Birth is a powerful, instinctive, and deeply embodied experience. Yet it has only been in the last century that childbirth has become widely medicalised and normalised as a condition that needs to be “managed.”
Historically, unless there was a clear health concern requiring medical supervision, birth took place in domestic settings. It was an intimate, physiological event guided by the birthing person’s body, instincts, and timing. With the shift of childbirth into hospital environments, trust in the body’s natural processes has gradually declined. Birth began to be perceived as something that needed to be treated, controlled, and timed.
While modern medical technology can be lifesaving in critical situations, research consistently shows that in hospital settings the likelihood of unnecessary interventions increases dramatically—especially when birth is approached as a problem to be solved rather than a process to be supported.
One of the clearest examples of this is the widespread use of the supine (lying on the back) or semi-reclined position during labour and birth.
The problem with lying on your back during labour
The supine position—lying on the back with legs apart, flexed, and supported in stirrups (also known as the lithotomy position)—is relatively new in human history. This position primarily benefits the doctor or birth attendant, as it allows direct access to the birthing person and baby.
From a physiological point of view, however, lying on the back works against the body and gravity.
When labouring in this position:
- The pelvis collapses instead of opening
- Movement of the coccyx is restricted
- The perineum becomes tense and more prone to tearing or episiotomy
- The weight of the uterus presses on the vena cava and the descending aorta, reducing blood flow to the placenta
- Oxygen levels for the baby can drop, increasing the likelihood of interventions such as synthetic oxytocin (Pitocin) or caesarean section
Lack of movement also makes labour more painful. This increases the likelihood of pain relief interventions, the side effects of which are rarely fully explained to expectant parents. Once pain is medically managed, further interventions often follow.
In horizontal or semi-reclined positions, the uterus must work harder against gravity. As a result, contractions can become less effective, labour may slow down, and interventions such as induction, vacuum extraction, or forceps become more likely.
Benefits of moving during labour
When lying on the back, the labouring person is placed in a passive role. In contrast, changing positions and moving freely allows her to actively participate in her birth experience and reclaim a sense of agency.
Movement during labour helps to:
- Reduce pain and discomfort
- Support efficient contractions
- Improve emotional wellbeing and confidence
- Strengthen trust in the body’s innate wisdom
Staying active during the first stage of labour—when contractions become regular and strong—helps labour progress more smoothly, more quickly, and with less pain.[1]
Upright positions:
- Work with gravity to guide the baby down
- Increase pressure on the cervix, supporting dilation
- Improve placental blood flow and oxygen supply to the baby
- Reduce the risk of perineal tearing
The movements learned during pregnancy can be very helpful during labor and delivery
Labour positions that support physiology and comfort
Standing
Standing allows the pelvis to remain mobile and responsive. Gravity supports the baby’s descent, helping cervical dilation. You can walk between contractions and lean against a wall or partner during them.
Supported standing postures
Leaning, stretching, or pressing against a wall encourages optimal foetal positioning (OFP). Circling or tilting the hips can be calming and effective. Using a chair to step one foot forward creates asymmetry, which can help if the baby feels stuck. Hanging from a rope or scarf can also be deeply supportive.
Hands and knees
This position relieves lower back pain and may help rotate the baby into an optimal position (facing the sacrum). Resting on pillows or a birthing ball between contractions conserves energy. Gentle rocking and sound-making pair beautifully here.
Kneeling
Place a pillow under your knees and rest your upper body on a chair, birth ball, or partner. This position is excellent for pushing and for receiving comforting back massage.
Sitting
Sitting upright—on a chair, bed edge, or birth ball—allows gravity to assist while offering support. Swaying the hips side to side or in circles can ease tension. Sitting on the toilet can also help, as an empty bladder and bowels allow the uterus to contract more effectively.
Semi-squatting
From kneeling, extend one leg forward into a bent position and gently rock back and forth. This opens the pelvis asymmetrically. Try both sides to see which feels best.
Squatting
Squatting opens the pelvis and lengthens the pelvic floor muscles. It can increase the pelvic outlet by up to 28% compared to lying down.[2] Squatting can relieve back pain and accelerate labour by relaxing the pelvic and perineal muscles.[3]
Start practicing during pregnancy using props such as a chair, wall, or yoga blocks. Gradually lower the height until you can rest in a full yogi squat. A rolled towel under the heels can make this position more accessible.
Creating a labour movement circuit
A labour circuit can be created in almost any space. Think of it as transforming your environment into a gentle yoga space that supports movement and rest.
Use props such as:
- Birthing balls
- Pillows and blankets
- Yoga blocks
- Chairs, beds, walls, or windowsills
Create “stations” and spend around 20–30 minutes in each position. Moving through this circuit provides rhythm and repetition, which can calm the mind while stimulating the body.
Movement can be beautifully supported with:
- Energy-conserving breathing techniques
- Visualisations
- Sound practices
- Affirmations and mudras
The best way to feel confident using these postures during labour is to practice them throughout pregnancy in yoga classes designed specifically for birth preparation.
Preparing for birth starts before labour begins
Birth is not something to endure—it is something to participate in. When you understand how your body works and how movement supports labour, you can approach birth with more trust, confidence, and calm.
By practising mindful movement during pregnancy, you are not just preparing your body—you are cultivating a deeper connection to yourself and your inner strength.
Ready to prepare your body and mind for birth?
If you’d like gentle guidance on how to move, breathe, and connect with your body during pregnancy, I invite you to join my free yoga series for pregnancy: Balanced Before Birth.
This series is designed to help you:
- Feel more grounded and confident in your changing body
- Learn supportive postures for pregnancy and labour
- Prepare physically and emotionally for birth
Sign up today and begin preparing for birth with trust and balance.
Consulted bibliography
- Balaskas, Janet. Active Birth: The New Approach to Giving Birth Naturally. Beverly: Harvard Common Press, 1992.
- Chidi, Erica. Nurture: A Modern Guide to Pregnancy, Birth, Early Motherhood – and Trusting Yourself and Your Body. San Francisco: Chronicle Books, 2015.
- England, Pam, and Rob Horowitz. Birthing from Within: An Extra-Ordinary Guide to Childbirth Preparation. Albuquerque: Partera Press, 1998.
- Freedman, Françoise Barbira. Yoga for Pregnancy, Birth and Beyond. London: DK, 2004.
- Gaskin, Ina May. Ina May’s Guide to Childbirth. London: Penguin Random House, 2003.
- Has the medicalisation of childbirth gone too far? National Center for Biotechnology Information. Visited January 2026. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1122835/
