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Maternal Movement and Position Changes


Bhavani Shankar Kodali MD, Associate Professor

Karl Frindrich MD, Clinical Fellow

During Labor Laboring women find some positions and movements more comfortable than others in different stages of labor. Since the early 1900's birthing has moved from the home to the hospital with the use of medical staff, intravenous lines, epidurals, and other forms of medical care. This may have served to limit the freedom of movement of the birthing mother. 

When the mother alters position, she changes the relationships of the babies head position, uterine contraction, and her pelvis with gravity. Movements and positioning in labor may be recommended to rotate a malpositioned baby or correct slow labor progress in dilation or descent. Many studies suggest walking or sitting more upright speeds the rate of labor. 

Sample Positions

  • Upright 

  • Squatting 

  • Side 

  • Flat 

  • Hands and knees 

Recently birthing balls have been used to provide comfort during labor. The mother can sit, rock, bounce, or stretch on the inflatable ball to ease pain or increase the rate of delivery. 

Limitations

No studies have reported any position that has been found to be harmful to the baby or mother. Women should be encouraged to seek any position that provides comfort and maintain an upright position if she wishes. Certain procedures such as epidurals may make ambulation unsafe even with adequate leg strength. Many labor units lack man power or designated areas to facilitate walking with epidural placement. 

Birthing balls should not be used without the assistance of experienced caregivers to prevent against falls. 

The above information was obtained from the following publications. If you would like more information on movement and position changes we suggest reading the papers and discussing this with your obstetrician. 


Simkin PT, Bolding A. Update on nonpharmacologic approaches to relieve labor pain and prevent suffering. J Midwifery and Women's Health 2004;49:489-504

Murray Enkin, A Guide to Effective Care in Pregnancy and Childbirth, 3rd Ed., Oxford University Press, 2000 

Eappen S, Robbins D., Nonpharmacological means of pain relief for labor and delivery, Int Anesthesiol Clini. 2002 Fall; 40(4): 103-14, Review 

Simkin P.,Nonpharmacologic relief of pain during labor:Systematic reviews of five methods, Am J Obstet gynecol, 2002 Volume 186, Number 5 ,S131-159

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