Let’s Talk About Labor Positions!

It's Labor Day in the States. So, to honor that, I want to talk to YOU about Labor Positions. Specifically, I want to teach you which are the best, which are the worst and which depend on the situation :).

Wait...There's more than one labor position?

Sadly, there is a common misconception that the only position a person can have a baby in, is on their backside. It's technically called the lithotomy position. That's true. Look it up.

It was traditionally the most common position for having babies in, historically...NOT because it's the best for mom & babe, but because it traditionally "provides the doctor with easy access to mother & baby."

Hurgh.

So, is lithotomy position Bad?

A wise man named Jack Black once said-sung in his hit song [Name of Song Redacted Due to Strong Language], "What's Your Favorite Posis(tion)? That's cool, it's not my favorite, but I'll do it for you."

That's how I feel about lithotomy. It's not my favorite (for reasons we'll discuss in a moment), but if it works for you, it works for you. And...spoiler alert...

I had both my babies in lithotomy position

Yep. Truth.

Q: Is it weird that I'm strangely embarrassed by that?

A: YES! What the heck kind of a society judges a mother by how she does, or doesn't have a baby? She just grew a human inside her abdomen, then brought him to the outer world. That's boss.

When the time comes for you to bring your little bundle into the world, there will be some things you can control, and some things you can't. And you HAVE to let go of the control, and be at peace with what happens.

And if you end up in lithotomy, I have tips for you ;).

Dr. Kelly's Top 3 Labor Position Tips

1a. Lithotomy is not the devil

Studies have shown that it is correlated to higher levels of maternal pain in second stages of labor (Valiani M, Rezaie M, Shahshahan Z. Comparative study on the influence of three delivery positions on pain intensity during the second stage of labor. Iran J Nurs Midwifery Res. 2016 Jul-Aug;21(4):372-8. doi: 10.4103/1735-9066.185578. PMID: 27563320; PMCID: PMC4979260, or click here) BUT lots of people end up here (including yours truly...TWICE!!)

1b. And if you do end up in lithotomy...consider this

The reason that lithotomy position is associated with increased pain is that the pelvis and sacrum are blocked from moving by the firm mattress. The pelvis & sacrum need to move to let baby down and out.

Counter this by having a softer mattress, having a small pillow or two under one half of your body (and alternate this every 45 minutes or so), to allow space for the sacrum and tailbone to MOVE.

2. What position is best for fastest labor?

I will answer your question. BUT, remember this:

'Fast' labor does not equal 'better' labor

This. is. hugely. important. to. understand.

A slow gradual progression of labor allows the tissues time to stretch, and adapt to the pressures of emerging baby.

A faster labor can result in greater levels of pain & tearing, especially in first time moms.

But what position does result in fastest labors? Squatting, of course. Gravity works to our advantage, and if you can relax your pelvic floor muscles & let the uterus do it's work, this position has the 'fastest' rate of delivery.

And....squatting ALSO has the highest rate of perineal tearing, especially in first time moms.

So while it's GREAT for laboring, I rarely recommend that first time moms deliver in a squatting position due to risk of tears.

3. And which position has the lowest rate of tears?

I thought you'd never ask :). Side-lying position has the lowest rate of perineal tearing. It also has the bonus of being a good position if you have orthopedic hip issues, or are suffering from a lumbar disc or stenosis during time of delivery

Wow! Thanks, Dr. K! Do you have any other awesome Labor Tips??

I sure do, and you can see them ALL in my hit Push Prep class, available for immediate streaming on all compatible devices :) Including what's THE ONE HUGE SAFETY THING that I wish EVERYONE KNEW when getting an epidural??

Thanks for Reading!

xoxo, Dr. Kelly 😊

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