The MamasteFit Podcast Episode 74 – The Best Positions for Birth

[00:00:00] Gina: If you’re wondering what the best labor position is and what the best position for your baby is, and whether or not you need to force them into that position in order to have a “good” quote unquote labor, I’m here to tell you that there is no one best position that you need to be in throughout the entire duration of labor, and there’s not necessarily one best position for your baby either, and trying to force them into that position is not necessary during pregnancy.

[00:00:24] Gina: So we’re gonna discuss how to know what the best position is for you at different points of labor, what different movements and positions that your baby’s going to navigate through, and then how can you prepare to support that during pregnancy? Because it’s not just to cross your fingers and hope everything goes really well. There is some preparation involved supporting our baby’s position.

[00:01:34] Gina: Welcome to the MamasteFit Podcast. In this episode, we’re going to be talking all about the quote unquote “best” positions because there’s always “the squat is the best.” “This movement is the best.” “Everyone should push like this.”

[00:01:47] Roxanne: Hands and knees is the only position for labor.

[00:01:49] Gina: Yeah, you have to be upright, or else. Like gravity…. So there are good reasons why people recommend certain laboring positions. However, it’s important to note that there’s not just one position that’s going to open your entire pelvis. And there’s not one position that your baby is going to be in as they shoot through your pelvis either. they have to rotate and navigate through the pelvis because Each pelvic level is a slightly different shape, and so they kind of have to like wiggle and move through. So there’s not even one best position for your baby either. And so if you went to a prenatal appointment and your provider was like, “Your baby’s in the perfect position….”

[00:02:29] Roxanne: For now.

[00:02:29] Gina: For now. Like it really depends on what pelvic level they’re at. are they engaged? Are they still trying to engage? Generally, we want baby more towards the front, but there’s not one best position. And trying to force them into that position, if you’ve been pregnant, these babies wiggle and move around. Do they have side preferences? Sure. But they don’t just…

[00:02:52] Roxanne: They don’t stay there.

[00:02:54] Gina: They’re going to kind of wiggle and move. And so until we have strong contractions, we don’t necessarily need to force our babies into any specific position. Because one, we don’t know what the best position is for them, depending on where they are within the pelvis.

[00:03:09] Gina: Even if they are in a specific part of the pelvis and we know exactly where that part is, we don’t know, okay, well, do they need to tuck their chin a little bit more? Is their head a little bit crooked? So there’s a lot of variables that we want to be thinking about when we consider the best position.

[00:03:24] Gina: But it’s really, it’s good clickbait to be like, “This is the best labor position.” Or “POV, I did this one movement and my baby fell out of my body.” So we’re going to break down what the different labor positions are,

what the different movements that your baby is going to be kind of navigating through, and how we can support that during pregnancy and during labor.

[00:03:47] Gina: So let’s start with the top of the pelvis. How does that open? Good thing I have this pelvis here to demonstrate for those of you that are watching our YouTube video. So the top of the pelvis is known as the pelvic inlet. This is where your baby’s going to first enter or engage into the pelvis.

[00:04:04] Gina: And generally the movements that open the top of the pelvis are going to be like those deep squat movements. Like what quote unquote everyone says is the best labor position.

[00:04:12] Roxanne: Wide knees.

[00:04:13] Gina: You can engage your baby. You could push your baby out in this way. And there’s some nuances to that. But generally, we want to think more wide knees, so external hip rotation with abduction. So legs moving away from midline is going to help to create that space from side to side in the top of the pelvis. And so these are going to be all those deep squats, butterfly poses, all those birth preparation exercises where we have like open hips, like hip openers. So think about hip openers. That’s what’s going to open the top of the pelvis.

[00:04:42] Gina: However, there are other levels to the pelvis that open with different types of movement patterns that are even opposite of that. So we don’t want to think only deep squats only butterfly pose for all of labor, and we don’t want that to be the only way that we’re preparing for birth either because we need to be able to do internal hip rotation, asymmetrical movements, in addition to pelvic tilting. So being able to move that pelvis from front to back.

[00:05:08] Gina: So in addition to those wide legged positions, we also want to be able to find more of that anterior pelvic tilt, where the pelvis is tilting more forward, so think more arching in your back. The good news is, we already like those positions during pregnancy. We just kind of let our belly, lead the way. Just like we’re gonna let our baby let us know when they’re ready for a lever and all that good stuff. We’re letting belly kind of lead the way so we tend to find a more arched position. And this continues into the postpartum as well. This is a common postural position for us just in general. It’s just, it’s a power position, it’s easy to be in, it’s most comfortable. This more arched position changes this pubic bone angle, it can make it easier for your baby to enter into the pelvis, so it’s kind of opening more of the front half of the pelvic inlet. But we also want to be able to find a posterior pelvic tilt, so we’re tucking the butt underneath, so think like a rounded back, like you’re pushing your butt underneath your hips.

