As you prepare for the arrival of your little one, you may be wondering how you can increase your chances of having a vaginal birth versus cesarean, which is major abdominal surgery. Otherwise known as normal labor and birth, vaginal birth has fewer risks and typically an easier recovery as compared to cesarean. So let’s take a look at the best birthing positions.

Currently, the CDC reports that 31.7% of all births are by cesarean, which means your odds of a normal birth are twice that of cesarean. You can help boost those odds using active labor strategies and positions.

Frequent position changes during labor to help you be more comfortable and help baby get into the best position, say obstetricians and certified nurse-midwives. Your birthing position in labor can help your cervix dilate and thin out so that your baby moves down more easily into your pelvis.

Your nurses will recommend different birthing positions to try as they monitor your baby’s heart rate during contractions. Try to avoid lying in bed, flat on your back—this puts pressure on blood vessels, decreases blood flow to your baby, and if you lie on your back and stay.

in this birthing position you can actually slow down your labor, reducing baby’s opportunities to move into the best position for birth.

Having pain medication such as narcotics or an epidural may also decrease your ability to change birthing positions during labor. If you choose to receive a narcotic or an epidural for pain, try to move as much as you can beforehand. This could involve independent movement, or with the aid of a birthing or peanut ball.

Birthing balls can be unstable—ask your nurse or a family member close by to support you as you get on and off and rock on the ball. Peanut balls are helpful when you’re laboring in bed, and are more typically used if you’re using a narcotic or epidural, or if you prefer the peanut ball to a stability ball.

Ultimately, you need to choose birthing positions that are the most comfortable and safe for you.

Birthing positions may help increase the likelihood of having a vaginal birth:

Standing or Walking

Standing or walking works with gravity, allowing your pelvis to open and your baby to move down into the birth canal. Walking can be done any time during labor. While you’re walking, leaning against a wall, or your partner, for support during contractions may be helpful.

Squatting or Sitting

Like standing, squatting also opens the pelvis to give your baby more room to move down. Ask your support person to help you get into a comfortable squatting position. Some hospitals also have a squatting or birthing bar. A squatting bar connects to your labor bed. Leaning on the bar can also help your legs from becoming tired. Some women like to remain squatting during birth. This may be more difficult to do with an epidural in place.

Sitting on a birthing ball can help with pain during and between contractions, and sitting on a birthing ball also helps keep your pelvis open for baby. Sit, rock side to side, or back and forth, or bounce gently for counter pressure for your perineum.

Hands and Knees

Going on hands and knees (all fours) in a birthing bed is another way to cope more comfortably especially if you’re experiencing back labor. With this birthing position, gravity pushes baby’s head downward against the cervix, which may help speed up dilation.

While on hands and knees you can raise the head of the bed so you can lean forward to stabilize yourself. Have your support person or nurse nearby for extra stability, comfort and support. Nurses can help if this is a difficult birthing position to get into with narcotics or an epidural onboard.


This birthing position is very helpful when there is a need to rotate a posterior baby (back of the baby’s head is towards your back) to a better position for birth. Lying on your side is more comfortable if you’re tired and don’t want to remain upright.

If you have an epidural and must remain in bed, side-lying is preferred over lying flat on your back. When side-lying, use a peanut ball between your legs to open your pelvis. Hook your legs around the narrower part, or aligned with both knees and ankles resting on the ball. If your hips become uncomfortable, readjust the ball.

When Cesarean Birth is Necessary

Sometimes a cesarean surgery is needed, especially if labor isn’t progressing. Stalled labor might occur if your cervix isn’t opening enough despite strong contractions through several hours of labor. Labor can also slow down or stall if baby isn’t in the best position for a vaginal birth.

Now that you have read our article on the best birthing positions to Promote Vaginal Birth; here are other articles that you may find useful:

Prepare for Natural Childbirth

Try a birthing ball for labor


Danielle Beasley, PhD, RN, RNC-OB, CNE is an Assistant Professor at the University of South Florida, College of Nursing. She specializes in Maternal-Child Nursing, with an emphasis in labor and delivery.

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