Your baby’s position plays a huge role in your labor progress! Both you and your baby work together during your birth.
You move to create space in the pelvis for your baby to navigate more easily. Baby wiggles and adjusts their head position to navigate the pelvis.
There is a lot going on during your birth!
But what happens if there is a pause or stall in your labor? We need to look at WHY there is a pause!
It could be:
- A normal pause or break in a normal, physiologic labor
- There may be restrictions or limited space in the baby’s path, such as the pelvis, pelvic floor, or surrounding musculature
- Baby’s position may be a little off making it harder for them to navigate the pelvis
- Your contraction strength may be affected by environmental factors or internal factors, such as hunger, fatigue, or sickness.
Let’s explore ways to support baby’s position if their alignment to the pelvis or their head positioning is contributing towards the labor stall!
3 Labor Positions to Support Baby's Position During Birth
Your baby navigates through the pelvis by aligning their head to each pelvic level. There is no one perfect position for all of labor for your baby, as they will rotate and shift to fit through the pelvis.
Common reasons for a labor stall due to your baby’s position include:
- Baby is not aligned to the pelvic opening at that particular level.
- This may include a posterior or OP presentation (the back of your baby’s head is to your spine)
- Baby’s head is titled to ascynlintic
- This may be due to uneven pelvic floor tension
We can use movement to release tension that may be contributing towards baby’s position (the passage stall is closely related to the passenger stall) and create more space for baby to adjust their position, as we find labor progress again!
1) Inversions: Allow Baby to Adjust Their Position
First, if baby’s position is “off” we can invert to use gravity to bring baby to a pelvic level that they may have had more space in. This will allow baby to wiggle their head around and potentially adjust their position.
In addition, if baby’s head is a little tilted or deflexed, they can sometimes tuck their chin better in an inversion.
When we invert, we are also releasing the lower uterine ligaments (uterosacral and round ligaments) that may be restricted affecting baby’s position.
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Depending on if you have an epidural or not, we can do either a forward-leaning inversion or you can Trendelenburg the bed!
In both inversions, the head is below the hips and could support baby’s position.
If doing the forward-leaning inversion during labor, hold for three contractions. Come up to rest in between contractions.
If you Trendelenburg the bed, maintain the inversion for about 20 minutes. But be mindful that epidurals are gravity fed, so if you stay in an inversion too long it could become uncomfortable, or you may begin to feel your contractions again.
If you have high blood pressure, inversions may be contraindicated, so before doing an inversion, discuss it with your medical team.
Learn more labor positions to support your baby’s position in our childbirth education courses!
Our childbirth education course teaches you the science of birth so you know WHY you may want to do a specific labor position. We offer our course completely online and self-paced, and also live in-person or virtually via zoom!
2) Release Pelvic Floor Tension
Next, we can focus on releasing pelvic floor tension, particularly if it is uneven tension. The pelvic floor plays a large role during birth! The pelvic floor supports your baby tucking their chin, but if there is uneven tension, it can cause your baby to tilt their head to the side.
The posterior pelvic floor tends to hold more tension, and we even have an uneven distribution of tension due to common postural tendencies.
Hip-shifted positions, both during pregnancy and labor, can release uneven tension in the pelvic floor.
The side-lying breathing drill can be done both with or without an epidural. In the position, you will place the peanut ball (or a bunch of pillows) between the knee and ankle.
Movement tips:
- Shift the top leg BACK
- Think to drive the femur into the hip socket
- This will cause you to tilt a little backward
- Round slightly in your lower back
- Inhale and focus on feeling your ribs and back expand! You should also feel some stretching in the pelvic floor
- Exhale to RELAX
Learn more breathing drills and pelvic floor relaxation exercises to do during pregnancy to prepare your pelvic floor for birth in our pelvic floor prep course!
Watch the breakdown video for a more throughout breakdown of how to do this breathing drill to release the pelvic floor tension.
3) Create More Space in the Pelvic Level
And then finally, we want to create more space in the pelvic level baby is currently trying to navigate to make it easier for them!
If baby is still high, or you find that you are favoring front-to-back movement patterns, you may want to focus on opening the top of the pelvis.
If baby is engaged, or you find that you are favoring side-to-side movement patterns, you may want to focus on opening the midpelvis.
If you are pushing AND baby is very low either at or under the pubic bone, you may want to focus on opening the outlet of the pelvis.
Inlet: Engagement
The top of the pelvis opens more with wide knee and pelvic tilting. We can focus on movements such as a seated ball rock with partner support.
In this labor position:
- Rock forward and backward on the ball.
- Focus on tucking the butt under as you spread the knees as you move forward
- And then arch in the back as you shift backward
During pregnancy, we can focus on ensuring we have the movement capability to open each pelvic level! Our prenatal fitness workouts can support opening each pelvic level with external rotation, internal rotation, and lots of thoracic and pelvic mobility.
Midpelvis: Rotation
If baby is engaged, but they are not finishing their rotation, we can focus on opening the midpelvis.
The midpelvis opens more with side-to-side movement, asymmetrical movement, and both internal and external rotation (closed and open hip movements).
The elevated lunge is a great upper midpelvis opener that many of my clients will intuitively move into as they sway side to side.
If baby is in the lower midpelvis and trying to finish their rotation, opening the lower midpelvis with more internal rotation can be helpful! This could include doing half-kneeling positions or hip-shifted positions.
When I support births, I tend to find that my clients will continually shift their weight into the same leg as they labor when their baby is really low. This intuitive movement creates mores space int he lower midpelvis by rocking that hip into internal rotation!
Watch the video below for a breakdown of three different labor positions that you could try to help baby finish their rotation.
Outlet: Extension
If baby is in the outlet, or trying to navigate under the pubic bone, we can create more space with internal rotation, or knees in, ankles out.
We are typically trying to open this level of the pelvis when we are pushing!
Watch the video below for some counter-pressure techniques you can try while pushing to help baby get under the pubic bone!
Find Labor Progress: Focus on Baby's Position
Your baby WANTS to fit through your pelvis! There is a relationship between HOW we move and HOW baby rotates through the pelvis during birth.
- We rock our hips front to back to help baby enter into the pelvis.
- Then we rock our hips side to side to wiggle and rock baby through the midpelvis.
- Then we shift our weight repeatedly into one leg to help baby finish their rotation as we begin to push!
We can support baby’s position by inverting to help them adjust their position and head, plus release lower uterine ligaments to make it easier for them to tuck their chin. We can release pelvic floor tension that may be affecting their head positioning. And we can create more space in the pelvic levels that that they are trying to navigate!
Learn more about labor positions and biomechanics in our childbirth education courses and upcoming labor biomechanics webinar! If you want to prepare for birth with prenatal fitness and pelvic floor prep, grab our prepare for birth bundles to save 15% on all our courses!