Movement and Positioning refers to the practice of encouraging the birthing person to actively walk, sway, rock, and change positions frequently throughout the labor process, rather than being confined to a bed.
The basic premise is that labor is not a passive event; it is a powerful, physical process that works best when gravity is utilized and the pelvis is mobile.
New Traditions Midwifery Philosophy: Midwives treat labor as an athletic event. They provide an environment where you are free to move, use props like birthing balls and squat bars, and instinctively find the positions that work best to shorten labor and ease discomfort.
Why Movement is So Beneficial
The freedom to move addresses the two most critical physical factors in birth: gravity and the mobility of the pelvis.
1. Working with Gravity to Shorten Labor
- Aids Descent: Upright positions (standing, walking, squatting, or kneeling) use gravity to help the baby move down and apply steady, effective pressure onto the cervix, which helps it dilate faster.
- Stronger Contractions: When upright, the uterus is tilted forward, which allows the contractions to be more direct and efficient. Studies show that people who remain upright and mobile during the first stage of labor often have a shorter overall labor time—sometimes by over an hour.
2. Optimizing Pelvic Space for the Baby
- The human pelvis is not a fixed bone; it is made up of three parts that can move and shift. Different positions can increase the diameter of the pelvis by up to 2 centimeters, making space for the baby to pass through.
- Frequent Position Changes: Moving from side-lying to hands-and-knees, or from standing to squatting, constantly changes the shape of the pelvic outlet. This helps the baby navigate the turns of the birth canal, particularly assisting with rotation if the baby is in a less optimal position (like posterior or “sunny side up”).
3. Enhancing Comfort and Reducing Intervention
- Natural Pain Relief: Movement is an intuitive coping mechanism. Positions like kneeling on all fours are especially effective for back labor, as they take the pressure of the baby’s head off the spine. Rocking and swaying help stimulate endorphin release, acting as the body’s natural pain reliever.
- Increased Control and Satisfaction: Being allowed to listen to your body and choose your own positions gives you a profound sense of control and empowerment, leading to a more positive and satisfying birth experience.
- Lower Risk of Interventions: Upright and mobile positions are linked to a lower need for pain medications (epidurals) and a lower rate of Cesarean births.
Examples of Effective Positions in Labor
New Traditions Midwifery encourages exploration of positions that include:
- Standing and Swaying (The Slow Dance): Excellent for early labor; utilizes gravity and involves the partner for support.
- Leaning Forward: Often done over a birthing ball, bed, or partner; great for resting and relieving back pressure.
- Hands-and-Knees (All Fours): Ideal for managing back pain and encouraging a baby to rotate out of a posterior position.
- Side-Lying with a Peanut Ball: A position used for resting or when mobility is limited (e.g., if IV fluids are needed); the peanut ball opens the pelvis effectively.
By advocating for Movement and Positioning, New Traditions Midwifery ensures that the birthing person’s body is actively engaged, maximizing comfort, efficiency, and the chance for a spontaneous, unmedicated birth.
