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Finding The Best Way To Labor

By Michele L. Deck, RN, MEd, BSN, LCCE, FACCE

Finding The Best Way To Labor

Do you know your best way to labor? Close your eyes and imagine you’re in labor. If you picture the scene as it occurs regularly in movies, on television and in hospitals everywhere, you probably see yourself lying in a hospital bed, hooked up to an IV, and wearing belts around your belly to continuously monitor your baby’s heartbeat and the contractions. Your range is limited to a few square feet.

What’s wrong with this picture? A lot, according to research.

“The best way to keep your baby moving down and out is to keep your own body in motion,” says Marilyn Curl, CNM, MSN, LCCE, FACCE, president of Lamaze International, an international non-profit organization dedicated to promoting a natural, healthy and safe approach to pregnancy, childbirth and early parenting.

“Being confined to bed, tethered to monitors and IVs interferes with the body’s ability to move the baby through the pelvic bones and down the birth canal.”

Many hospitals and birthing facilities have routine protocols, such as requiring continuous fetal monitoring, that inadvertently limit your movement. If you’re using an epidural, for example, then you’ll typically be required to remain in bed.

Researchers have examined published studies that compared policies that encouraged movement during labor with policies that restricted movement. The conclusions show that women who are encouraged to walk, move around, or change positions during labor may experience:
less severe pain
less need for pain medications, such as epidurals and narcotics
shorter labors
less continuous monitoring
fewer cesarean surgeries
lower likelihood for an episiotomy and use of vacuum extraction or forceps


Why does movement during labor have these effects? Staying upright during labor means that gravity can aid your body’s natural efforts, it lets your pelvic bones open as much as possible. When you’re laying on your back, confined in bed, you lose this advantage, which increases the likelihood that your baby will be unable to navigate through your pelvic bones.

“It’s frustrating to see women routinely put on their backs and confined to bed and then be told that they ‘failed to progress’ or that the baby ‘didn’t fit’ through their pelvis when a simple move into an upright position could easily resolve both situations,” said Marylou Carrico Tietz, LCCE, FACCE, a childbirth educator in Bethesda, MD.

“Women need to be encouraged to listen to their bodies in labor and question routine hospital policies that may slow their progress.”

It’s no surprise that childbirth educators find that many women also report that movement during labor is an effective pain management tool, reducing pressure on the lower back and increasing space within the pelvis and allowing for an easier descent.

“The mother’s movement throughout labor can help ease the baby through tight spots in the journey to being born. The easier it is on the baby, the easier it tends to be for the mother as well,” says Tietz.

Follow these tips to locate a labor-friendly healthcare provider and avoid unnecessary confinement to bed during labor:
Choose a care provider who supports “mobile moms”—If they express support, put their answer to the test and ask what percentage of their patients end up staying up and mobile during labor
Know the facts on fetal monitoring—In low-risk mothers, research shows that occasional checks of the baby’s heart rate are just as safe as constant monitoring
Know the facts about epidurals—The benefits are well known, but also consider the possible drawbacks. Switching positions can help get babies “un-stuck,” but an epidural will render you mostly immobile
Choose the right support—A doula or labor support person can help you stay moving and “negotiate” with your care provider or nurses, as needed. They can also help you manage each and every contraction
Use a birthing ball when you need a rest—Remember that you may need to bring your own, since many hospitals and birthing centers may not support women laboring in upright positions
Stay upright during the pushing phase—Many care providers will “let” mothers walk or sit up during the dilation phase, but will put them on their back or bottoms during the pushing phase. These positions shrink the pelvis and make it harder to push the baby out
Don’t be afraid to insist—It’s difficult to go against hospital or birth center routines but remember that many routines are in place for the comfort and convenience of staff, not the health and safety of you and your baby. The easier the birth is for you and your baby, the better the chances of a safe and healthy outcome for both of you.

Let labor begin on its own
Walk, move around and change positions throughout labor
Bring a loved one, friend or doula for continuous support
Avoid interventions that are not medically necessary
Avoid giving birth on your back and follow your body’s urges to push
Request to be kept together with your baby at all times; it’s best for you and baby and for breastfeeding


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Michele L. Deck, RN, MEd, BSN, LCCE, FACCE, is the president-elect of Lamaze International; read more at www.lamaze.org/healthybirthpractices.

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