Are you #duein2024 and wanting to know the best birthing positions? Read on to learn about which positions have the best, and worst, rates of perineal tearing!

Dr. Kelly to the Rescue for all your Push Prep Needs!

Birthing Positions with Low Rates of Perineal Tearing

1. The Side Lying Position has the lowest rate of perineal tearing

Not only does side lying position have the lowest rate of perineal tearing of all positions, it is also amazing for delivery if you are experiencing back pain from a herniated disc, severe stenosis or back labor. Your tailbone is free to move, so this is also useful in cases of tailbone pain.

Use a birth peanut or ball, a chair, or have your birth partner support your upper leg. If your leg is numb from an epidural, be sure your birth partner is changing hand positions often!!

This position might not be great for you if you have pubic symphysis dysfunction (pain in the lower front of your pelvis), as the pressure on one side of your body might irritate that.

2. All Fours, or kneeling over the birth ball, is also a good option.

For those of you who can't do side lying due to pubic symphysis pain, hand and knees position, or kneeling over a birth ball, could be a good option.

This offers some of the benefits of squatting, but with a bit slower delivery speed, which is not a bad thing from your perineum's perspective, especially if you are a first time mom.

Knees relatively pointed outward (feet in, knees out) will open the upper pelvis (early to mid labor), while knees relatively in (feet out, knees in) will open the lower pelvis (mid to later labor), so keep this in mind in these positions.

Birthing Positions with Higher Rates of Perineal Tearing

1. Squatting

Squatting, while it can be fabulous for laboring, has the highest incidence of perineal tearing, especially for first time mothers. This is likely due to the advantageous pressure and position considerations that lead to a faster birth. Faster births don't give the perineum as much time to adjust to the changes in length, hence could result in more tears.

Using a sheet-assist, or a birthing bar, can help unload your spine, but remember that deep squatting could move the spine in a way that would aggravate spinal stenosis as well as lumbar disc herniations, so if that describes you, an alternative birth position should be chosen.

Birth Position Education is Just a TASTE of What’s Offered in Pelvic Floored's Push Prep Course!

It is important to know that Pelvic Floor PTs are not only vital in your fourth trimester, but they are also a huge asset to your birth preparation. Even just ONE visit of PT to connect to your body and your needs, can lead to HUGE gains in understanding the labor and delivery process, as well as what you can do to reduce the risks of perineal tears (beyond just knowing about positions) 😃. Here’s how to find a Pelvic PT near you, or here’s my scheduling site if you’d like to work with me.

For those seeking alternative avenues, perhaps you’re not ready to see a Pelvic PT in person, consider a high-quality online course from a trusted professional (like me!). Pelvic Floored offers world-class streamable pelvic wellness programs, that you can work through at your own speed, in the comfort and privacy of your own home, for a fraction of the cost of one:one Pelvic PT.  Push Prep is my delivery-focused streamable course, and it includes in-depth knowledge in labor positions, as well as instruction in perineal stretching, counter-pressure techniques for birth partner, and more!  And while it's AMAZING to buy earlier in Pregnancy, about 25% of people that buy Push Prep, do so on their way to the delivery room, to help them in choosing labor and delivery positions! 

And if an online course isn’t in the cards right now, no worries. At a minimum, please consider following me on Instagram, or joining my Newsletter via the form below, for free, awesome pelvic wellness tips!  My VIPs (Very Important Pelvis) e-Newsletter subscribers also get first notice and best prices on all my programs, so don’t miss out–join today!

Thanks for reading!

xoxo, Dr. Kelly