Childbirth positions

The term childbirth positions (or "maternal birthing position") refers to the physical postures the pregnant mother may assume during the process of childbirth. They may also be referred to as delivery positions or labor positions.

In addition to the lithotomy position, still commonly used by many obstetricians, other positions are successfully used by midwives and traditional birth-attendants around the world. Engelmann's seminal work "Labor among primitive peoples" publicised the childbirth positions amongst primitive cultures to the Western world. They frequently use squatting, standing, kneeling and all fours positions, often in a sequence. They are referred to as upright birth positions

Various people have promoted the adoption of upright birthing positions, particularly squatting, for Western countries, such as Grantly Dick-Read, Janet Balaskas, Moysés Paciornik and Hugo Sabatino. The adoption of the non-lithotomy positions is also promoted by the natural childbirth movement.

Being upright during labour and birth can increase the available space within the pelvis by 28-30% giving more room to the baby for rotation and descent. There is also a 54% decreased incidence of foetal heart rate abnormalities when the mother is upright. These birthing positions can also reduce the duration of the second stage of labour as well as reduce the risk for emergency caesarian sections by 29%. They are also associated with the lower need for epidural.

Different positions may be associated with different rates of perineal injury.

The squatting position gives a greater increase of pressure in the pelvic cavity with minimal muscular effort. The birth canal will open 20 to 30% more in a squat than in any other position. It is recommended for the second stage of childbirth.

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