Chances are that at some point in your life, you’ve seen a video of a woman giving birth, and aside from all her yelling during contractions and the obligatory vaginal shot when the baby’s head appears, you probably remember the woman as being in bed and on her back. What you may not realize is that this is the least effective position in which to give birth: gravity is working against instead of for you. Additionally, if you remain in one position for the duration of your labor, you are most likely going to be in more pain than if you move around. Now, being upright and moving around aren’t going to completely remove the pain of labor -- it’s still going to hurt -- but they will do a great deal to helping you cope.

“Mothers who move about during labor and assume an upright position during delivery, experience less pain, and need less analgesics,” Ms. Leino writes in The Amazing Hidden Facts of Good Birthing Positions. “Additionally, mothers who change positions have shorter labor, less perineal tears and rarely need episiotomies; besides, their babies show less fetal distress and have a better supply of blood and oxygen” (p5). According to Ms. Leino, the supine (or back-lying) birthing position first originated early in the 19th century following the appearance of profession of “obstetrician” and the growing practice of birthing in a hospital. The combined reasons of hospitals being teaching institutions, ease of managing labor from the doctor’s point of view, and being in a better position to use instruments in case of complications soon standardized the supine birthing position. Use of anesthesia also demanded the mother being lying on her back.

However, a mother’s being upright puts the baby in the right position to prepare for labor and increases pressure on the cervix via the weight of the baby’s head. This leads to a greater release of birthing hormones and also endorphins, which increase stamina and suppress pain. When the mother is also allowed to shift positions as she desires, the baby is facilitated in moving into the optimal position for descending and moving through the birth canal (the baby must actually rotate slightly during delivery). Changing positions keeps labor moving and contributes to a 50% shorter labor, according to studies. And finally, being upright and moving reminds both you and your doctor that you are not a patient to be medicated but an active participant in your birth event: your practitioner will be less likely to offer unnecessary interventions.

In our culture, birthing is far removed from most people’s everyday lives: births take place in hospitals, with a bare minimum of attendants. Not only that, but the positions we assume day-to-day do not have much variety either. We sit. We stand. We lie down. Not much to work with there. For these reasons, Lean Leino’s book contain detailed instructions complete with color photos of positions you can work with during labor and delivery. Once you are aware of your options and practice with your support person, assuming new positions, such some version of squatting during labor, will feel more natural to you.

It is important to go over these positions, first, with your support person so that they can (literally) support you while you assume them and suggest different positions should you need a reminder during labor. Second, it is a good idea to discuss your convictions regarding movement with your practitioner, “in order that the obstetrician does not become and ‘obstruct-trician’ in the way of your natural delivery,” cautions Ms. Leino. For anyone hoping to maintain a natural birth event, The Amazing Hidden Facts of Good Birthing Positions is an indispensable guide to finding the most effective positions for all stages of laboring and delivery.