[00:06:05] Gina: We have this junction between our lumbar spine and our sacrum, so the sacrum is that triangular bone on the back of your pelvis and the lumbar spine is like your lower back. It’s known as the sacral promontory, so that kind of pushes into the inlet and kind of decreases that space from front to back. When we have that more posterior pelvic tilt, that junction moves backwards, and so we we increase the diameter of the pelvic inlet from front to back. And this primarily targets like the back half of the pelvic inlet, so like the posterior inlet. And so when we’re laboring, if our baby is still trying to enter or engage into the pelvis, we’re favoring a lot more of those like wide leg positions and lots of tilting. So front to back kind of pelvic tilting.

[00:06:47] Gina: And so if your baby is still trying to enter into your pelvis, you may find that movements that are like those deep squats, pelvic tilting from front to back, either seated on a ball, all fours, but we’re doing just like a lot of tucking type movements. We’re just like constantly like, tuck, tuck, tuck, because we’re intuitively trying to create that space for baby.

[00:07:07] Gina: But the key is, it’s not just one movement that we’re doing until baby engages. It’ll be like squats for 20 to 30 minutes. And then we’re going to shift to do like pelvic tilts for 20 to 30 minutes, and then you’ll shift to a different position, but it’s this constant moving and changing of positions that’s kind of helping baby kind of rock and rotate to be able to enter or engage into the pelvis.

[00:07:33] Gina: So the top of the pelvis is the pelvic inlet. Certain movement patterns are going to open the top and there’s a variety of labor positions that we can do to create that space. Typically wider knees and lots of pelvic tilting from front to back. So really any position that does that is going to be beneficial. They can be upright positions. You can be using a peanut ball laying down if you want to rest a little bit more. You can also do it like in a tub as well. And so there’s no one specific way that you have to labor. It’s all about what feels good for you at that time. And it’s okay to get into a more reclined or restorative position if you need to rest. So you don’t have to stay upright and use gravity the whole time. Sometimes our body is asking us to rest a little bit more as well.

[00:08:16] Gina: But before we dive into what is the best position, we first have to understand what the different positions that our baby can even be in during pregnancy, during labor. And then we’ll talk about how baby’s going to navigate through this space.

[00:08:30] Roxanne: So the different positions that baby can be in is first, head down, they can be breech, but they can also be transverse. This is important because transverse will sometimes be called OT and that is different. That is a different transverse than this transverse. If they’re going to talk about baby

being sideways, they’re going to say transverse. If they’re going to be talking about baby facing sideways, that will be OT, but it’s also called transverse.

[00:08:58] Roxanne: But when baby’s in the pelvis, baby’s either going to be facing to the right, or to the left, or to the front, or back. If they’re facing towards your right hip, because most babies that are going to be born vaginally are going to be head down, there is like the few that can be born vaginally with a provider for breech, but most of them are going to be head down, so they’re going to be talking about their occiput, which is the back of their head. So “O.” So then it’s going to be occiput, either transverse, so the baby is transverse facing one of the hips, so either ROT if they’re facing the left, or LOT if they’re facing the right. So it is, again, it’s referring to the back of their head where that is facing. And that’s why if they’re facing the right, it’s going to be L O T, because that means the back of their head is on the left. And it’s always referring to your body, your right and left, which can be confusing if I’m looking at you and being like, “Oh, the baby is R O T.” No, it’s not. It’s L O T because they’re left, my right. I always get those confused and I always have to like, rethink it.

[00:10:02] Roxanne: The other common position that some people will say is the perfect position, your baby is in the best position during pregnancy, is OA. So this is, they are facing backwards, and their back of their head is anterior, or to the front. And then the one that they say is least optimal, “the worst position,” some people will even call it, is OP. So the back of baby’s head is to the posterior portion of your body, or the back of you, and their back, their spine is in line with your spine. This is also called sunny side up because if you look about there like the face is up, the sunny side is up. I feel like it sounds a little bit nicer than “OP.”

[00:10:45] Gina: I’ve heard it referred to as a stargazer. So they’re like looking at the stars when they’re born because everyone’s on, most of the people, are on their back.

[00:10:52] Roxanne: Because when they’re born, they do look up. It’s almost confusing, sometimes when a person is in hands and knees position, their baby comes out OA and I, I have to be like, “Oh, this baby’s OA, and that’s why they’re looking up.” Because normally if they’re on their back, they’re looking up and that’s like, “Oh, that’s… that was hard! Good for you!” But the other way, it’s completely fine.

[00:11:13] Roxanne: But, so babies, again, can be forward, backwards, OA, OP. But most of the time, they’re not just straight like that. They’re usually going to be somewhat kind of diagonal as well. So they can be, you know, ROP, LOP, then ROA and then LOA. So a lot of people refer to like the LO sides as being the more optimal side, so LOT, LOA, or OA. Those are like, that corner

of the compass, is the more optimal side. And then the R sides as being less optimal. But that’s not always the case.

