Positioning and Stages of Labor
At Foundations Pelvic Health, our pelvic floor physical therapists help so many through pregnancy and help talk you through the ins and outs of labor and delivery. Let’s chat today about the benefits of staying mobile and changing positions during labor and delivery!
Have you heard that there are different stages of labor? There are 4 total:
The 4 Stages of Labor:
Stage 1: Onset of true labor to complete dilation of cervix
Stage 2: Complete dilation to birth of baby (includes pushing!)
Stage 3: Birth of baby to delivery of placenta (“Afterbirth”)
Stage 4: Delivery of placenta to stabilization of the birthing person’s condition (“Recovery”)
As pelvic floor physical therapists, we focus on the first two stages of labor with mobility and positioning:
1st Stage of Labor:
The 1st stage of labor is divided into latent, active, and transition phases, each with hallmark measures.
Latent Phase
Thinning of the cervix and early dilation
Active Phase
Cervical dilation 6-10cm
Baby’s head comes down
Contractions will occur no greater than 5 minutes apart and last for 45-60 seconds
This phase typically lasts 3-5 hours
Transition Phase
Cervical dilation to 8-10 cm
Contractions will occur no greater than 2 minutes apart and last for 60-90 seconds
This phase typically lasts 30 minutes to 2 hours
Generally, we want to think about changing our position about every 30 minutes. In order to help the baby descend and prepare for the second stage, we want to consider positions that use gravity to help, as well as encourage opening of the top of the pelvis.
Examples of these positions or movements may include:
Walking
Standing or supported standing - sometimes leaning onto your partner
Sitting on a yoga ball
Can also add rocking or rhythmic movements to these positions can further help baby to descend into the pelvis
2nd Stage of Labor:
The 2nd stage of labor can also be divided into 2 phases: latent and active. This stage usually lasts between 1-4 hours for the first time, and 30 minutes - 2 hours for subsequent births.
The active phase is the pushing phase, which is signaled by the urge to bear down or push.
Pushing:
In movies and TV shows, we really only see women pushing on their backs with their feet up, but actually there are MANY options for pushing positions! We’ve had patients who deliver on hands/knees, seated on the toilet, tall kneeling…you name it.
Something to think about during pushing: conserving energy! As pushing can sometimes last for a while, different breathing techniques can be very helpful. Positioning during pushing can also help, as creating more space at the bottom of the pelvis can help baby make their way out. Some positions also help optimize pelvic floor relaxation and lengthening!
Examples of opening the bottom of the pelvis may be:
Tall kneeling with head of bed elevated for support
Squatting - using the squat bar on hospital bed for support
Sidelying with a peanut ball under top leg for support
Hands and knees with knees in
For guidance, it is recommended to review birth prep with a pelvic floor therapist who can provide additional ideas and modifications for your individual body and needs.
At Foundations Pelvic Health, we support people throughout their entire pregnancy! We work on maintaining their mobility and strength throughout all the trimesters so that they can stay mobile during delivery, and during the 3rd trimester we focus on labor and delivery preparation, including:
Perineal Massage
Breathing & Pushing Mechanics
Pelvic Floor Relaxations
Positioning for Labor & Delivery
Partner Visits
Postpartum Considerations
Hi! We are Boston’s pelvic floor physical therapy experts specializing in all things bladder, bowel, sexual dysfunction & pregnancy and postpartum specialists.
If you’re struggling or have questions about preparing for labor and delivery, we’d love to help you at Foundations Pelvic Health - located in the South End of Boston, MA.