Why Upright Positioning for Birth?

In active birth and hypnobirthing workshops you will hear me talking a fair bit about going to the bathroom. I’m not trying to antagonize the heavily pregnant women with a human baby sleeping on their bladder, I do it because there are a lot of similarities between birth and going to the loo, and it’s easily relatable to both men and women.

You will also hear a lot about using gravity to your advantage. When you go to the bathroom, you don’t lie on your back, put your legs up in the air and hold your breath as you eliminate. In baby care classes you will be taught to hold baby in an upright position if they appear to be having trouble passing a bowel movement. We rely on gravity to help our body perform an elimination process.

Birth is no different. When a woman comes into a back-laying position, or a Lithotomy position if we want to get fancy, birth is going to be a lot harder for her and baby than what it needs to be. There are a few reasons for this:

• Gravity helps the uterus to keep those nice, regular and strong surges coming. Consequently laying on your back can result in a longer labour.

• Upright positioning can help baby settle into a better position for birth.

• When we lay on our back there is less space in the pelvis for baby due to decreased movement of the sacrum.

• The birth canal is curved, and when you are in an upright position baby can move down and out easier, and you can also angle your own body to make it easier for baby. When we are laying on our back baby is going to have a harder time getting out. This can increase the need for interventions such as assisted deliveries and episiotomies.

• Prolonged pressure on the back can affect oxygen supply to your baby.

Your antenatal education should cover some good upright positioning and incorporate tools such as birth balls, bean bags, stools, support partners etc. There is no right or wrong way to move during labour. When a woman is comfortable in her birthing environment (think dimly lit with minimal interruptions) she will instinctively move in a way that feels best for her. That also applies to laying on your back. A small number of women find that most comfortable, whatever works for you mumma!