[00:11:50] Roxanne: Because when babies are trying to engage at the top of the pelvis, the largest portion is from side to side and their head from front to back is the larger portion. So they’re going to engage in that OT position, but that’s again, not the full picture. Because if you think, if you look at the top of the baby’s head, this is a larger portion if they just come straight down, versus, when a baby’s chin is tucked. That is another really important question that we need to think about when a baby is navigating the pelvis. Is their chin tucked? Because that means a smaller portion of their head is navigating and engaging and moving through the pelvis versus if a baby is looking straight up.

[00:12:30] Gina: So if you ever put a t shirt on, which I’m assuming everyone has, we typically will tuck our chin to put the t shirt over the crown of our head, as opposed to keeping our head straight. If you try to put your t shirt directly over the top, looking forward- or if you have a small child and you’re trying to get their shirt on their head, you have to start at the back and kind of pull it forward. And that’s kind of the same thing with baby. Like we want the smallest circumference to be pushing through the pelvis and that’s going to be like the crown of their head with this chin tucked, as opposed to looking forward.

[00:13:08] Gina: And so something that really frustrates me because we’ll have folks that will message us that are like, “I am going for a VBAC, but my provider told me my pelvis is too small because my baby didn’t fit through my pelvis last time, or my baby’s really big.” And I don’t want to dismiss the fact that, yes, there are some pelvises that have been impacted by a childhood illness or trauma, that they physically cannot open enough for a vaginal birth, and so a C section is a very valid way to give birth for those folks and for folks that just need or want them throughout their pregnancies. However, your baby’s heads may have been in a deflexed position where they’re looking forward. And so they were presenting much larger than if they just tucked to their chin. And so if you were trying to put that T shirt on your child’s head and they kept their head forward and you were just pulling it down, we wouldn’t be like, “Your shirt is too small.” I mean, their shirt can be too small.

[00:14:06] Roxanne: Maybe it could be too small, but.

[00:14:07] Gina: But we would be like, “Oh, well, if you tuck your chin, I’ll get it over this smaller portion.” And now the shirt fits over their head. And it wasn’t like the shirt suddenly got bigger, we just changed their head position, so we got a smaller circumference through the hole of the shirt.

[00:14:24] Gina: And it’s the same for you. If you’re pulling your shirt down and it’s a really, it’s a smaller neck opening, and you tuck your chin, it’ll fit through the shirt. And so it’s really similar to our pelvis. If baby’s extended and looking forward, they’re going to have a harder time navigating the space because they’re presenting larger, as opposed to if they tuck their chin, and that space is significantly smaller, entering into the pelvis.

[00:14:48] Gina: So the left side of our uterus tends to have a little bit more curvature to it, and the right side tends to be a little bit straighter. Because our organs are not perfectly symmetrical, like we have different size lungs, our diaphragm is different on each side. And so it would make sense that the uterus is also not perfectly symmetrical either. But on the right side, it tends to be a little bit steeper or straighter, so babies tend to be in a more extended or deflexed position, so they’re just kind of looking forward, so they just present larger, and so it can be a little bit harder for them to enter into the pelvis.

[00:15:21] Gina: However, this is not the case for everybody. Some folks, their babies will still tuck their chins and fit right into the pelvis on the right side. So, left versus right is not necessarily, “your baby must be on this side. to have an easier labor,” but most babies are going to prefer the left side. And so when we’re thinking about laboring positions, focusing on helping baby rotate, typically it’s the left side that we’re thinking about creating that space for baby to rotate on, which will make more sense when we get to the mid pelvis.

[00:15:51] Gina: So after the inlet, which is where baby engages, baby now needs to change their position from that OT and then rotate forward into an LOA, if they’re rotating from the right, an ROA position, to finish to get underneath this pubic arch here in that OA position. So, during pregnancy, baby being OA but not engaged doesn’t necessarily mean they’re in the best position because OA doesn’t align with the pelvic inlet. OA aligns to the pelvic outlet. And so, this is where it gets hard when folks say, “My baby’s not in the best position,” or, “my provider said I need to try to get my baby into this perfect position,” because it depends on where the baby is within the pelvis. So the middle of the pelvis is where baby’s typically going to rotate to that like, the other perfect position that everyone refers to is LOA, which is left occiput anterior. It means baby’s back of the head is towards the left side rotating, towards the front, so they’re kind of, diagonal in between L O T and O A.

[00:16:53] Gina: And it is important to know these acronyms because this is what they’re going to be referred to in, a labor room. They’re going to be the terms that your provider is using when they discuss baby’s position. Very rarely will somebody say, “Your baby’s left occiput anterior.” They’ll say “Baby’s L O A. Baby’s OP, baby’s…”

[00:17:10] Roxanne: Or they might explain “Oh, the baby is facing towards your right back, like right butt cheek or your left butt cheek or your right, like front pubic bone or your left pubic bone.”

