What's the best position for giving birth?

Times have changed since women were expected to labour only on their backs.
Times have changed since women were expected to labour only on their backs. Photo: Getty Images

If you paid attention to the movies you would probably think that most women give birth on their backs. But while this might make for good drama on the screen, it has been wildly acknowledged that it isn't the best position for the real life leading lady – i.e. the woman giving birth.

So what's wrong with it? Midwife Lisa Berson says that women have been giving birth on their backs for hundreds of years for one reason only: it's the most convenient position for caregivers.

But while it may work for the obstetricians and midwifes, the reality is that the woman giving birth is effectively working twice as hard as she needs to. "Because of the way the pelvis and anatomy is positioned laying down, the woman has to push 'uphill' first to get the baby out," explains Berson.

So if doing it on your back is out, what is the best position for giving birth?

Until recently, many obstetricians believed that the optimal position was for the mum to lie on her side, with her hips tilted at a 15-degree angle.

The rationale was that women giving birth on their backs were at risk of dangerously low blood pressure caused by the compression of both the inferior vena cava and the aorta due to the weight of the fetus. However, by giving birth on her side, the pressure was reduced.

It all sounds great in theory, but when put to the test in a recent study at Tokyo's Women's Medical University, scientists found that the woman giving birth would have to tilt her hips to a 30-degree angle before the compression risk was significantly reduced.

But while the 30-degree hip tilt might technically be the best position, there are many other factors that come in to play during labour. One of these factors is whether or not the woman giving birth needs to be constantly monitored, as this can mean their movement is restricted.

However, according to birth educator and doula Lucretia McCarthy, if the laboring woman doesn't need to be monitored, the best position is whatever feels best.

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"If the baby is doing well the most important thing is that the woman is in the most comfortable position for her," she says.

McCarthy, who has been assisting women with childbirth for more than 17 years, says that the optimal birthing positions are the ones that allow the pelvis to open up as widely as possible so the baby can pass through.

She says this includes "birthing on all fours, laying on your left side, squatting, standing, using the buoyancy of water if you are in a birth pool … basically any position other than on your back!"

Some antenatal classes encourage women to practice birthing positions at home in the final weeks of pregnancy, as this will give them a good understanding of what might work for them. In addition to this, McCarthy uses a doll and model pelvis to demonstrate how different positions work.

However, as McCarthy notes, while most women have an idea of the position they want to birth in, that position can often change once they are actually in labour. And of course, most women change positions several times during labour, particularly if it has been going on for some time.

If you are due to be playing the starring role in your own birthing feature soon, McCarthy's advice is to stick to what feels best. "Trust your instincts," she says. "Your body will know what is best."