If you’re nearing the end of your pregnancy, you may have already brushed up on how to push during childbirth. But what about birthing positions? While many mamas probably imagine laying on their back to push, the fact is there are several positions you can try when it comes time to deliver your little one. Here’s an overview of some of the most common pushing positions at the end of labor.
Reclining
This position is probably the most common way women give birth in the United States, particularly in a hospital setting. During a reclining birth, you’ll lay on your back with the head of the bed lifted to your comfort. To keep your hips open as baby moves into the world, place your feet wide on the bed with knees bent or in stirrups as you push. It can be helpful to hold behind your knees for leverage while pushing. Your partner or care team may help you support your legs, especially if you’ve had an epidural.
Pros:
- This position is comfortable for mamas who have had a spinal block or epidural
- Less energy is used while pushing than in other positions
- Your care team has good access to baby as they’re delivered
Cons:
- Your body can’t work with gravity as you push, which means it may take longer to push your baby out
- Lying flat on your back may put pressure on major blood vessels and cause dizziness
Side-Lying
Giving birth on your side can be a great way to get some rest from pushing between contractions. While lying on your side, open your top leg up and hold it behind the knee, or ask your support person to help hold it in order to keep your pelvis open. It may be helpful for your care team to place pillows behind your body to better support you in this position.
Pros:
- This position can be done by mamas who have had a spinal block or epidural
- Can help prevent tears and the need for tools like forceps or a vacuum
- Takes the pressure off of your back and tailbone
Cons:
- Your body can’t work with gravity as you push
Squatting
Squatting is a great way to give birth, as it enlarges the pelvic opening and gives gravity an opportunity to help the process. In order to squat during childbirth, keep your knees wide and feet flat and parallel to each other. Use your partner, care team, doula or a birthing bar to support you as you push. Taking breaks in a non-squatting position might be helpful as you rest between contractions.
Pros:
- Gravity helps reduce the amount of time you spend pushing
- Shown to decrease the need for tools like forceps or vacuum during delivery
- Can help to reduce back pressure
Cons:
- There’s a higher potential for tearing as you push
- This position may not feel comfortable depending on baby’s position
- Remaining in the squatting position can get tiring
- Not an option if you’ve had a spinal block or epidural
On All Fours
This is a very supportive position for childbirth, and still helps you keep a wide pelvic opening. When it’s time to push, your care team can help you get on your hands and knees, with your knees spread wide.
Pros:
- Gives you stronger support than squatting
- Can relieve back pressure as you push
- May assist with baby’s rotation as they are delivered
- Your care team can easily see what’s happening
Cons:
- It’s harder for the birthing person to see the delivery happen
- Not an option if you’ve had a spinal block or epidural
Kneeling
The benefits of giving birth in a kneeling position are similar to pushing on your hands and knees. To kneel while pushing, get on your knees and use a birthing bar or the headboard of the bed to hold yourself up and lean into it for support. Some women like to kneel on one leg, then open up the other leg and plant their foot down on the bed.
Pros:
- Gravity helps reduce the amount of time you spend pushing
- Can help ease back pressure
Cons:
- Can be harder for continuous fetal monitoring during delivery
- Not an option if you’ve had a spinal block or epidural
As you’re creating your birth plan, or even when you are admitted to the hospital during labor, it can be helpful to discuss how you’d like to labor and push with your care team. They will be able to give you more detail on how different medications could interfere with your labor and delivery goals.
When it comes time to start pushing, ask your care team to help you get into a position that feels the most comfortable. And if one position doesn’t feel like it’s working for you, try a different one! Your instinct is important, mama. Your care team should allow you to deliver your baby in whatever position works best for you.