[00:17:19] Gina: So if you’re confused, definitely ask what they mean by it.

[00:17:23] Roxanne: Oh, your baby’s facing your right or left hip.

[00:17:25] Gina: But it can be helpful to just know what those acronyms mean. And I think they’re easier to say because it’s obviously much shorter.

[00:17:32] Gina: So baby’s going to rotate forward because your pelvis has this ischial spine, which is this little jutted out bone that comes out to the back half of that front pelvic half. And they need to rotate in front of that to get underneath the pubic bone. And so they’re going to rotate internally towards the front to get in front of that bone. And this is going to be where we start entering kind of the narrowest space of the pelvis, which is kind of the lower mid pelvis area.

[00:18:00] Gina: And so if baby is rotating on the left side, which is where most babies are going to be rotating from, and they’re beginning that rotation, we want to think about the upper mid pelvis, which is going to be one sided open hip positions. So these are going to be like our elevated lunges where the leg is more open, those half lunges, like anything like where one leg is a little bit more out than the other is going to open the upper mid pelvis to help baby rotate.

[00:18:24] Gina: And then if you’re like, “Well, I don’t know which side to do because I have two sides. Is the left side better or the right side better?” My advice is to try it. Do the left side and then do the right side during a contraction and see what feels better. And you’ll probably be like, “The left side felt better.” do that. So that’s usually what I would recommend if you’re like, “Well, I don’t know what side’s the best. I don’t know what side my baby’s on.” Do both. And whichever one feels better for you, do that side. That’s usually what my, my go to is because we have a lot of intuition on what feels good for us. Now, even if you have an epidural, I still find that even with an epidural, when I ask somebody what side you want to lay on, they’ll still be like, “I feel like my left side feels good.” like they still have some of that intuition as well. But if you’re like, “I don’t know,” just do both sides. Do one side for 20 minutes and then do the other side for 20 minutes. Like we want to continually move because that’s how baby’s kind of wiggling and rocking through.

[00:19:22] Gina: Now, when it comes to the mid pelvis, just in general, we’re thinking like side to side swaying type motion. So, shifting the hips from side to side is really beneficial. Like just shifting our weight from leg to leg, hip circles, either seated on a ball, all fours, standing sways, peanut ball, and so you can see that there’s lots and lots of positions that we can start doing.

[00:19:44] Roxanne: There’s not one best position.

[00:19:45] Gina: There’s not one best position. Because each of us has different preferences too. I absolutely hated sitting. I did not like sitting on a ball at all. It did not feel good for me. Roxanne loved it.

[00:19:58] Roxanne: Yeah. I think the biggest thing with the mid pelvis, though, is the movement. Is moving into all of those internal and external on each side, however feels good for you.

[00:20:10] Roxanne: So, movement, “motion is lotion,” it’s my favorite saying. Motion is going to help your baby shimmy through that pelvis, whether it’s curb walking or whatever type of like movement you’re doing, even if you’re just sitting in the bed shimmying your hips. That was probably like my favorite for in the car or waiting in triage when I couldn’t get up and move too, too much shimmying my hips, still movement in your hips to help your baby shimmy through that middle, they are shimmying through the middle portion of your pelvis.

[00:20:42] Gina: So we’re not holding static positions.

[00:20:43] Roxanne: Yeah.

[00:20:44] Gina: I’m not holding a deep squat for eight hours.

[00:20:46] Roxanne: Yeah.

[00:20:46] Gina: “Well, this is the best position!”

[00:20:48] Roxanne: Whatever position you can still move in is the best position for you. Which is just the theme of this episode.

[00:20:54] Gina: Yeah, and we’re not trying to find the most uncomfortable, painful position either, because more intensity does not necessarily mean better either.

[00:21:03] Roxanne: No.

[00:21:04] Gina: Because sometimes that’s a misconception, where like, “Well, we want you to be in pain.” Well, yes, contractions, depending on how you describe that sensation, you may describe it as painful. I would describe it as painful at certain points. But I find that if I do a labor position that is too intense, even though it’s probably doing a lot, I can’t relax with it. And so it becomes counter intuitive at that point, or counterproductive at that point where it’s like, yeah, it’s super intense, but I’m fighting the contractions now.. And so we’re trying to find that happy medium where we have the intensity, but we’re able to release and relax as much as possible with it so the baby can navigate more easily. So if you think about trying to, push through, really taut rubber bands versus, very loose ones, the loose ones would be much easier than the super tight ones. So, you know, we’re using all the analogies this episode!

[00:21:54] Gina: After baby has kind of neared the end of their rotation, we’re in like lower mid pelvis, and this is where we’re going to be a lot of like repetitive hip shifts into one side because we’re trying to create space in the lower mid pelvis to help baby finish that rotation. Usually this is accompanied with lots of pressure. Where you’re like, I think I might need to poop. And someone might be like, “Well, maybe it’s your baby and you might be like, I don’t know, kind of feels like poop too. Maybe it’s both.”

