It is said that the first woman to give birth lying down was the mistress of Louis XIV.
The French king wanted to watch his child being born and instructed his mistress’s doctor to have her lie down, while he hid behind a screen.
The doctor realized that it was also a lot easier for him to oversee the birth, rather than having to kneel or squat under the woman, and so from then on he requested that all of the women he attended gave birth in bed, lying down.
As this was then deemed the 'posh' thing to do it soon became the 'normal' birthing position however, it has never been the 'natural' position.
For many years doctors have advocated that pregnant women should be free to move around and adopt whatever position feels most natural to them.
Some would go even further and say that lying down to give birth is more painful than many other positions as it can limit the unborn child's ability to manoeuvre itself into the right birthing position - making it far more likely that medics will have to intervene.
Some maternity units have devoted more resources to alternative birthing options which allow women to squat or sit and give birth in whatever position comes naturally to them, but still many women say they were never encouraged or even informed about the alternatives available.
When a heavily pregnant woman lies on her back her uterus compresses major blood vessels which can cause dizziness and make her feel nauseous.
In addition, when reclining, the baby’s head puts pressure on the pelvic nerves in the pregnant woman’s sacrum, increasing pain during contractions.
Remaining upright and leaning forward reduces this pressure while allowing the baby’s head to constantly bear down on the cervix. As a result, dilation tends to occur more quickly.
She will be able to advise you of what is possible at your planned place of birth.
The set-up in the delivery room, epidurals and the necessity to sometimes monitor the baby’s heartbeat during labour may dictate which positions you will be able to adopt, so it’s best to know beforehand what different options there are:
On all fours. This position eases back pain and helps the baby rotate into the optimal position for delivery facedown.
Leaning forward. This can help make uterine contractions more effective in bringing the baby down. Try leaning over a table, bed, countertop, pillow or exercise ball.
Lying on your left side. This may increase blood flow to your baby and can help reduce back pain. Support your belly and legs with pillows.
Lunging. Place one foot on a sturdy chair or footstool and lean into that foot during contractions.
Rocking. Sit on an exercise ball, the edge of the bed or a chair and gently rock back and forth.
Sitting and leaning. Sitting in a chair, prop up one foot and lean forward into it during contractions.
Swaying. Put your arms around your partner’s neck and sway back and forth as if you are slow dancing.
Squatting. Squatting is very effective when you’re ready to push because you are working with, not against, gravity, to enlarge the pelvic opening. Some maternity units have a special birthing stool or chair which allows you to squat. In other units the bar on your bed can be used for support so you don’t have to squat in the middle of your hospital room. The correct position is knees wide, feet flat on the floor. Don’t try squatting unsupported unless you’re sure you can hold the position and keep your balance. It’s a good idea to get in shape by practicing squats during your pregnancy to ensure your leg and thigh muscles can take the strain. The downside of squatting is that it is associated with an increased risk of tearing. Ask your doctor for more information.*
The ideal size of birthing ball for most women is about 65 cms in diameter. When you sit on it, your knees should be bent at 90 degrees. There are various ways to use one.
Place the ball on a bed or sturdy chair, stand facing it and lean forward so that your upper body rests on the ball. This will enable you to stand up longer without tiring your muscles.
Or kneel in front of the ball and drape your body over it. This will encourage a baby who’s face up to rotate into the proper position for delivery (face down) and relieve the pain of back labour.
Sit upright on the ball. This relieves pain and pressure on your back and perineum (the area between the vagina and rectum).
*Source: The Royal College of Midwives