Why You Shouldn’t Give Birth on Your Back & What to Try Instead

Different Birthing Positions from a Women’s Health Physical Therapist

Women are supposed to give birth on their back, right? At least, that’s how they do it in every movie/T.V. show that portrays labor and delivery. WRONG – you don’t HAVE to give birth on laying on your back and it really may not be the most advantageous position to birth in. 

According to Katherine Graves, author of The Hypnobirthing Book, women started giving birth on their back in the 1700s after King Louis XIV insisted that his wife give birth on her back so he could watch his child be born. After hearing this news, everyone assumed that if royalty birthed on their backs then this surely was the best way. Whether this is true or not, it has surely become the most common practice and is often never questioned.

Why birthing on your back may not be the most advantageous position: 

If you picture a birthing person, you probably picture someone laying on their back with their feet in the stirrups. However, laying with your feet rotated outward in this way actually narrows your pelvic outlet or the lowest portion of the pelvis where the baby passes through just before being born. Laying on your back also does not allow your sacrum to rotate as easily to open the canal. In addition, gravity is unable to assist the baby’s descent down through the birth canal. This means a lot more pushing and a lot more work for the birthing person. However, advantages to this position is that it is easier to rest between contractions and overall less tiring and it allows providers to intervene quicker if needed. 

Other positions to consider: 

Squatting Position

This is considered one of the most innate birth positions and in many countries around the world, is the most common position to birth in. In this position, the birthing person is seated in a really deep squat or sitting on a birthing stool. The squatting position is one of the most advantageous positions to give birth in because you have gravity assisting your baby down through the birth canal. With gravity’s assistance, the baby’s head puts lots of pressure on the cervix and helps it dilate and open. Also, a deep squat helps open up the pelvis and relax the pelvic floor, giving the baby less resistance to descend through the birth canal. However, a downside of this position is that it can be really exhausting for the birthing person. Some options to conserve energy are sitting on a birthing stool, holding onto a squatting bar or having your partner/support person hold underneath your armpits for support.

Hands & Knees Position

Similar to the squatting position, being on hands and knees helps open up the pelvis and give the baby more space to descend through the birth canal. It can also be easier on the birthing person and allow them to rest between contractions. However, one disadvantage is that gravity is no longer working in your favor.

Side Lying Position

Another great birthing option is laying on your side, especially with a peanut ball between your legs or having a partner hold the top leg in order to open the pelvic outlet. A study in 2002 showed that birthing in the side lying position was associated with the least amount of perineal tearing as this position puts less stress on the pelvic floor muscles. This can be a really great birth position if you’ve had an epidural. 

This is a great topic to bring up with your provider as you head into the last few weeks of your pregnancy – what positions will they let you labor and deliver in? A doula or your labor & delivery nurses are great resources to help navigate positioning during labor to keep labor progressing and make you as comfortable as possible. 

Breathe. is unique! Private, personalized care that celebrates client victories, big and small. We believe all women deserve to live energetic, vibrant and active lives and it’s our mission to be a partner in achieving that, by specializing in dry needling, DRA, pants peeing, pregnancy/postpartum pain and recovery, pelvic floor dysfunction, headaches, back pain and other orthopedic concerns. 

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