1 Birthing Positions, by Penny Simkin

[Adapted from The Birth Partner, by Penny Simkin. Copyright 2008, used by permission of The Harvard

Common Press.]

Takes advantage of gravity during and between contractions

Makes contractions shorter and more productive

Helps position the fetus to enter the pelvis

May speed labor if the woman has been laying down

May increase the urge to push in the second stage

Same as standing, plus:

Causes slight changes in the pelvic joints that encourage rotation and descent

Mother can lean on the partner, the bed, or a birth ball

Same as standing, plus:

Relieves backache

Makes it easy for the partner or doula to give a back rub

May be more restful than standing upright

Can be used with an electronic fetal monitor (the mother must stand by the bed unless wireless monitors are used)

2 Birthing Positions, by Penny Simkin

The mother leans against her partner, resting her head on his or her chest or shoulder. The partners arms are under the mothers, around her back, with fingers interlocked at her lock back. She can tuck her thumbs into the partners waistband or belt loops for comfort. They sway, perhaps to music, and breathe in rhythm.

Same as standing, plus:

Causes changes in the pelvic joints that encourage rotation and descent

Being embraced by a loved one increases the mothers sense of well-being

Rhythm and music add comfort

Pressure from the partners hands relieves back pain

Standing beside a chair and facing forward, the mother places one foot on the chair seat, with her raised knee and foot turned out. Bending her raised knee and hip, she lunges sideways repeatedly during a contraction (either in the direction that is more comfortable, or to the right for two or three contractions, and then to the left). She holds the stretch for two to five seconds at a time. She should feel the stretch in her inner thighs. Secure the chair, and help her keep her balance.

Widens the side of the pelvis toward which the lunges

Gives room for the baby to change position, if necessary

May ease backache after trying this for a few contractions

Can also be done in a kneeling position

From starting position a, she bends her raised knee and hip and lunges sideways (as in b) repeatedly during a contraction in the direction that is more comfortable, or to the right for 2 or 3 contractions, then to the left for 2 or 3. She holds that stretch for 2 to 5 seconds at a time. She should feel the stretch in her inner thighs.

Same as standing lunge

3 Birthing Positions, by Penny Simkin

Gives the mother a rest between contractions

Uses gravity to help the baby descend

Can be used with an electronic fetal monitor

Same as sitting upright, plus:

May help relax the perineum for effective bearing down

Same as sitting upright, plus:

Makes a vaginal exam possible

Easy position to get into on a bed or delivery table

Can be done on a rocking chair or birth ball

Same as sitting upright, plus:

May speed labor

Helps relax the mothers trunk and perineum

4 Birthing Positions, by Penny Simkin

Same as sitting upright, plus:

Relieves backache

Makes it easy for the partner to give a back rub

Helps relieve backache

Assists the rotation of a baby in OP position

Allows for pelvic rocking and other body movements

Takes pressure off hemorrhoids

Can be done on a chair seat, the raised head of the bed, a birth ball, or the side of a tub

Same as hands and knees, plus:

Puts less strain on wrists and hands

Relieves back pain very effectively when done in a large tub

The mother gets on hands and knees, then lowers her chest, spreads her elbows, and rests her head on her hands. Make sure her knees are back far enough to raise her buttocks higher than her chest. You can support her by sitting on a chair, your feet about 9 inches apart. She puts her head between your shins, and leans her shoulders against them.

May be helpful in pre or early labor

Uses gravity to move babys head (or buttocks) out of the pelvis, which may be desirable in early labor if the mother has backache or the baby is OP. Should be done for 30 to 45 minutes.

May reduce pressure on her cervix, which helps if it is swollen.

5 Birthing Positions, by Penny Simkin

In the side-lying position, the mother lies on her side with both knees flexed and a pillow between them (a). In the semiprone position, she straightens her lower leg, rolls slightly toward her front, flexes her top hip and knee, and rests the top knee on one or two pillows (b). During the birthing stage, you can hold the mothers top leg up as she pushes (c).

Gives the mother some rest

Makes interventions easy to perform

Helps lower elevated blood pressure

Safer than standing or the hands-and-knees position if pain medications are used

May promote the progress of labor when alternated with walking

Can slow a very rapid second stage (c)

Takes pressure off hemorrhoids

Allows relaxation between pushing efforts

Shifting between side-lying and semiprone positions, on both sides, helps change the babys position

Works well with an epidural

The mother squats on the floor or bed, holding onto your hands (a), a railing, or a squatting bar (b) attached to the bed. Or, if you sit with your feet spread, she may stand between your knees (facing away from you) and lower herself into a squat, with her arms resting on your thighs for support (c).

May relieve backache

Uses gravity to help the baby descend

May aid the babys rotation

Widens the pelvic outlet

Provides the mechanical advantage of the upper trunk pressing on the uterus

May help bring on the urge to push

Requires less bearing-down effort

Allows freedom to shift weight for comfort

6 Birthing Positions, by Penny Simkin

Sit on an armless straight chair. The mother sits on your lap facing you, straddling your thighs. Embrace each other. When a contraction begins, spread your thighs, allowing her buttocks to sag between. Have a support person or doula stand behind you and hold the mothers hands for safety. After the contraction, bring your legs together so the mother is sitting up on your thighs again.

Same benefits as squatting, plus:

Avoids the strain on the mothers knees and ankles

Allows for more support with less effort for an exhausted mother

Enhances feelings of well-being, as the mother is held close

Hold the mother under her arms as she leans with her back against you during contractions, and bear all her weight. Between contractions, she stands.

Lengthens the mothers trunk, allowing more room for the baby to maneuver into position.

Enhances pelvic joint mobility

Uses gravity to help the baby descend

Sit on the edge of a high bed or counter, with each foot supported on a chair and your thighs spread. Standing, the mother backs between your legs and places her flexed arms over your thighs. During contractions she lowers herself. Grip her chest with your thighs as she lowers. You support her full weight. Between contractions, she stands.

Same as dangle with partner, plus:

Puts much less strain on the partner

The mother lies flat on her back and holds her knees apart and draws them to her shoulders. She lowers her legs between contractions.

Should not be used routinely as it is tiring and works against gravity

May be helpful in prolonged second stage

Rotates pubic bone upward; may help if babys head is not descending beneath the pubic bone, by moving pubic bone over the babys head