Baby Delivery Positions. Comprehensive List.

Since young age when watching how women deliver babies in Hollywood movies I always wondered why they are always lying down on the bed. When I got pregnant luckily there was plenty of information available to explore all options. And here what they are:

- Standing. I talked to a few women who delivered a baby while standing and leaning over a bed. In this position baby weight will gravitate down and speed delivery process. It is however one of the challenging positions physically because you need to stand thought out entire pushing stage. Pushing can take anywhere from 5 minutes to 3-4 hours. I did meet one woman who said she pushed for 3 hours and was standing the entire time. There are few videos on YouTube demonstrating the experience. Most famous video is from "Business of Being Born" film. Disadvantage is that you can't have an epidural with this position because epidural will completely paralyze or at minimum waken your legs.

- On knees while facing a back of the bed. Most of delivery beds nowadays incline and transform into a high back chair. If you like standing position but are concerned with ability to handle it for a long time, consider kneeling. You would be able to sit down between pushing and take short rests. Similar to standing, the main advantage of this position is that baby will gravitate down speeding up the delivery process. Mobile (partial) epidural would be an option for this position.

- Sitting up while holding the rope. In some countries (ex. Germany) birthing suites have a rope connected to the ceiling above the bed. Delivering woman would sit up or squat and hold the rope for better balance. Holding onto a rope would also help managing pain. Since you will be in upright position, baby will also gravitate down and hopefully will speed up the grand entry. Full epidural should be no problem for this position, given that someone will be at your back supporting you.

- Squatting. This was a position that I delivered my baby in. When you squat your pelvis opens up by 30% to accommodate your weight and balance your body in the air. If you have a big baby and or small pelvis this is recommended position. Not only you will allow for more room for the baby you will also take advantage of gravity phenomenon to help baby make smooth entry to the world. In addition you may have easier time pushing as when you squat pelvic floor muscles naturally activate as squatting has historically been pooping position for humans. If you can't push for some reason, try squatting to at least activate pelvic floor muscles. I had mobile epidural and had no problem squatting. I was able to lean back onto the bed and take short rests between pushing. In hospital where I gave birth, North York General in Toronto, the bed had a squatting bar, so I didn't need anyone to help me. Once contraction came, I just reached over to a bar to lift myself off the bed to a squatting position. Otherwise your husband or a nurse should be able to help you if bar is not available. Disadvantage of this position is that full epidural would not be an option as you need good control over your legs. Also, your baby may come out fast which may result in more tearing. Squatting is the most popular baby delivery position among African tribes. I chose this position because I wanted to avoid instruments at all costs and thought that baby will have easier time to come out. I pushed for 20 minutes what appeared effortlessly. I didn't even sweat.

- All Fours. This is one of the best positions to give birth from what I read if you want to avoid tearing. When you are on all fours (like a cat standing on your arms and knees), baby weight pushes in opposite direction from Perineum. This creates less strain on Perineum where most of tears occur. In fact from what I read many women who delivered in this position didn't have any tearing at all! This position is an option when you have full epidural. You can lean over the wall, or have someone hold you. This position was also reported as one of the most comfortable for women who had no pain drugs, aka non-medicated birth.

- Lying on the Side. This is not very common position for delivery but happens depending on circumstances. Full epidural is no problem for this position given that someone will hold you leg in the air. This position was found comfortable for some women who had unmanageable pain. Rolling onto a side can help managing pain as your may release some of the muscles and compressed veins. Also, if you have a very fast delivery, lying on the side can slow things down a bit to help avoid or minimize tearing.

- In the Bathtub. In bathtub you can take several positions while pushing and thus find the most comfortable one for you. There is no concern of you tripping or falling over and there is no concern of baby slipping off anyones hands. Of course epidural would not be an option for bathtub, but bathtub is chosen by women who want to have home birth anyways. There are lots of YouTube movies demonstrating bathtub birth and they all look quite serene.

- Lying on Your Back. Most of women in North America deliver in this position. Reportedly this position is prefered by doctors. Most of delivery beds incline a bit so woman can grab her own knees while pushing, but her back will be more or less horizontal. Doctor will be sitting on a chair with full control over the situation. This is also one of the most common positions for women who have an epidural. It is considered the safest position with epidural and would be recommended for that reason. For many women who had no epidural and can't manage pain well, lying was also a preferred position as more muscles are relaxed causing less strain on abdominal and transverse muscles. This is the least natural position however for the baby.