[00:22:21] Roxanne: It’s all right next to each other.

[00:22:22] Gina: It is. It is. So when that is happening, we’re going to start shifting into one hip kind of repeatedly. You may notice like you’re coming up on your tippy toes, maybe doing some mini squat type movements. And so we’ve kind of shifted from more of the deep squat movements with really wide knees to now the hips are a little bit more upright and like more of a hinge type motion.

[00:22:44] Gina: So, as we move towards the later part of labor where baby’s getting super low within the pelvis, they’re kind of rotating from that LOA to that OA position we’re probably going to one, be feeling all that pressure, but transitioning to more hinge type motion. So beginning of labor, more of the deep squats, and then towards the end of labor with pushing is more of the hinges. Because that is activating the hamstrings, which then creates more of that internal hip rotation, creating more space side to side in the bottom of the pelvis.

[00:23:14] Gina: And so this is where those labor positions are starting to look really different. So top of the pelvis, really wide knees, so it’s traditional birth prep exercises. Squats, butterfly pose, like legs are super wide, open your hips, open your pelvis for baby, like all that, that’s opening the top of the pelvis. And then we start moving to the middle of the pelvis and now all the movements are

like very side to side, very sway, asymmetrical, so one leg is doing something different than the other. We have external rotation on one side, internal on the other. And then we move to the bottom and it becomes more internal hip rotation. So knees in, ankles out, creating that space from side to side. Knees don’t need to be touching, they can still be wide, just ankles a little bit further out, in addition to a slight posterior pelvic tilt, because it’s not just twerking our hips into various positions. The position of our pelvis influences how well we can find different hip orientations. So, trying to find more external hip rotation, more of an anterior pelvic tilt, so arching your back and spreading your knees wide, will feel more comfortable than bringing your knees together and having your ankles out.

[00:24:22] Gina: So if you’re seated in a chair, find an arched position in your back and then try to spread your legs wide and see how that feels. Just kind of pay attention to the sensation in your lower back. And now maintain that arched position and bring your knees together and your ankles out. And you’ll probably feel a little bit more strain in the lower back because again, your pelvis is not in a “good” quote unquote position for internal hip rotation.

[00:24:52] Gina: And now, if you found a more rounded position and you found that internal hip rotation, it probably feels so much more comfortable to be in. I also find that the external hip rotation feels fine with the rounded back as well, but it’s like a little bit more of a strain. So if I found my knees wide with the rounded position versus an arch, the arch position is a little bit more comfortable and like intuitive. But it’s really the internal rotation that you can tell the difference between the two. So if you find it a rounded position with knees and ankles out versus the arch position, there’s more strain in like the lower back. And you probably won’t be able to find quite as much internal hip rotation. And so, your pelvic position influences how well you can move your hip.

[00:25:35] Gina: So when it comes to opening the bottom of the pelvis, we want more of that internal hip rotation with a slight posterior pelvic tilt. So we’re not arching it back, we’re kind of rounding a little bit more. And if you think about it, like, when we’re rounding a little bit more, we can sometimes kind of help push our babies out.

[00:25:54] Gina: So in summary, there is no one best position for you to labor in, and there’s no one best position for your baby to be in either. And so, we want to be able to move through a variety of different types of hip orientations, pelvic positions, and so this is where like the birth preparation aspect becomes really important, in addition to, our baby needs to be able to change positions when labor begins relatively easy because the musculature and kind of the

surrounding structures are free of obstacles or restrictions or adhesions. And so this is where our birth preparation can be really beneficial.

[00:26:32] Gina: And so during pregnancy, we want to be able to one, find bilateral, external hip rotation. So both knees are wide as we’re spreading them outwards. We’re finding that external hip rotation on both sides. This is what’s going to be like those deep squat movements, those butterfly poses, like those type of movements. But we also want to be able to find asymmetrical positions. So one side in an open hip position and the other side in a closed hip position, and vice versa. So this is going to be like those half lunge positions where the knee is more open in addition to hip shifts, which is a huge aspect of birth preparation within our prenatal fitness programs. Because hip shifts are going to be harder for us to find.

[00:27:15] Gina: Like I said earlier in the episode, we tend to favor more external hip rotation and extension during pregnancy. And so we really need to emphasize the internal hip rotation with that posterior pelvic tilt during pregnancy to help us prepare for birth, which is what we do with the MamasteFit birth prep circuit. We’re targeting those common areas of tension that we tend to develop throughout pregnancy because we’re just kind of falling into these more comfortable positions. There’s nothing wrong with them, but It could make it a little bit harder for us to create the space that we need within our pelvis.

