Pregnancy encyclopedia: Positions during labor and birth to Refresher childbirth classes

Positions during labor and birth

Standing	Standing takes advantage of gravity during and between contractions. It makes contractions feel less painful and be more productive. It helps your baby line up with the angle of your pelvis. Standing may increase your urge to push in the second stage of labor.
Walking	Walking has the same advantages as standing. The movement causes changes in the pelvic joints, helping your baby move through the birth canal.
Standing and leaning forward on partner, bed, birthing ball	This position has the same advantages as standing. It is a good position for a backrub. It may feel more restful than standing. This position can be used with electronic fetal monitor.
Slow dancing	Stand with your arms around your partner's neck, head resting on his chest or shoulder, with his hands rubbing your lower back. Sway to music and breathe in rhythm if it helps. It has the same advantages as walking. Back pressure helps relieve back pain. Rhythm and music help you relax and provide comfort.
The lunge	Stand facing a straight chair. Place one foot on the seat with your knee and foot to the side. Bending raised knee and hip, lunge sideways repeatedly during a contraction, holding each lunge for 5 seconds. Have your partner hold the chair and help with balance. You'll feel a stretch in your inner thighs. This position widens one side of the pelvis (the side toward which you lunge). It encourages rotation of baby. It can also be done in a kneeling position.
Sitting upright	This position is good position for resting. It has more gravity advantage than lying down. It can be used with electronic fetal monitor.
Sitting on toilet or commode	This position has the same advantages as sitting upright. It may help relax the perineum for effective bearing down.
Semi-sitting	Set the head of the bed at a 45-degree angle with pillows used for support. It has the same advantages as sitting upright. This is an easy position if you're on a bed.
Rocking in a chair	This position has the same advantages as sitting upright. Rocking movement may speed up labor.
Sitting, leaning forward with support	This position has the same advantages as sitting upright. It is a good position for back rubbing.
On all fours, on your hands and knees	This position: helps relieve backache assists rotation of baby in posterior position allows for pelvic rocking and body movement takes pressure off hemorrhoids still makes it possible to have vaginal exams is sometimes preferred as a pushing position by women with back labor
Kneeling, leaning forward with support on a chair seat, the raised head of the bed, or on a birthing ball	This position: has the same advantages as all fours position puts less strain on the wrists and hands
Side lying	This position: is a very good position for resting is convenient for many kinds of medical interventions helps lower elevated blood pressure may promote progress of labor when alternated with walking is useful to slow a very rapid second stage takes pressure off hemorrhoids facilitates relaxation between contractions
Squatting	This position: may relieve backache takes advantage of gravity requires less bearing down effort widens pelvic outlet may help baby turn and move down in a difficult birth helps if you do not feel an urge to push allows freedom to shift weight for comfort offers an advantage when pushing, since upper trunk presses on the top of the uterus
Supported squat	Lean back against your partner, who supports you under the arms and takes all your weight. Between contractions, stand up. This requires great strength in your partner. This lengthens your trunk, allowing more room for your baby to maneuver into position. This lets gravity help.
Dangle	Your partner sits on high bed or counter with feet supported on chairs or footrests and thighs spread. You lean back between your partner's legs, placing your flexed arms over his thighs. He grips your sides with his thighs. You lower yourself, allowing your partner to support your full weight. Between contractions, stand up. This has the same advantages of a supported squat. This requires less physical strength from your partner.

Postpartum

Medically, the period of time after your baby is born until your baby is 6 weeks old. In reality, this adjustment time lasts most of the first year after your baby's birth.

Postpartum "baby blues"

This is a common reaction that occurs during the first few days after birth, usually appearing on the third or fourth day. More than half of all new mothers experience this feeling of let-down after the emotionally charged experience of birth.

You might cry for no apparent reason or be impatient, irritable, restless or anxious. You may also feel extremely fatigued, due to lack of sleep. This is the most common and the less severe of the postpartum reactions.

Postpartum depression

One in 10 new mothers experiences various degrees of postpartum depression. Still, it remains one of the least understood postpartum reactions. It can occur within days of the birth or it may appear gradually, sometimes even up to a year later.

Symptoms may include:

• nervousness, anxiety, panic
• sluggishness, fatigue, exhaustion
• sadness, depression, hopelessness
• appetite and sleep disturbances
• poor concentration, confusion, memory loss
• over-concern for your baby
• uncontrollable crying, irritability
• lack of interest in your baby
• guilt, inadequacy, worthlessness
• fear of harming your baby and/or yourself
• exaggerated highs and/or lows
• lack of interest in sex

If you have postpartum depression, you may experience one or a combination of these symptoms. Your symptoms may range from mild to severe. You may have good days alternating with the bad. Postpartum depression is not the same for every woman. The symptoms can be quite distressing and can leave a woman wondering if she is "going crazy."

Treatment for postpartum depression varies, depending on the type and severity of symptoms. All of the symptoms, from the mildest to the most severe, are temporary and treatable with support and skilled professional help. Talk to your health care provider about what you are feeling. Call your hospital birth center. Find information about support groups and other resources.

Are you wondering if you have "baby blues" or true depression? Consult the Postpartum Depression Worksheet.

Preeclampsia/pregnancy-induced hypertension

A condition of pregnancy with high blood pressure, swelling due to fluid retention, and abnormal kidney function.

Prenatal classes

A variety of classes are offered at many hospitals, clinics, and in the community.

Typically, prenatal classes are meant to be taken in early pregnancy and cover:

• nutrition
• exercise
• safety and health tips
• the development of your baby during pregnancy
• the changes to expect in your body

Ask your health care provider for a recommendation for a class near you.

Prenatal screens

Prenatal screens measure the level of risk for certain problems. They do not tell you or your health care provider whether you or your baby actually have the problem. (For example, a breast self-exam is a screen. If you find a lump, you won't know if you have cancer. You still need a diagnostic test -- a mammogram or biopsy -- to know that.)

Other common pregnancy screenings:

• maternal serum screen, or "multiple marker/triple screen"
• blood tests for risks of spina bifida, Down syndrome, and chromosomal abnormalities

If the results are abnormal, your health care provider will offer more testing -- perhaps an ultrasound, or amniocentesis (withdrawing some of the fluid around your baby and checking the cells). Most of the time, your baby is fine, even if the screening is abnormal.

Screenings are often optional. You and your health care provider can discuss whether certain screens are right for you.

Prepared childbirth classes

These classes are typically taken so you finish them about a month before your baby is due. They focus on learning how to cope with labor and birth. You are encouraged to attend with your partner or labor companion.

Topics of prepared childbirth classes include:

• relaxation and breathing techniques
• the stages and phases of labor
• tips for labor companions
• Cesarean birth
• your hospital stay
• immediate newborn care and feeding
• postpartum care

Ask your health care provider for a recommendation for a class near you.

Refresher childbirth classes

These are prepared childbirth classes designed specifically for parents who have already had a baby. These classes include a review of the topics covered in prepared childbirth classes and include sibling adjustment issues. Ask your health care provider for a recommendation for a class near you.

Copyright: (c)2002 Allina Health System

First published: 10/04/2002
Last updated: 02/16/2004

Reviewed by: Allina Patient Education experts