Squatting to give birth

Two of my friends, who gave birth naturally, sing the praises of giving birth in the squatting position. I would like to try it, but I am wondering how squatting benefits the birthing woman and her baby?


Peg Plumbo CNM

Peg Plumbo has been a certified nurse-midwife (CNM) since 1976. She has assisted at over 1,000 births and currently teaches in the... Read more

The practice of squatting to give birth has its roots in ancient history. As far back as we have records or stories about birthing, we see references to women giving birth in an upright or squatting position.

It is only within the last 100 to 150 years, since the physician or obstetrician has taken over control of birthing practice, that women have been required to push lying on their backs with their legs in the air. Physiologically, this is a very poor position in which to facilitate maternal pushing efforts as it opposes gravity. It is also not ideal for the baby, as the large uterus rests against the major vessels leading to the uterus and can impede blood flow during labor when the vessels may already be somewhat compromised due to strong contractions. Low fetal heart tones often recover when the mother assumes an upright position.

American women often find the squatting position uncomfortable, so they do not usually wish to assume this position for great lengths of time. We do not squat to conduct business, or converse with friends, as they do in some cultures. Our leg muscles and tendons do not support this position for long.

Women will often be encouraged by midwives to push on the toilet, which is the next best thing. As the baby's head gets close to birth, she is then assisted to the birthing stool or bed and the baby is delivered. For those women who wish to squat, kneel, be on "all fours" or stand to give birth, the midwife would accommodate her wishes is it is safe to do so.

One disadvantage to the squatting position is the risk of perineal Tearing, which can occur in this position. This increase in perineal trauma can occur for several reasons. The birth attendant may be unable to adequately support the tissues and prevent rapid birth of the baby's head. The baby may deliver more quickly in this position, thus providing less time to slowly stretch the maternal tissues.

Some birthing rooms and birthing beds are equipped with a squatting bar (a support bar), which allows the mother to grasp it and lift herself up to a squat. It also stabilizes her while she pushes. Birthing stools are also available which allow the mother to sit to push and give birth.

Squatting in a tub of water is another alternative. The buoyancy of the water makes it easier to remain comfortable and upright while pushing. In this way birth can even take place in the water.

I would say the upright position, regardless of how mothers choose to attain it, is an excellent position in which to give birth. Above all, mothers need to have the freedom to assume any position which they feel is comfortable and helps facilitate the birth of their baby.

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