Birthing Positions

  • Useful if mother has epidural anesthesia
  • Often makes contractions more effective
  • May promote progress of labor
  • Easier for mom to relax between contractions during second stage
  • Allows posterior sacral movement in second stage
  • Can slow precipitous delivery
  • Partner may need to support leg
  • Partner can assist in delivery
  • Lowers chance of laceration or need for episiotomy
  • Access to perineum is excellent
  • Disadvantages

    • Access to FHTs poor if mother is lying on same side as baby’s back
    • No help from gravity
    • Mother must support her leg under knee if no one is there to hold leg
    • Mother may feel too passive

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    Leaning

    Advantages

    • Great for rotation of posterior presentation
    • Uses gravity
    • Contractions often less painful
    • Contractions often more productive
    • Baby is well-aligned in pelvis
    • Relieves backache
    • Facilitates use of back pressure
    • May be more restful than standing

    Disadvantages

    • Hard for attendant if used at delivery

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    Next Page: Kneeling; Squatting; Hands and Knees

     

    Kneeling, Leaning Forward with Support

    Advantages

    • Helpful with persistent posterior presentation
    • Assists rotation of baby
    • Good for pelvic rocking
    • Good for use with birth ball
    • Less strain on wrists and arms

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    Squatting

    Advantages

    • Encourages rapid descent
    • Uses gravity
    • May increase rotation of baby
    • Allows freedom to shift weight for comfort
    • Excellent for access to the perineum
    • Excellent for fetal circulation
    • May increase pelvis diameter by as much as two centimeters
    • Requires less bearing-down effort
    • Upper trunk presses on fundus to encourage descent
    • Thighs keep baby well-aligned

    Disadvantages

    • Often tiring to mother
    • Sometimes hard to hear FHTs
    • May be hard for mother to assist in delivery

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    Hands and Knees

    Advantages

    • Good for bradycardia (low heart tones)
    • Good for back labor
    • Useful with birth ball
    • Assists with rotation of posterior presentation
    • Takes pressure off hemorrhoids
    • Best position to avoid laceration or need for episiotomy
    • Good delivery position for large baby
    • Excellent for shoulder dystocia

    Disadvantages

    • Hard to maintain eye contact with mother
    • Hard for mother to see
    • Baby must be passed through mother’s legs
    • Can be disorienting to inexperienced attendant.

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