[00:27:47] Gina: And so we want to be releasing tension in our lats, in our hip flexors, and then also helping us to find more internal hip rotation with hip shifts. And there’s so many different hip shifted variations that you can do as well that we incorporate within the prenatal fitness programs and we incorporate within the birth prep circuit.

[00:28:04] Gina: The birth prep circuit is free. You can grab the freebie down in the show notes below and then our prenatal fitness programs we offer in two main formats. We have our app based program, which is going to be a list of exercise with demo videos. This is going to be a great option for somebody that wants to work out at their own pace, they like going to a gym, they want to work out with a barbell. But we do have a mini program as well that is like a great at home option also that’s only like 15 to 20 minutes. And then we also have our on demand program, which are going to be those full length workout videos that you follow and work out with at the same time. But both of them are going to incorporate the movements that we need to create space within the pelvis. So we have those externally rotated positions. We have those asymmetrical positions. Those hip shifts and the movements that create space in the bottom of the pelvis, which are going to be more of those hinge type movements, like deadlifts, adductor strengthening, helping with that pelvic

tilting and mobility. So lots of movements that we can do. We have a whole program with daily workouts for that. So you can check out our fitness programs on our website at mamastefit.com. And as a thank you for listening to this episode, you can use code STORY10 to get 10 percent off any of our online fitness programs for pregnancy, postpartum, childbirth ed, really anything that we offer online, you can grab 10 percent off with that code.

[00:29:15] Gina: And so when we’re preparing for birth, we want bilateral external hip rotation, asymmetrical position- so one hip open, one hip closed, particularly with those hip shifts- and then we want bilateral internal hip rotation, because that’s going to be what creates space in each of the pelvic levels. Cause there’s not just one position that opens the entire pelvis. And there’s also not one movement that stretches the entire pelvic floor. So, pelvic floor prep is more than just butterfly pose and deep squats. We also want to think like hero’s pose with knees and ankles out, 90/90s, hip shifts, things that are going to kind of change that pelvic position because the pelvic floor attaches to the pelvis. And so, because it attaches to the pelvis, different hip positions are going to change the pelvic shape a little bit, which then would stretch the thing that attaches to it in different ways. So hopefully that makes sense of why we need to do more than just butterfly pose. We definitely don’t need to do kegels. We can do a whole episode. I think we have a whole episode on why kegels are not beneficial.

[00:30:15] Gina: Now when it comes to supporting baby’s position, so that’s how we create space within the pelvis so we could figure out what labor position that we want to get into. So we also have to think about supporting our baby’s position without trying to force them into OA, LOA, which are the two most common ones that I hear. We want to ensure that their path to rotate is clear, and sometimes that is confusing. What does that mean? What do you mean? It means that the structures that are kind of surrounding baby and their path through your pelvis is relatively free of obstacles, so that it’s easy for them to make those adjustments. Now there’s still tons of tissue and muscle and ligaments and things that they are moving through. So it’s usually not just like a quick rotate and out, like there’s still an effort that happens. But we can release tension that maybe creates like obstacles for baby.

[00:31:07] Gina: So if we start with the uterine ligaments, we have various ligaments that attach the uterus to the surrounding structures, releasing tension within them so they’re balanced. So this is where things like inversions come in to help release tension in the lower uterine ligaments. The broad ligament with like belly sifting or like strengthening the abdominal wall, wearing a belly band, can all be things to help kind of release tension in that ligament. And then we can think about ensuring that the musculature that kind of surrounds baby and the uterus is relatively free of obstacles as well, which is typically the pelvic

floor. So learning how to release tension throughout the entire pelvic floor. Again, wide knees is not the only position that stretches your pelvic floor. I know that it’s if you scroll Instagram long enough, it’s top five moves for birth prep. I guarantee it’s squats, butterfly pose, half lunge with an open hip position, some other open hip position, and like adductor rockbacks. All opening the anterior portion and stretching the anterior portion of the pelvic floor, but neglecting the posterior portion where more of us have more tension. And so this is where those hip shifts and internally rotated positions are going to be super, super beneficial.

[00:32:15] Gina: So I feel like I’ve got a broken record at this point where I’m like, “Do more than just deep squats. Also. Learn how to hip shift.” We have tons of videos on how to do hip shifts. We incorporate within all our prenatal fitness programs. If you’re still like feeling very confused, finding a provider near you, like a physical therapist that specializes in postural restoration or has a certification in PRI can be super beneficial. This is like one of the foundational things for them. But it’s so helpful to creating, one, creating space within your pelvis, releasing tension in the back half of that pelvic floor. So if you’re having issues with tailbone pain or constipation or pelvic pain, like we’re usually finding a hip shift and releasing tension in that posterior pelvic floor is going to resolve a lot of that. So learn how to hip shift.

