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Comfort Measures for Labor

Labor Positions

When it comes to positions in labor, more is better. Changing your position can help align your baby properly, speeding the labor process. Some positions can help reduce specific types of pressure or pain, so be willing to use whichever are necessary when labor begins. Being familiar with how the positions feel before labor begins is helpful, so take some time to try them out and decide which ones are most comfortable to you.

During the labor, what you prefer may change as the baby's position and your energy level change. A position that wasn't comfortable a few hours ago may be perfect now. Stay flexible and choose positions for comfort and effectiveness in labor.

Movement in Labor

Combining movement with positions can help encourage a productive labor while helping you cope with the stress and pain of contractions. Walking, swaying and rocking your hips are especially helpful because they make it easier for your baby to move through your pelvis.

Specific movements can be used to achieve specific goals. For example, pelvic rocking can reduce the pain of a sore back. Understanding which movements and which positions help to encourage specific outcomes can help your labor move as quickly as problem free as possible.

Childbirth Positions Research

Gupta JK, Hofmeyr GJ. Position for women during second stage of labour (Cochrane Review). In: The Cochrane Library, Issue 1, 2004. Chichester, UK: John Wiley & Sons, Ltd.
Reviewers' conclusions: The tentative findings of this review suggest several possible benefits for upright posture, with the possibility of increased risk of blood loss greater than 500 ml. Women should be encouraged to give birth in the position they find most comfortable. Until such time as the benefits and risks of various delivery positions are estimated with greater certainty, when methodologically stringent trials' data are available, women should be allowed to make informed choices about the birth positions in which they might wish to assume for delivery of their babies.

El halta, V. (1995). Posterior labor: A pain in the back. Midwifery Today, 36, 19-21.
If these pre-labor contractions are close together and painful but not progressing, it may help if the woman spends 5 to 15 contractions in the knee/chest position. If the baby's head is posterior or asynclitic, the knee-chest position may allow the baby to back out of the pelvis and re-enter later with the fetal head more favorably positioned.

Hofmeyr GJ, G'lmezoglu AM. Maternal hydration for increasing amniotic fluid volume in oligohydramnios and normal amniotic fluid volume (Cochrane Review)
This review was looking at the value of maternal hydration for improving amniotic fluid volume. It was determined that maternal hydration does increase the fluid volume. This is a reminder to mothers to stay well hydrated during pregnancy because it does affect the fetal environment. In fact, low fluid volume may suggest a problem to the caregiver who would suggest the mother undergo tests to determine the cause. If the cause was lack of adequate hydration the mother is subjected to the stress and worry for nothing.

Gupta JK , Nikodem VC. Position for women during second stage of labour (Cochrane Review)
In this review, the researches found that using an upright position for pushing (rather than the lithotomy or back lying position) was associated with:

  • Reduced duration of second stage of labour
  • A small reduction in assisted deliveries
  • A reduction in episiotomies
  • A smaller increase in second degree perineal tears
  • Increased estimated risk of blood loss > 500ml
  • Reduced reporting of severe pain during second stage of labour
  • Fewer abnormal fetal heart rate pattern

The researchers concluded that women should be allowed to use whichever position is most comfortable for them during pushing.