When you think about labor, you may envision lying in bed.
But that's not necessarily the best place to be, especially during active labor, the rigorous phase of childbirth in which contractions arrive roughly every three minutes and the cervix fully effaces and dilates between 5 and 8 centimeters.
"Unless there's a medical reason for remaining in bed, such as high blood pressure or pre-eclampsia, there's very little reason to be there," says Karen Barr, a certified nurse-midwife at Rush-Copley Medical Center in Aurora. "In fact, I find that women who do spend a lot of time in bed during labor have a harder time coping with the discomfort of the contractions. It can also impede progress."
Besides walking-an age-old labor trick for prodding Mother Nature-striking an upright pose, preferably a different one every half hour or so, can enlist gravity and pelvic movement to help keep labor moving along, says Barr. It may also help rotate your baby out of a posterior (forward facing) position in the pelvis, which can be painful, and increase blood flow to the placenta to enhance baby's oxygen supply, reducing the risk of fetal distress.
Here are some positions that may ease pain during active labor and help labor progress. Practice these exercises now so you're comfortable with them by the time you're ready to give birth.
With your feet spread apart, put your elbows on the bed or hold on to the bed or a chair for support, then bend your knees and squat, either halfway or fully to the floor. "Just don't bear down," cautions Martha Barry, a certified nurse-midwife at Advocate Illinois Masonic Medical Center in Chicago, since your cervix isn't dilated enough at this stage of labor to push the baby out. During a contraction, round your back. (Doing this can help redistribute pressure.)
To build leg power, practice squatting several months to weeks before your due date. Or sit on a birthing ball, aka an exercise ball at the gym, in a squatting position. "A birthing ball gets you into a squat while providing support for your lower back and legs so they don't get tired. Do a hula motion with your hips," Barr says.
Place one foot on a sturdy chair, bed or stairway, lean into a lunge position and rock your hips during contractions. Switch legs every now and then. "When you put your foot on a higher level, your pelvis opens up. The baby has more room to descend the pelvis," says Barry. Stair climbing does the same thing. "Try spreading your legs and going up the stairs two at a time," she says.
On the floor or in your bed, get on your hands and knees and alternate rounding your back and flattening it, rocking your hips with each contraction. "This is one of the least stressful positions because your baby is no longer pressing against your spine. It's also easier for anyone assisting you to apply warm compresses to your back, which can be soothing," says Barry.
Place a pillow on top of a bureau, a table or a hospital bed that has been raised to its highest level. Then, simply lean forward, drape yourself onto the pillow and sway your hips during a contraction. Since you're standing, you're working with gravity. "And leaning into something soft feels really good," says Kim Wheaten, a certified doula in DeKalb.
Raise the back of the hospital bed so that it's in an upright position. Kneel on the bed, facing the pillow and lean forward carefully, draping yourself over the raised portion. Or simply face forward. "This position gets you into a squat-like position in bed and you're upright, so you're using gravity to help your baby descend," says Barr. It's especially helpful if you have to remain in your bed and be on the monitor for some reason.
At some point during active labor, you may want to rest. And if you get an epidural or you're being induced or monitored, you can find yourself bedridden. To help labor progress if you're bedridden or resting, lie in bed on your side with pillows stuffed between your legs, says Wheaten. Unlike lying on your back, your weight won't be on your aorta (a major artery), which can affect your circulation and your baby's oxygen supply.
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