Comparing Child Birth Positions, Which Is Right For You?

Are you wondering the best position to birth your baby in, read more to find out exactly what position you should birth the baby in, and what is right for your body. And maybe if the position doesn't matter at all, I'm Dr. Allison Feldt, owner of Body Motion Physical Therapy in Edmonds, Washington and the leading PT that has developed the Body Motion Birth Prep Protocol system, which will be released in my new book coming out this fall, I have wanted to share these techniques for a long time. If you are currently pregnant and wondering what position to birth your baby in, keep reading. 

There are so many options out there. And usually, it actually doesn't matter as long as you have the control and ability to relax your pelvic floor. And if you have trained your pelvic floor, so it is not tight and shortened, which can be a barrier to getting the baby easily through the birth canal. So how do we do this, there are many positions in which one can birth their baby. 

Okay, so we could be on our backs with our knees bent, we could be on all fours, you could be in a half kneeling position, you could be with your leg up on a stool. And those all work, you could be on your side, if you deliver at hospital and you have an epidural, usually there's only two positions available for you. That could be on your back or on your side. And occasionally there's a trapeze that you could hold on to the bar and be in a squat position, those are great positions. 

A lot of people come to me and say, “Hey, I've heard people get injured if they deliver on their back. Is that true?”  Of course it's true people can get injured in any position that they deliver in. But more specifically, how can we prepare the pelvic floor so that if you end up on your back, you're not pushing for hours and end up with this massive third degree tear or second degree tear? How can we minimize the trauma that you experienced to the pelvic floor itself? 

Sometimes people come to me and say, “Hey, I delivered on my side. And so I got a nerve injury because of the side that I delivered on.” If you're on your side sometimes your pelvis is thought not to open in both directions, it's blocked by the bed on this side. And so they can only open on this side. So that can cause injury. But truly injury can happen at any position. So I want to be here to break that myth that it doesn't actually matter what position you birth your baby. As long as your pelvic floor is dynamic enough to get the baby out, then you don't have to push hours and hours and hours and create a lot of trauma and tearing to the perineum. All right.

So this is the pelvis. Here is the pelvic floor, of course, you're gonna see the urethra, you'll see the vagina, you'll see the anus. Now, if we birth baby through vagina, and our vaginas aren't used to over stretching in this direction, there can often be tearing that occurs, there is first degree tearing, which is tearing just through the initial, it's a very small tear, then there's a second degree tear, which can go up in towards the anal sphincter. And then there is a third degree tear, which can start to go through the animal sphincter. And the fourth degree tear goes all the way through the anal sphincter. Typically, those require surgery reconstruction.

Now, it makes sense, that woman would tear when the baby comes through the birth canal, if the tissue isn't already going through those positions. So there's something called perineal stretching, that is commonly talked about, usually starting at 36 weeks. So occasionally at 32 weeks, there is research that supports that it helps the tissue, but it does not help prevent the tearing. But if we can help the tissue, get more blood flow, give them a little bit more elasticity prior to the birth, then that can help the healing times. Okay, so that can be a really beneficial thing. 

However, what we do in a pelvic floor physical therapy office with our birth prep protocols is we prep all three layers of the pelvic floor. So the pelvic floor is three layers, it is this first layer, which is where oftentimes where those tears occur, it's the second layer, which is a fascial layer with some sphincters that control like the urethra, so how you pee, and, and whatnot. So if you can relax to go pee that's controlling that urethral sphincter. And then you have the third layer, which is these deep layers, these connect to your hips as well. And so oftentimes, because before we have kids, we usually don't connect to these areas. You know, we're not taught as children to be like, “Oh, let me relax my pelvic floor and get in touch with my pelvic floor.” Now, that just doesn't happen. So we have to learn how to relax these muscles, and we have to learn how to open and bulge these muscles. 

Alright, so a few things you can start to do to change the length of your pelvic floor  muscles. The goal is to see a Pelvic Expert physical therapist, Body Motion has a travel program, you can come for a week and stay in town and come for therapy consecutive days in a row. And we can change the length of these muscles for you, then we can teach you how to maintain that length, so that you can effectively breathe your baby out in any single position that you choose. So that's an option! 

Option  B is you can work with our online birth prep program. And you can learn how to start controlling these muscles with that program and that's an online program, you can find that in our link below. But truly, what I want to show you here is we're going to start breathing together to start to open up and relax these muscles. This is really important. There's research that shows that women who walked down a dark alley tend to naturally contract their pelvic floor, they don't actually know that they're contracting their pelvic floor. But they walked down the dark alley, the biofeedback that's connected to their perineum, in these studies, then shows the muscles contracting and holding. Oftentimes, once that pattern occurs, we don't just actually let it go, we're not really trained to know how to just let it go. And so much of our life is lived in a very stressful environment or in a high go go go state that usually our bodies are more in this fight or flight or what's called sympathetic response, where we are currently you know, where we are, we are always go, go go. 

That state of being, that emotional state of being, increases the tightness, the tension and the contraction and shortening of the pelvic floor itself. So we want to be in a state that doesn't cause that constantly, we want to be in a constant state of relaxation, or at least be able to get there. If you're in this constant state of contraction, and tightening and go go go, then you're gonna have a hard time getting baby through that go, go go state, no matter how hard you push. That can lead to hours and hours of pushing, sometimes that leads to cesarean. Because the baby isn't progressing down through the birth canal. So we want to help prevent that. And so how we do that is by training all three layers in the pelvic floor, by connecting our breath to these muscles, okay? 

Once we have that and we can breathe these muscles into relaxation we can really start lengthening these muscles and opening these muscles up, then we're gonna be able to achieve new lengths. And so when we're in labor and the baby is coming, it won't matter what position our babies are born in. Now in our clinic, we test what positions can you relax the most? Where do you have the most control? Is it on all fours? Is it standing supported on a table, you know, with a table in front of you? Is it with a physio ball or an exercise ball? Is it sideline with a peanut ball? Those are all valid and good positions. But what matters most is that you have this ability to relax and lengthen your pelvic floor with your breath. 

So let's go ahead and do it together. We are going to take some nice diaphragmatic breaths, I'm gonna have one hand on my belly and one hand on my chest. We're gonna go ahead and inhale. And then exhale. I want you to see in your body where that air went, did it go into your belly? Did it go into your chest? Did you feel it more out into your ribs, when we are talking about relaxing the pelvic floor and helping baby make its way down through the birth canal, we want to be breathing into our bellies. 

So let's do that together. We are going to have the hand on our chest and try not to move too much. But we'll have the hand on the belly. Let's breathe all the air into that hand on the belly. So go ahead and go.

Now when you're in labor, this is the type of breath pattern that you want to use to help move baby down through the birth canal and help open up the pelvic floor. Come see us because we can help change the pelvic floor muscles so A. you're not pushing through a brick wall and B. so we can find out at which position does your pelvic floor have the most elasticity. 

Subscribe to my youtube channel, I am here for more information for you. If you have any questions at all, please drop them in the comments. I am happy to respond to you and help you have the best birth of your dreams.