Open The Pelvis: Often, we are asked “what positions should I do during each stage of labor?” Do you need to do squats during early labor, then lunges in active labor?! Not necessarily!
First, there is no one movement that will open the entire pelvis (squats will not open the top, middle, and bottom of the pelvis), and these movements are not tied to a specific phase of labor. You may even be doing midpelvis opening movements when you are pushing!
Now, what labor positions should you do, and when should you do them?
1. Consider your baby’s position and station.
We want to create space in the pelvic level that baby is at. If they are still trying to engage, to enter into the pelvis, we want to focus on opening the top of the pelvis. If baby is engaged, and trying to rotate through the midpelvis, we want to open the middle of the pelvis with asymmetrical or sideways type movements. If your baby is aligned with the outlet, we want to focus on internal rotation to open the bottom of the pelvis for pushing.
If we create more space at the pelvic level baby is trying to navigate through, they will have an easier time moving through that space.
2. Open the top of the pelvis
If baby is still trying to engage, or enter, into the pelvis, we want to open the inlet of the pelvis. Baby is commonly -2 or higher station.
We can achieve this with external rotation of the femurs, or wide knee movements, and posterior pelvic tilt, or tucking the butt underneath.
This could include deep supported squats, for example.
3. Open the middle of the pelvis
Midpelvis has two levels, the upper and the lower level. But simplistically, we can open the mid pelvis with asymmetrical or uneven movement patterns. So, one leg is moving differently than the other leg.
Focusing on opening the midpelvis is important when the baby is engaged, or entered into the pelvis, and trying to rotate through. This will commonly be a -1 to +1 station.
Movements could include side lunges, curb walking, or walking upstairs sideways.
4. Open the bottom of the pelvis
When opening the outlet, or the bottom of the pelvis, we want to focus on the internal rotation of the femurs, or knees in, and ankles out. Internal rotation of the femurs helps to spread the ischial tuberosities, or sitz bones, further apart from one another creating more space in the bottom of the pelvis.
If you are feeling the urge to push, or your baby has +2 station or lower, then focusing on opening the outlet may be appropriate.
Movements could include all fours or kneeling pushing positions with the knees in and ankles out, or even a side-lying or supine pushing position with the same leg position.
As you can see, none of these positions are linked to a specific stage of labor. Some babies engage, entrance to the pelvis before labor has even begun. So, if you were focusing on deep squats during early labor, and your baby was already in the mid pelvis, it won’t necessarily stall or stop the labor progress, but it may be not facilitating it.
On the other hand, some babies do not finish the rotation before pushing has begun. So, doing outlet opening pushing positions, with the knees in and ankles out, won’t necessarily stall your pushing progress, but if you did an asymmetrical midpelvis opening position it may help your baby finish their rotation a little easier.
Laboring positions are dependent on where baby is within the pelvis, as opposed to what stage of labor you are in. Fortunately, most of us will move intuitively with labor, where you will do movements naturally that helped to create more space in the pelvic level baby is in. You are the smartest person in the room about your own labor experience!