Somebody asks whether you want to try a different position, and the next contraction is already building. That is a much easier question when you already have two or three favorites in your head. There are about a dozen worth knowing, and they are sorted here by when you will actually reach for them: the long first stage, the pushing, and what changes once you have an epidural.
For a long time, women were told to give birth flat on their backs. We know now that this is often one of the least helpful spots to be in. Staying upright and moving actually puts gravity on your side. It helps your baby move down, makes your contractions count for more, and is linked to shorter labors with less need for intervention. You will not get to script every minute of the day (nobody does), but knowing your options ahead of time makes it so much easier to speak up for what you want.
Why position matters in labor
Where you put your body changes a lot. It affects the path your baby takes through the pelvis, how much your contractions actually accomplish, how much it hurts, and even how likely you are to need help delivering. Upright positions, the ones where your torso is vertical or tipped forward, open the outlet of the pelvis more than lying back does. They also let the weight of your baby’s head rest on your cervix, which nudges it to open and gets your own oxytocin flowing.
And here is the part that surprises most people. Study after study on labor positions lands on the same theme. When women are free to move and choose for themselves, they tend to look back on the birth more warmly, even when the pain was about the same. So it is less about nailing one perfect pose and more about being allowed to move at all.
Positions for the first stage (active labor)
The first stage is the long one, when your cervix is doing the slow work of opening. Comfort and steady progress are the whole game here, so drift between a few of these as your body asks for them. You really do not have to overthink it.
- Standing and swaying: Lean on your partner, a wall, or the bed rail and rock your hips through each one. It keeps your pelvis loose and helps baby settle in. It is the position a lot of people come back to again and again.
- Walking: Early and active labor are a good time to be on your feet. The sway of your hips and the little push of each step coax baby down.
- Hands and knees: On all fours, wrists under shoulders, knees under hips. It is a favorite for a reason, especially with back labor, because it lifts baby’s weight off your spine and gives a back-to-back baby room to turn.
- Leaning forward: Draping over a birth ball, the raised head of the bed, or a pile of pillows takes the pressure off your lower back while keeping you upright.
- Birth ball: Sitting and rolling your hips in slow circles keeps you moving while your legs get a break. A little gentle bouncing between contractions is weirdly soothing.
- Lunges and stairs: A supported lunge, or taking the stairs slowly and sideways, opens one side of the pelvis at a time. Handy for a baby who is taking their sweet time coming down.
- Side-lying to rest: When you just need to save some energy, curl onto your left side with a pillow between your knees. It keeps things moving better than lying flat on your back does.
Positions for pushing (second stage)
Once you are fully dilated, the job changes and you are pushing baby out. The principle does not change with it. Upright and forward tends to work with gravity instead of fighting it.
- Squatting: A deep, supported squat opens the pelvic outlet and lets gravity pitch in. Use a squat bar, your partner, or something sturdy so you are not carrying your own weight.
- Hands and knees: Still great for pushing. It can take the edge off the pressure on your perineum and gives baby a roomy way out.
- Side-lying: Lying on your side with your top leg held up is calmer than it sounds, works well for pushing, and may help you tear less.
- Kneeling upright: Kneeling and draping onto the raised head of the bed keeps you vertical without asking your legs to do all the work.
- Semi-reclined: Propped up rather than flat. It is the classic hospital setup and it does the job when you want your back supported but still want gravity at an angle.
If you have an epidural
An epidural does not pin you flat on your back. Your legs will be numb, so you will need your nurse or partner to help you shift around, but you still have real options.
- Side-lying with a peanut ball: That peanut-shaped ball tucked between your knees keeps your pelvis open while you rest on your side. If you take one thing from this section, make it this one.
- Supported semi-upright: Just raising the head of the bed keeps a little gravity working for you.
- Throne position: Sitting all the way up with the bed raised and your feet supported, sometimes called the throne, opens the pelvis while you stay safe and steady.
- Regular position changes: Ask your team to help you switch sides every 30 to 60 minutes so baby keeps making their way down evenly.
A quick word on back labor
If most of your contractions land as a deep ache in your lower back, baby might be facing your front (posterior, or back-to-back, is what you will hear it called). Hands and knees is your best friend here. It gets baby’s weight off your spine and hands them the space to turn. Rock your hips or make slow circles on all fours, and it can bring real relief while it helps the rotation along. For more on riding out that kind of pain, our guide to coping with contractions goes deeper.
Birth positions at a glance
| Position | Best for | Stage |
|---|---|---|
| Standing and swaying | Keeping labor moving, pain relief | First stage |
| Hands and knees | Back labor, turning a posterior baby | Both stages |
| Birth ball | Staying mobile while resting the legs | First stage |
| Squatting | Opening the pelvis for pushing | Second stage |
| Side-lying | Resting, epidural labor, gentler pushing | Both stages |
| Peanut ball (side-lying) | Keeping the pelvis open with an epidural | Both stages |
How to get ready
You do not need to memorize a routine, I promise. What helps most is just knowing your options, trying a couple out ahead of time (hands and knees and a supported squat are easy to practice at home in those last weeks), and talking through what you want with your provider before the big day. Jot your favorites into your birth plan, then hold them loosely, because the best position really is whatever feels right when you are in it. If you are still sorting out the final stretch, our third trimester guide helps you prep without the spiral, and our walk through the stages of labor shows where each of these fits.
One question, if you have done this before. Which position did you actually end up in, and was it anywhere near the one you had planned on? The gap between those two is the most interesting part of this whole topic, and the comments are open.
Medical disclaimer: This article is for general educational purposes only and is not medical advice. It does not replace care from a doctor or midwife. The right positions for you depend on your health, your baby, and your birth setting, so always talk with a qualified healthcare professional about your labor and birth plan. If you think you may be experiencing a medical emergency, contact your local emergency services right away.
Sources
- American College of Obstetricians and Gynecologists. “Approaches to Limit Intervention During Labor and Birth.” 2019, reaffirmed 2023.
- Cochrane Database of Systematic Reviews. “Position in the second stage of labour for women without epidural anaesthesia.” 2017.
- Mayo Clinic. “Labor positions: Comfort and control.” 2023.
- Lamaze International. “Healthy Birth Practice: Walk, Move Around, and Change Positions Throughout Labor.” 2023.
Did this help?
If it did, tap Yes below. It is the only thank-you we ask for, and it tells us what to write more of.
Thank you so much, that genuinely helps and means a lot.
Thanks for the honesty. Tell us what was missing and we will make it better.
From other parents