Birth Positions: An Overview of Your Options for Labor and Delivery

Explore upright and ground-level birth positions, their pros and cons, and find out how to choose the most comfortable and effective position for your labor and delivery.

 

You may have noticed that in movies, women usually give birth lying on their backs with their legs bent. But this is just one of many birth positions you can choose to bring your baby into the world. In this article, you’ll find a comprehensive overview of different birth positions, including their advantages and disadvantages, and learn why there is no single “right” way to give birth.

In general, birth positions are divided into upright and ground-level positions. While it’s theoretically possible to give birth entirely in one position, most women change positions throughout labor depending on how they feel and which stage of labor they are in.

Upright Birth Positions

At the beginning of labor, many women feel more comfortable in upright positions. They often move instinctively, naturally shifting from one position to another as labor progresses.

Walking During Labor

During the early stage of labor, when the cervix gradually opens, many women walk between contractions and gently circle their hips. This movement helps the baby move further down into the pelvis. During contractions, it can feel helpful to pause and hold onto something stable.

Advantages of walking during labor:

  • Movement can distract you from pain.
  • Your baby moves deeper into the pelvis.
  • Cervical dilation is encouraged, helping labor progress.
  • Breathing becomes easier, supporting optimal oxygen supply for your baby.
  • Contractions may become more regular and effective.
  • Disadvantages of walking during labor:
  • It can become tiring over time.
  • Certain medical examinations may not be possible in this position.

 

Illustration of a standing or leaning-forward birth position

 

Standing or Leaning Forward

In this position, you stand with your legs apart and lean forward, holding onto a wall, your partner, a gym ball, or wall bars. Make sure your heels stay in contact with the floor to maintain stability.

Advantages of standing during labor:

  • Gravity supports the progress of labor.
  • Cervical dilation is encouraged.
  • Contractions may become more regular and effective.
  • Breathing is often easier, improving oxygen supply for your baby.
  • Disadvantages of standing during labor:
  • This position can be exhausting over time.
  • Some examinations cannot be performed. 
Illustration of a standing birth position, where the mother holds onto a rope hanging from the ceiling

 

Hanging From a Cloth or Rope

In many delivery rooms or birthing centers, a double cloth or rope hangs from the ceiling. In this position, you hold onto it and allow yourself to “hang,” taking weight off your legs.

Advantages of the hanging position:

  • Your body is relieved as your weight is partially supported.
  • Gravity helps labor progress.
  • Cervical dilation is encouraged.
  • Breathing may feel easier.
  • Contractions can become more regular and effective.
  • Disadvantages of the hanging position:
  • It can be physically demanding over time.
  • Some medical examinations are not possible.

Ground-Level Birth Positions

In ground-level positions, many women find it easier to actively push and support their baby’s movement through the birth canal. As labor advances, many instinctively adopt one of the following positions.

Illustration: Birth position supine position (lithotomy position)

Supine Position (Lying on Your Back)

In the supine or lithotomy position, you lie slightly elevated. Your legs are bent and either supported by your partner or a midwife, or placed in special leg holders. This is the most commonly used birth position, often because it provides healthcare professionals with optimal access. In certain situations, such as when assisted delivery is required, this position may be necessary.

Advantages of the supine position:

  • Medical care and interventions are easiest in this position.
  • It conserves energy, allowing you to rest between contractions.
  • Disadvantages of the supine position:
  • The risk of birth injuries may increase.
  • Vena cava syndrome can occur, where the baby presses on a major vein, affecting blood flow and potentially impacting oxygen supply.
  • Some women feel restricted and unable to move freely.
  • The pelvis narrows when lying down, and the cervix may open more slowly. 
Illustration of birth position: hands and knees position

 

Hands-and-Knees Position

In the hands-and-knees position, you kneel on the floor or bed and lean forward, supporting yourself on the floor, a pillow, or a gym ball. Many women find this position particularly comfortable as labor progresses.

Advantages of the hands-and-knees position:

  • The perineum is protected.
  • You have freedom of movement and a sense of control.
  • You can rest between contractions.
  • It may relieve back pain, and your partner can massage your back.
  • You can take your baby into your arms directly after birth.
  • Disadvantages of the hands-and-knees position:
  • It may feel unfamiliar and become tiring over time. 
Illustration of the squatting birth position

 

Squatting (With or Without a Birthing Stool)

In this position, you squat on your heels or sit on a special birthing stool with an opening. Because squatting is physically demanding, many women use it toward the end of labor. During the final contractions, it can feel especially effective, as you instinctively push downward.

