This blog reflects a Facebook Live conversation that I had with fellow birth professional Amelia from Wonderbirthing. Amelia and I spoke about the benefits of being active in labour and the best positions for birth. This blog is a summary of our chat! 

One of the main things Amelia and I agreed upon was that, when you're making your Birth Plan is a great time to think about how you might want to labour. Research positions (there's a sheet of positions later in this piece) and even practice them ahead of the day. Practicing might feel a little strange but it will give you a sense of what works for you and your physiology, what feels natural and what doesn't and there are definitely big benefits to sorting that out and not figuring such things out on the day. 

In general you want to keep 'Upright and Forward' at the forefront of your mind, any position that adopts these elements will allow your pelvis to open and will utilise gravity to your advantage.

The great thing about adopting positions that work with your body extend beyond gravity and pelvic opening. The more comfortable and involved you are in your labour, the lower your stress levels and so the lower your pain perception. It really is a beautiful circle that brings ever increasing benefits.

Early Labour

You really don't need to give too much attention or energy to your early labour. Yes, you will be having contractions but they likely won't be so strong that they require all of your attention or stop you from whatever else you might be doing. So, as exciting as it can be to know that your labour has started, try and carry on with your day or better yet try to take a nap (or carry on sleeping if your labour starts at night). Paying too much attention to your early labour will tire you out emotionally and physically and when things do become more intense you may not have the energy or reserve to cope with it. 

Once your labour has a consistent rhythm it's a great idea to go for a walk with your birth partner. This helps your baby shift further down into your pelvis and efficiently dilate your cervix. I often use the 'key in a lock' example - sometimes your door key doesn't work so you jiggle it in the lock and then it turns easily. Going for a walk has a similar effect and can really help establish your labour. A walk can also help your frame of mind, getting outside is good for your mood and will raise your spirits - this will prove invaluable later in labour. 

Established Labour

Some signs that your labour is establishing are:

• you have trouble speaking through a contraction

• you have difficulty remembering your phone number

• you don't care what clothes you have on

• your labour is requiring your attention and stops you in your tracks

If you're planning to deliver at a birth centre or hospital, this is the time you might think about going there. Once you're at your place of birth, have your birth partner or doula arrange the room to suit your labour - you can adjust the lighting, put up visual aids, find the birth ball, organise extra pillows and even move the bed to one side if the layout allows for that. 

Using the props in the room to support good positions for birth can save a lot of effort. You can adjust the bed to different heights to lean on it, the head of the bed can be raised so that it is upright to meet you if you're kneeling on it. Just remember that it doesn't have to be flat!

Some hospitals in Sydney have a CUB, this is a piece of equipment developed by a British midwife and is essentially an inflatable 'C shape' which can be used as a more stable version of a birthing ball. If your place of birth doesn't have one and you might like to use one then you can buy or rent them. I've never supported a birth that has one but the reviews are great and I really like the look of them. 

But What If You Can't Be 'Upright and Forward'?

If your mobility is reduced then obviously your options for positions are also reduced. You may be restricted by your physiology, by monitoring technology or you may have had an epidural and are really restricted to the bed. But there are still options to optimise your situation and allow your pelvis and gravity to play their role in helping baby out. I've included a great sheet below for reviewing options with an epidural in place, I am also a fan of using a peanut ball under a mum's legs for stability. So even when an epidural has been administered there is plenty that you can do to actively optimise your situation. 

So on the day, your caregiver, doula and birth partner will all work together with you, no matter what comes, to help your labour be as comfortable and efficient as possible. Just have a think, have a practice and be confident that you have tools on the day to have the best possible birth.