[00:33:02] Gina: So those are kind of like the main things that we can do to help support baby’s position is to focus on the uterine ligaments, releasing tension within them, releasing tension to the surrounding musculature, which is going to include your pelvic floor, the abdominal wall, so if you had a C section, scar mobilization is going to be really important. If you had any sort of like abdominal surgery, scar mobilization on that, on those scars is going to be really beneficial. And it’s not just on the scar. Sometimes you have to go a little bit above or below or even to the side to help release some of those adhesions. We had one gym client who said that she just felt like her baby like could not move into her pelvis and that at a certain point she felt the adhesions of her scar like release and then he engaged and she was like pushing. And I was like, “I thought I told you to do scar mobilization.” But like we sometimes forget how impactful some of that tissue, that scar tissue can be. So if you are going for a VBAC, make sure that we’re doing scar mobilization, even during pregnancy, can be really beneficial as well. And if you don’t feel comfortable doing scar mobilization during pregnancy, working with a professional like a physical therapist, massage therapist, can be really helpful as well.

[00:34:11] Gina: Let’s take a break from this week’s episode to talk about our Podcast sponsor, Needed. Needed is a nutrition company that specializes in optimizing the nourishment for the perinatal timeframe. So this is like preconception, conception, pregnancy, all the way through the postpartum.

They’re a brand that Rox and I have utilized to support our pregnancies and postpartum and we’re really excited to share about them.

[00:34:29] Roxanne: So Needed’s prenatal is one of our favorite prenatals and it’s ones that we’ve utilized during our pregnancies and even still to this day for my postpartum. But did you know that they have three different options for prenatal? Because one, there’s no one prenatal that’s best for everybody. They have a capsule version, but then within the capsule, there are two versions of the capsules. They have one that’s eight capsules or one that is three capsules because not everybody wants to take a bunch of capsules, but they still want the nutrients in the best forms to be absorbed by our bodies. And then they also have a powder version because, again, capsules aren’t for everybody. Some of us can’t swallow capsules very easily. So having a powder option that you can either add to your coffees or your morning smoothies is also a really great option. But all of them are in the form that is readily absorbed within our bodies and at the dosages that we actually need within our bodies. So Needed is one of our favorite companies. Again, we took their prenatals along with a lot of the other supplements that they offer. And if you want to try them out, you can go to thisisneeded.com and use code MAMASTEPOD to get 20 percent off your first order or the first month of your subscription.

[00:35:36] Gina: So in summary, there is no one best position for you to labor in. There’s no one best birth prep exercise either, just to make things more complicated. There’s a number of different hip positions that we need to be able to move through during labor, which we can focus on during pregnancy to ensure that that movement pattern is accessible to us.

[00:35:56] Gina: The big things that we want to focus on during pregnancy is helping you to find a more rounded position or that posterior pelvic tilt, because that tends to be more challenging for us. In addition to more internal hip and pelvic rotation. This is where like hip shifts are going to be super beneficial. And so we have our free MamasteFit Birth Prep Circuit that you can grab that has six exercises to help one, support your baby’s position and also to release common areas of tension that we have found with our gym clients, with our birth clients, that we find to be really beneficial to release in order to make it easier for a baby to kind of navigate through your pelvis. And then we don’t want to force baby into a specific position, but rather ensure their path to rotate is clear. And this is where more of that preparation comes in with the birth prep circuit, pelvic floor release exercises, and just general movement during labor as well. We don’t want to be stuck in one position. We want to change labor positions like every 20 to 30 minutes. And you’ll kind of know what feels best for you. We’re not trying to find the most painful position either, the most intense position. We’re looking for intensity, but to a point that we can still relax.

[00:37:03] Gina: And so we’re kind of, it’s like a fine line of balancing between intensity and like relaxation. Cause we also don’t want to like just do nothing to where we feel no contractions, we do want some contractions. So it’s like this balance of like intensity with relaxation and kind of finding whatever that point is for you. So for me, sitting did not feel good. The toilet was too intense. So I would like pee as fast as I could and then jump off the toilet before my contraction came. Some folks love the toilet because it really helps them relax and they feel like this is, very restorative for me. Some people love sitting. It doesn’t mean it’s wrong just because I didn’t want to do it. It was just a personal preference.

[00:37:45] Roxanne: I think it’s a very important through this entire podcast episode of learning to listen to your intuition so that you can move through labor in a way that is best for your baby in your body because your body will give you the signs of what is most comfortable for you. Like where can you relax most? And like you will feel like this is a one that I’m good with. I’m good with this position for now. And then usually within 20, 30 minutes, you’re like, and I am ready for something else. So let’s go somewhere else. And so letting go of expectations and just kind of listening to our intuition is hard, but it is so empowering and helpful during your labor progress, whether or not you have an epidural or not.