Advantages of the squatting position:

  • The pelvis widens, and gravity is used optimally.
  • Your baby can descend deeper into the pelvis.
  • You can push actively and effectively.
  • Breathing may feel easier.
  • Disadvantages of the squatting position:
  • It requires significant strength and stamina.
  • Remaining in a squat for too long can strain the tissue and increase the risk of birth injuries.
Illustration of the birth position: Birth in side-lying position

Side-Lying Position

In the side-lying position, you lie on your left or right side with your upper body slightly elevated. Your top leg is bent at the hip, and you may place a pillow between your knees. This position is well suited for resting between contractions and can also be used in the final stage to round your back and push actively.

Advantages of the side-lying position:

  • It is comfortable and ideal for breathing through contractions.
  • It may encourage your baby to turn into a more favorable position.
  • The vena cava is relieved of pressure.
  • You can rest between contractions.
  • The pelvis opens, especially when the top leg is elevated.
  • Disadvantages of the side-lying position:
  • The pelvis is somewhat narrower when lying down.
  • Contractions may be less effective, potentially prolonging labor.
Illustration of the sitting birth position

 

Seated Position

In the seated position, you sit facing backward on a chair with your legs spread, holding onto the backrest. Alternatively, you can sit on a gym ball or birthing stool and hold onto your partner or wall bars.

Advantages of the seated position:

  • It combines stability with freedom of movement.
  • The pelvis widens.
  • Contractions may be more effective.
  • Breathing is often easier.
  • You can rest between contractions.
  • Disadvantages of the seated position:
  • Increased pressure while sitting may intensify pain.

Water Birth

A water birth takes place in a special birthing tub filled with warm water (34–36°C / 93–97°F). The soothing warmth is often used during early labor, but the entire birth can also take place in the water. In the tub, you can freely choose positions such as hands-and-knees or lying back, with the water providing additional buoyancy and freedom of movement.

Advantages of water birth:

  • Warm water can promote relaxation and pain relief.
  • Heat and moisture make the tissue softer and more elastic.
  • Disadvantages of water birth:
  • The warmth may cause circulatory issues.
  • An epidural (PDA) is not possible in the tub.
  • Rapid medical intervention may be more difficult if complications arise.

Which Birth Position Is Right for You?

There is no one-size-fits-all answer to the question of the best birth position. What feels comfortable varies from woman to woman and even from one birth to the next.

During labor, you will likely change positions several times depending on your needs and the stage of labor. If there are no complications, you can usually choose the position that feels best for you. Often, your body will intuitively guide you toward the most comfortable and effective posture.

Tips for Finding Your Ideal Birth Position

  • Try out different birth positions before labor begins to discover what feels most comfortable.
  • Discuss your preferences with your partner so they can support you during labor.
  • If possible, inform your midwife or doctor in advance about your preferred positions.
  • Stay flexible and open-minded. A position that felt good during practice may feel different during actual labor.
  • Trust your instincts. Every birth is unique and cannot be fully predicted.

Trust your body—it will intuitively guide you toward the birth position that is right for bringing your baby safely into the world. Wishing you a smooth and empowering birth experience!

 

Frequently asked questions

What birth positions are there?

The possible positions in which you can give birth to your baby are almost endless. Nevertheless, a few birth positions have emerged that are particularly popular. For example, you can give birth standing, lying on your back, on all fours, in a squat, on your side, or during a water birth.

What is a water birth?

During a water birth, you as the expectant mother lie in a birthing tub filled with water, which is approximately 34 to 36 degrees Celsius warm. Even with this method of birth, there are no limits to the birthing positions, and you can, for example, switch to a hands-and-knees position or lie on your back in the water.

What is the best birth position?

Which birth position suits you best is something you should decide for yourself. Therefore, we recommend familiarizing yourself with the different positions in advance and trying them out. Many women find, for example, that giving birth standing up is comfortable because breathing is easier in this position. In ground-level birth positions, women can actively push, and a water birth can help with relaxation and pain relief. All birth positions have their advantages and disadvantages, and only you can feel which position makes you feel most comfortable.

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