Active Labor: 10 Positions Changes You Should Practice and Use

Updated: Mar 3, 2019



You've heard that you should get active in active labor, and change positions often. But what does that mean? If you haven't been in labor before (or even if you have!), it's sometimes hard to remember what to do in the moment. I've broken it down here, to make it easy. Here are 10 positions you can get into to keep labor progressing.

Doulas are a great tool during labor, because we have an internal collection of position changes and other ideas to keep labor progressing and to keep you comfortable, as well. It's what we're trained to do!

If you don't have a doula on your team, it's not too late to hire one. Meanwhile, check out these tips and practice them with your birth partner. You are much more likely to use these tips if you take the time to practice and really picture yourself using them. The time to practice is now. A rule of thumb is to change your position every 20-30 minutes. In labor, we have a habit of finding one position that "feels better" and we like to hang out there, because let's face it, hanging out in a painful position is pretty counter-intuitive! But we need to find a balance between a position of rest, and a position that's going to help your contractions progress. Those harder contractions are the ones that bring your baby here! Need a refresher on pain coping strategies? Check out my blog post 10 Simple Tips For an Easier Labor.

10 position changes you should try in active labor:

1. Side-lying Release There's a reason this is first on my list. Everyone can benefit from a side-lying release to help balance the body. You'll need to know what you're doing though, so check out the link on spinningbabies.com. It requires a spotter to keep your hips stacked and your shoulders stacked, to allow the psoas muscle to release and relax, which is paramount in labor's progress.

2. Easy lunges, both sides To do this, have a stable chair on hand. Hold your partners hand and face both of your feet directly forward. Put your left leg up on the chair for your lunge so your left knee is bent 90 degrees. Hang out there for the duration of three contractions, and rest in between. Repeat on the right side. You'll likely find that one side feels tighter or way more uncomfortable than the other. Feel that imbalance? That's what the lunges are working to alleviate. Read more about balancing the body for a smoother labor at spinningbabies.com.

3. Lying on your side, and switch sides Sometimes you just need a rest, and that's ok. Trust your body. If you're going to lay down during active labor, keep it to 20-30 minutes on one side and then turn to the other side. Ask your partner to put a pillow between your knees and another between your ankles, and if it feels good, one wedged under your belly, too. Allow your body to rest, and your mind to rest.

4. Face your partner, put your arms around his neck, and sway This one is just like it sounds. Let gravity help you out while you stand up, and accept your partner's help and love by letting him support you. Dance and sway to the playlist you made for your labor.

5. Standing and walking Again, gravity is at play here. Walk around your neighborhood if you're at home; walk around the halls if you're at the hospital; If you're feeling to vulnerable at those suggestions, get up and stand in your labor room, and walk around the room. Remember, the idea is to change positions every 20-30 minutes or so.

6. Hands and knees This one is a wonderful way to help position your baby into the ideal anterior position. It often relieves back pain and allows your birth partner access to your back for the double-hip squeeze, counter-pressure on your sacrum, and placing a heating pad on your back and hips. You can kneel on the floor, or on the bed, or in the bathtub. You can place your birth ball in front of you and you can hug your birth ball, too. Wedge a towel in front of your ball to keep it more stable. Make sure your partner is paying attention so the ball doesn't slip!

7. Hip circles on birth ball 20 minutes later, take that birth ball and sit down on it. You can circle your hips or lean forward while holding your partners hands. Stay active!

8. Supported squat against a birth ball Now take your birth ball and place it against a sturdy wall, on the floor. Squat against the ball with your back against the ball. Aaahh, doesn't that feel good?! You certainly won't stay in a squat for the entire 20-30 minutes, but spend a few contractions down low, particularly if you are in active labor and your baby is already engaged into the pelvis in a good position (generally, anterior). You don't want to encourage a posterior baby down further into the pelvis, necessarily, until you've given baby ample space and opportunity to turn. Otherwise, squat away.

9. Lay on the bed, shoulders touching the mattress, bottom way up in the air. In other words, the Open-Knee-Chest. This is what position to get into if you know your baby is posterior (sunny-side up, or face-up), to allow the head to float up out of the pelvis and turn. Often the strong contractions of active labor will turn your baby anyway, and the Open-Knee-Chest can encourage this along. Don't worry, your nurses have seen this position all of the time, you won't appear foolish. In face, your nurse might even suggest this! Make sure you know this position in the case you need to use it. It can be a game changer in an otherwise slow-to-progress labor.

10. Tub Get in the tub and allow yourself to relax. Put a drop or two of lavender in the water, sip some ice water and allow your mind and body to relax. Sometimes it feels so good in the water that you won't want to get out! This is one position that I encourage moms to stay in for as long as they desire. It's still a good idea to change positions in the water; switch between lying back, getting on hands and knees, and squatting in the water.

If you found this article helpful, leave me a comment below and share around with your pregnant and birthy friends!

Chris

In case you missed them, here are some recent blog posts you might find interesting, too:

  • Doula Package #1: Comprehensive Doula Care

  • Relax and Open

  • Transition in Labor: Catch the (Theta brain) Wave

  • Some Like it Hot! Choosing a Birth Attendant

  • 10 Simple Tips For an Easier Labor

  • Hospital Birth Plans: The Only Thing You Really Need To Include (with simple template)

  • Doula Package #2: Distance Doula Care

  • Are 5-Minute Long Contractions Normal?

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