Positions for Labour

Information for women

This leaflet can be made available in other formats including large

print, CD and Braille and in languages other than English, upon

request.

This leaflet explains the benefits of staying active during labour as well as suggesting different positions which can be used to help you cope with your contractions and help you have a positive birth experience.

What advantages are there to staying active during labour? Research shows there are advantages when women stay active during labour. These include:

contractions are stronger, more frequent and regular

the cervix (neck of the womb) dilates easier

the uterus (womb) relaxes better between contractions

the first and second stages of labour are shorter

women are less stressed and do not suffer as much pain so need less analgesia (pain relief)

there is less risk of your baby becoming distressed in labour. Using deep breathing and relaxation helps to make sure you and your baby have a good supply of oxygen during labour and birth.

Why is an active birth better? When in an upright position:

gravity, along with strong contractions help during the birth. When lying down contractions are often not as strong and more effort is needed to push your baby out.

your uterus does not have to work as hard. When lying down or leaning back your uterus has to work harder so tends to tire and ache more easily.

your baby’s head enters your pelvis more easily. The head presses down on your cervix with each contraction which helps it to dilate. When lying down your baby’s head does not press on your cervix as well.

there is improved circulation to your placenta giving better oxygen supply to your baby. When lying down your main blood vessels are compressed (squashed) by the weight of your baby and this can reduce the blood supply around your uterus and placenta.

there is less pressure on your pelvic nerves, therefore less pain.

your pelvic joints are free to move and adjust to the shape of your baby’s head. This means the bones in your pelvis can widen in certain positions, giving more room for your baby. Your coccyx (tailbone) also swivels backwards to make more room. This is not possible if you are sitting or lying down.

the skin around your vagina can stretch evenly and pull back over your baby’s head, reducing the risk of tearing. In reclining positions the skin cannot stretch as easily.

What are active positions for labour and birth? The positions you choose for labour and birth are important. They will help you be more comfortable during your labour. Some positions may also help speed up your labour. Trying different upright positions during your labour may help you to have a normal birth. Practising the following positions before you go into labour will make them more comfortable and natural when the time comes.

Standing and walking

These positions help your contractions as your baby’s head presses down on your cervix with gravity, helping it to dilate. Circling your hips while standing can also help to nudge your baby’s head into a better position. This will help your baby move further down into your pelvis. Standing supported by your birth partner can be comforting, knowing someone is near you. Your birth partner may also massage your lower back during contractions. Some women prefer to stand and walk during labour while others find that as the contractions grow stronger other positions are more comfortable.

Sitting

Sitting upright and leaning forward with your legs apart can feel very comfortable. Many women find sitting astride a chair, facing the chair back and leaning forward onto a cushion helps. In this position you and your baby are well supported, your pelvis is open, making more room for your baby to move down. This allows you to relax and have your back massaged if you wish. Sitting this way helps relaxation and allows you to rest. Many women find sitting on the toilet very comfortable during labour. Some women choose to give birth in a sitting position using a birthing stool.

‘All fours’

Some women find they want to get into this position towards the end of the 1st stage of labour, when your contractions are stronger. You will need to make sure you are comfortable using something soft under your knees, such as a mattress or folded blanket, plus a pile of cushions, a large bean bag or floor cushions to lean over. This position is helpful if most of your pain is in your back or if your baby is lying with his or her back towards your spine (back to back or occipito posterior or OP). It can help your baby to turn into a better position. Making circular movements with your hips as well as swaying them back and forwards can help your baby move into a better position. Your birth partner can also help by massaging your back in time with your movements. If you are having a very fast birth you can stay on your knees while lowering onto your elbows with your bottom in the air. This will help you slow down your contractions and make them less severe, as it helps to reduce the pressure of your baby’s head pushing against your cervix. This is also a good position for giving birth.

Tailor sitting Tailor sitting is a relaxing way of sitting. It can be done on the floor or on a mat, depending where you feel most comfortable. This is another upright position, which allows gravity to help and stretches your inner thigh muscles and back.

Squatting In this position your pelvis is opened to its widest and is the best position for your baby to be able to pass through your birth canal. You can squat using a low stool, supported by another person, holding onto something in front of you or leaning forward onto a pile of cushions. Squatting can strengthen your contractions so you may need to change position if you start to feel uncomfortable.

Sitting on a birthing ball

A birthing ball is popular in hospitals, birthing centres and home births. They are used in many exercise classes and can make you feel comfortable, not just in labour and birth but during your pregnancy. You should:

sit on your ball with your feet wide enough apart to help you balance

sit with your hips higher than your knees

keep upright. Your birth partner can give you extra support or massage your back. Using movement with the ball can also help. You can sway from side to side or in a circle. It is a good idea to practise these movements so you find they are easy to do when you are in labour.