[00:38:30] Gina: Yeah. For me with my last birth, so Roxanne had this super serene, birth center birth where she like pulled her baby out and was like, (angel choir music) and it was like just super calm. And I was like, “I’m gonna do that. I’m gonna do that.” And you’ll see all these birth photos where somebody’s like pulling their baby up and I’m like, “I want that. I want a photo like that.” That is not me. That is not how I birth. I am hanging on for dear life, like when I’m pushing I’m just along for the ride and I’m finding whatever position allows me to relax the most and for me ends up being kind of on my back slash on my side in the bed. Cause that’s just what feels most comfortable. That’s where I can relax the most.

[00:39:14] Gina: However, if I listen to like social media and what everyone says is the best pushing position, I would give birth and then be like, “I did something wrong because I didn’t push in a deep squat or I didn’t push standing up or in an upright position, I was just like laying on the bed, please get out, please get out.”

[00:39:32] Gina: And so if I ignore that, this is what felt best for me, I would feel like I did something wrong. And I don’t want anyone that’s approaching their birth to feel like they could do anything wrong because we’re all navigating our own individual journeys. And for some of us certain positions feel better than others and it doesn’t mean that’s bad.

[00:39:52] Gina: It’s about listening to what feels best for you while kind of ignoring like the unsolicited advice on quote unquote “best” for pregnancy. So I think what Roxanne said about, it’s about listening to your intuition and what feels best for you and letting go of the ego, is like so important, and something that you can reinforce throughout your pregnancy.

[00:40:10] Gina: So I do that with like my workouts where I’m like, you know, I was really hoping to lift this much weight today. It’s, I don’t really feel like that’s going to happen. Cause I just, you know, I just don’t feel like it, or I really would like to do the movement in this way. So for me, like hip thrust, I love doing hip thrust. Cause you can do so much weight. And you feel so strong. The barbell just doesn’t feel good for me right now. It’s also a lot of effort to put up, to set up and then tear down. And so I’m like, eh, I’m just going to let it go, and I’ll resume it in the postpartum. But sometimes it’s really hard to let go of that stuff because you’re like, oh, I have this expectation that I’m going to do all these things in this one certain way.

[00:40:46] Gina: And so I think letting go of the ego during pregnancy at various opportunities that you have really serves you during labor.

[00:40:52] Roxanne: But also parenthood.

[00:40:53] Gina: But then also serves you in parenthood because these children have things called opinions.

[00:40:58] Roxanne: And like wants and needs.

[00:40:59] Gina: On how they would like to do things, so.

[00:41:02] Roxanne: You can’t get your full workout in sometimes because they want you to hold them the whole time.

[00:41:07] Gina: So it’s a lot about letting go of control.

[00:41:11] Roxanne: It’s hard.

[00:41:11] Gina: It is.

[00:41:12] Roxanne: But labor is the first step.

[00:41:15] Gina: So for the third summary, there’s no best labor position. There’s no best position for your baby to be in, but we can support creating more space within our pelvis, supporting where our baby’s positioned by

ensuring that we can move well and that we’re ensuring that baby’s path to rotate is clear.

[00:41:29] Gina: We have tons of resources to support you to do that with out prenatal fitness programs, childbirth education course, which teaches you how the baby’s even moving through the pelvis. We have our free birth prep circuit. We have a free support your baby’s position workout video on YouTube as well. So there’s lots and lots of content on what you can do to support this process without hyper fixating on, “My baby’s in this position. How do I get them here? How do I help them engage?” Because engagement does not equal labor, unfortunately. If so, I would have been in labor like four weeks ago.

[00:42:04] Gina: So I hope this episode was enlightening for you and hopefully stress relieving because we get a lot of really anxious messages where folks are like, “My baby’s in this position. What do I do? How do I force them into OA, or how do I get them into this position?” And when we’re like, you don’t have to, but here’s some movements that you could do to support it when they, when labor does begin, I feel is much more empowering.

[00:42:28] Gina: So if you want more support with aria pregnancy, again, we have our prenatal fitness programs, childbirth education course, pelvic floor prep for birth course, postpartum, we got some education courses and postpartum fitness programs. We have a lot of resources. If you’re very overwhelmed by the options that we offer on our website, head to our homepage. There’s a quiz there that you can take and it’ll help direct you to the course that we recommend based on your preferences.

[00:42:50] Roxanne: Needed is a nutrition company focused on the perinatal timeframe that both Gina and I have utilized during our pregnancies, preconceptions, conceptions, postpartums, breastfeeding, all of the things. Our kids use it. Our husbands even utilize some of their products. And if you want to try them out, you can use code MAMASTEPOD at thisisneeded.com for 20 percent off your first order or the first month of your subscription because subscriptions are easy. They will show up at your door without you having to remember because pregnancy, postpartum brain.

[00:43:20] Roxanne: It’s real.

[00:43:21] Gina: It’s real. Thanks so much for listening to this episode. Be sure to like and subscribe to our channel so you get notified whenever we release new episodes. We release new podcast episodes every Wednesday and birth stories on Fridays.