Pregnancy

6 Moves that Make Labor Easier
By Sandra Gordon

Being active during the most intense part of labor can help ease pain and move your baby down the birth canal.

When you think about labor, you may envision lying in bed. But that’s not necessarily the best place to be, especially during active labor, the rigorous phase of childbirth in which contractions arrive roughly every three minutes and the cervix fully effaces and dilates between 5 and 8 centimeters.

“Unless there’s a medical reason for remaining in bed, such as high blood pressure, we encourage women to move around,” says Anita LaSala, M.D., an obstetrician at New York-Presbyterian Hospital in New York City.

Besides walking—an age-old labor trick for prodding Mother Nature--striking an upright pose, preferably a different one every 20 minutes, can enlist gravity and pelvic movement to help keep labor moving along, says Dr. LaSala. It may also increase blood flow to the placenta to enhance baby’s oxygen supply, reducing the risk of fetal distress. “And some women just find being out of bed more comfortable,” she says. Here are some positions that may ease pain during active labor and help labor progress. Practice these exercises now so you’re comfortable with them by the time you’re ready to give birth.

1. Lunge

Place one foot on a sturdy chair, bed, or stairway, lean into a lunge position, and rock your hips during contractions. Switch legs every now and then. “When you put your foot on a higher level, your pelvis opens up. The baby has more room to rock down and negotiate the pelvis,” says Karen Pestlin, director of teacher training at the Association of Labor Assistants and Childbirth Educators in Boston.

2. Deep Squat

With your feet spread apart, hold on to the bed or a chair for support, then bend your knees and squat, either halfway or fully to the floor.“Just don’t bear down,” cautions Dr. LaSala, since your cervix isn’t dilated enough at this stage of labor to push the baby out. During a contraction, round your back. (Doing this can help redistribute pressure.) To build leg power, practice squatting several months to weeks before your due date.

3. Cat Stretch

On the floor or in your bed,get on your hands and knees and alternate rounding your back and flattening it, rocking your hips with each contraction. “This is one of the least stressful positions for your baby because she’s suspended. There’s no pressure from the bed on your arteries or on baby’s umbilical cord like there is when you’re in bed,” says Dr. LaSala.

4. Supported Lean Place a pillow on top of a bureau, a table, or a hospital bed that has been raised to its highest level. Then, simply lean forward, drape yourself onto the pillow, and sway your hips during a contraction. Since you’re standing, you’re working with gravity. “And leaning into something soft feels really good,” says Pestlin.

5. Bed bend Raise the back of the hospital bed so that it’s in an upright position. Kneel on the bed, facing the pillow, and lean forward carefully, draping yourself over the raised portion. “This position is especially helpful if you have to remain in your bed and be on the monitor for some reason,” says Pestlin.

6. Lying low At some point during active labor, you may want to rest. Lie in bed on your left side with pillows stuffed between your legs. Unlike lying on your back, your weight won’t be on your aorta (a major artery), which can affect your circulation and your baby’s oxygen supply, says June Egee, a nurse and coordinator of the Alternative Birthing Center at Women and Infant’s Hospital in Cumberland, Rhode Island.

Side bar: Massage Moves for Active Labor

If there was ever a time for a massage, it’s active labor. As you try different positions, ask your partner or birth coach to apply relieving counter pressure with these three moves.

• Tailbone press: With each contraction, your partner presses on your tailbone with the heel of his hand or a tennis ball.
• Back caress: Your partner lightly runs his fingertips over your shoulders and down your back. “It’s almost a tickle,” says Suzanne Fremon, a New York City doula in private practice.
• Pelvis Press: While standing behind you, your partner puts his hands on your hips and pulls back on them firmly as each contraction hits (you tell him when). This maneuver can also help open the pelvis slightly to make more room for baby.

Side Bar: The 3 Stages of Labor

To give you an idea of how active labor fits into the entire childbirth process, here’s a play by play of what happens when.

First Stage: Contractions

Duration: An average of 12 hours

What happens: During this stage, your cervix dilates between 0 to 10 centimeters. Early on, contractions may be mild, but they may become more intense and closer together during active labor, when the baby descends the birth canal and you dilate between five to 8 centimeters. During early or active labor, your water may break and you may have vaginal bleeding. When your cervix is 8 to 10 centimeters dilated, birth is imminent and contractions, which can be particularly intense, are about two minutes apart, lasting a minute or so.

Second Stage: Birth

Duration: Two hours or longer.

When the cervix is 10 centimeters dilated and fully effaced, you’re ready to push your baby out. For more efficient pushing, take advantage of

gravity. Raise the bed into a chair position so you’re semi-squatting. Or try squatting on the bed or floor while holding onto your partner and labor coach for support.

Third Stage: Delivering the Placenta

Duration: Up to 30 minutes

You’re not done yet. During this stage, contractions will continue until the placenta is delivered, but they’ll be much less painful than those you experienced during the first and second stages.