It will also help to stretch your body and move your baby into a good position for birth. Half kneeling, half squatting with birthing ball This is also a good position to use and is easier than squatting. Change legs for each contraction and rock forwards and backwards towards your upper knee during contractions.

This position can help your cervix to dilate and may ease backache. Kneeling with birthing ball You can also lean over the ball in labour while your birth partner rubs your back. You can use swaying and circular movements to stretch your back.

You will need to use mats or cushions to support your knees and make sure the angle of your body is upright to allow gravity to help you. At certain times during your labour you may need to lie down. If so, it is best to lie down on your left side, propped up with cushions.

How can the way I breathe during labour help me? The way in which you breathe is important, as your muscles are working very hard and need a steady flow of oxygen. When your contractions are strong it is important to focus when breathing out, giving a long sighing breath each time. This helps to keep you relaxed, not tense up or breathe too fast. Breathing in this way will provide a good supply of oxygen for you and your baby. If you are becoming tense, especially at the peak of a contraction; breathe out and release it so you can start your next contraction relaxed. If you breathe too fast it can make you feel dizzy and light-headed and will tire you out quickly. If you are tense it will make your contractions more painful.

Contact numbers

If you need any further advice, or have any worries, please contact:

University Hospital of North Tees Community Midwives Monday – Friday, 8.30am – 9.30am

Ragworth Children’s Centre St John’s Way

Stockton If you live in Billingham or Stockton North Telephone: 01642 383441 or 01642 383442

If you live in Stockton South or Thornaby Telephone: 01642 383439 or 01642 383440

Non-urgent messages can be left on answering machine and will be picked up throughout day. If your call is urgent you should contact the hospital where you are due to have your baby. Antenatal Day Unit Telephone: 01642 624239 Monday – Friday, 8.30am – 8.00pm Saturday & Sunday, 9.00am – 5.00pm Outside these hours calls are transferred to the Delivery Suite. Delivery Suite Telephone: 01642 382718 24 hours a day, 7 days a week Antenatal/Postnatal Ward Telephone: 01642 382722 24 hours a day, 7 days a week

University Hospital of Hartlepool Antenatal Day Unit Telephone: 01429 522879 Monday - Friday, 9.00am – 5.00pm When the unit is closed calls are transferred to the Delivery Suite, North Tees. Community Midwives Telephone: 01429 522279 7 days a week, 9.00am – 10.00am Non-urgent messages can be left on answering machine.

East Durham Based at Peterlee Community Hospital Telephone: 01429 522270

Monday – Friday, 9.00am – 10.00am

Further information is available from: NHS Choices telephone: 111 (when it is less urgent than 999) Calls to this number are free from landlines and mobile phones or via the website at www.nhs.uk National Childbirth Trust Alexandra House Oldham Terrace Acton London W3 6NH telephone: 0300 330 0700 Monday – Friday, 9.00am – 8.00pm website: www.nct.org.uk

This page can be used for any questions or notes you have.

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Quality Assurance Team, University Hospital of North Tees or email: patientinformation@nth.nhs.uk

Comments, Concerns, Compliments or Complaints

We are continually trying to improve the services we provide.

We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team is here to help.

Our Patient Experience Team is here to try to resolve your concerns as quickly as possible. If you would like to contact or request a copy of our PET leaflet, please contact:

telephone: 01642 624719 Monday – Friday, 9.00am – 4.00pm

Messages can be left on the answering machine and will be picked up throughout the day.

freephone: 0800 092 0084

Email: patientexperience@nth.nhs.uk

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.

telephone: 01642 617617 24 hours a day, 7 days a week

The Patient Experience Team is available to discuss your concerns in person Monday – Friday, 1.30pm – 4.30pm. The office is based on the ground floor at the University Hospital of North Tees.

Data Protection and use of patient information

The Trust has developed a Data Protection, Caldicott and Disclosure Policy (IG5) in accordance with the Data Protection Legislation (General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect this policy and confidentiality is adhered to at all times. If you require further information please contact the Information Governance Team.

telephone: 01642 383551 or email: information.governance@nth.nhs.uk

University Hospital of North Tees, Hardwick, Stockton-on-Tees. TS19 8PE

University Hospital of Hartlepool, Holdforth Road, Hartlepool. TS24 9AH

Telephone: 01642 617617 Fax: 01642 624089

PIL1090 July 2019