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.

Mobile Epidural. My Experience

When I was pregnant I explored both non medicated and medicated delivery methods. There was no question whether I want vaginal or c-section because in Canada this is not a choice in many cases. C-sections are only allowed when there is medical reason to do so.

But there is a choice whether you want to have medications to deal with pain or not. I watched the movie "The Business of Being Born" and talked to many people who delivered in hospital with epidural, in hospital without epidural and people who delivered at home with midwife. I meet with many people during the day for my job and picking up a conversation about baby delivery was easy. I talked to over 400 women hearing all their stories. Out of probably 400 people I talked to no one ever said that they did not like an epidural. In fact many said that it was the most wonderful thing ever happened to them during birth and they could really enjoy birth of their baby in a completely pain free environment.

But my problem was that I wanted to deliver in squatting position and with classical epidural you can't move your body and only delivery position available to you is lying down. Then I read online about mobile epidural and asked my doctor about it.

My doctor was very supportive about the idea and said that I have to request it at the hospital. If I just ask for epidural anesthesiologist will assume I want the full force epidural and that is what I will get. I have to be very specific about the fact that I want mobile version of epidural. In fact I would be lucky if doctor dealing with me will know about it. Apparently not all anesthesiologists like to administer this type. So this is what I did. Once I entered the hospital in labor (in my case it was rather close to delivery after 36 hours of labor) first thing I did I asked for mobile epidural. To my surprise a nurse had no idea what I meant. I said that my doctor mentioned it and that I have to ask anesthesiologist for it specifically. It got to a point when nurse had to call my doctor and ask her what I meant. My doctor clarified something on the phone and while she was on the way to a hospital anesthesiologist came. He knew what I meant! Yey! He said that it is such epidural type that will not paralyze me completely. I may feel some pain but it will be more bearable. He said that I could potentially get out of bed and walk, but of course, it is not recommended.

He was very skillful and I didn't even feel a needle in my spine. About 5 minutes after he did it I felt no pain at all. I felt that I was in heaven. But surprisingly I could lift my legs and lift myself up in a sitting position. When my doctor came for a delivery she asked for a squatting bar to be installed on my bed. It is a bar that goes in front of you, so you can put your hands on it and lift yourself forward and up.

Also because the drug is not as strong as with standard epidural I did not feel cold afterwards. Some people are describing that they have very strong shivers for a few minutes after they got a needle. No such a thing in my case.

When I was pushing I could feel pressure in my butt - this was a contraction. When contraction came I lifted myself up and pushed. Once contraction stopped I laid back in bed waiting for the next one. No pain whatsoever! I felt strength in my legs to be able to squat for a few minutes at a time, and if needed I felt like I could handle good 10 minutes in such position at a time. I pushed for about 30 minutes very slowly to avoid tearing. When my baby came out, I could not believe it was over because I had so much strength in me that I could easily go for another hour.

I highly recommend mobile epidural. Not only it will free you from pain, it will also avoid common complications with standard epidural when woman is so sedated that can't she feel her muscles to push. If you can't push doc will have to use tools - something to avoid at all costs. Girls go for mobile epidural!