Standing
Advantages
- Excellent for oxygenation of fetus
- Uses gravity
- Contractions are more effective and less painful
- Helps speed up labor
- Helps create pushing urge
Disadvantages
- Poor control of delivery
- Visualization very hard for birth attendant
Walking
Advantages
- Uses gravity
- Contractions often less painful
- Encourages uterine contractility
- Baby well-aligned in pelvis
- May speed up labor
- Reduces backache
- Encourages descent
Disadvantages
- Often mother can’t use if she has high blood pressure
- Can’t be used with continuous electronic fetal monitoring
Sitting
Advantages
- Good for resting
- Uses gravity
- Can be used with continuous electronic monitoring
- Can be used with birth ball to encourage descent
Disadvantages
- Possibly can’t be used if mother has high blood pressure
Sitting on Toilet
Advantages
- Helps relax perineum
- Mother accustomed to open-leg position and pelvic pressure in this environment
- Uses gravity
Disadvantages
- Pressure from toilet seat can cause pain
Semi-Sitting
Advantages
- Comfortable for mother
- Good use of gravity
- Good resting position
- Works well in hospital beds
- Good visibility at delivery for mom, dad and others present
- Good access to FHTs (Fetal Heart Tones)
Disadvantages
- Access to perineum can be poor
- Mobility of coccyx is impaired
- Some stress on perineum, but less than lithotomy
Lithotomy – (on back, legs raised — avoid this position!)
Disadvantages
- Compression of all major vessels
- Laceration or need for episiotomy is more likely
- No use of gravity to aid delivery
Side-Lying
Advantages
- Good fetal oxygenation
- Good resting position for mother
- Helpful if mother has elevated blood pressure
- 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
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
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
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 centimetres
- 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
Hands and Knees
- Can be disorienting to inexperienced attendant.
