice online telling you to spend a certain number of minutes each day on your hands and knees, lie on one particular side or sit in a particular way to encourage your baby into an ideal position. It sounds wonderfully simple. Unfortunately, the evidence isn't that simple.

 

A Cochrane review found no evidence to guide practice on the best maternal positions in late pregnancy for changing the baby's position. Your baby has a lot of movement available to them, and their position can change throughout pregnancy. So by all means move. Explore different positions. Spend time on hands and knees if it feels good. But don't turn it into another pregnancy homework assignment that you feel you have to complete perfectly.

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Think of Positions as a Toolbox

 

Rather than learning a list of "correct" positions, think about building a toolbox.

 

If you need to rest:

Try side-lying or supported sitting.

 

If you want to stay upright:

Try standing, walking or sitting on a birth ball.

 

If your back is uncomfortable:

Try hands and knees, kneeling or leaning forwards.

 

If you want to explore pelvic movement:

Try standing, kneeling, hands and knees or supported squats.

 

If you want asymmetrical movement:

Try supported lunges or one-sided positions.

 

If you're in labour:

Try whatever feels most comfortable and appropriate for your circumstances. And then change your mind. You are allowed.

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Practise Before you Need it

 

You don't need to spend hours rehearsing birth positions. But it can be useful to explore them during pregnancy, particularly as you get closer to your due date.

 

Try them during your pregnancy yoga practice. Try them with your birth partner. Try them with a birth ball. Try leaning forwards over the kitchen worktop. Try a supported squat. Try kneeling. Try side-lying with cushions.

 

And notice: What feels good? What doesn't? What helps me relax? Where do I naturally want to move?

 

This gives you something far more useful than a list of positions. It gives you experience in your own body.

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Explore Next

 

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Pelvic Floor
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Body Ready Method®
Explore how biomechanics, balance and movement can form part of your physical preparation for birth.

 

Birth Positions
Explore how different positions can be used during labour and birth, and how your birth partner can support you.