When it comes to pushing during birth, one of the most common questions we hear is, “What’s the best pushing position?” The answer might surprise you—it’s whichever position feels best for you.
In this episode of the MamasteFit Podcast, we’re diving deep into pushing positions: what’s most common, what’s often misunderstood, and how to find the position that will help you feel supported and safe during one of the most intense moments of labor.
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Is Pushing on Your Back Really “Bad”?
You’ve probably seen the debate online: “Never push on your back!” But is it really the worst position?
The truth is—not if you choose it.
If you prefer to push on your back because it feels comfortable or helps you relax, that’s absolutely okay. But when someone is forced into that position because it’s more convenient for the provider or hospital staff, that’s when it becomes problematic.
When lying flat on your back, your sacrum (the bone at the base of your spine) has less room to move, which slightly reduces space in your pelvis. While we’re only talking millimeters, those millimeters can make a difference. The fix? A simple tilt—placing a pillow or towel under one hip or using the cutout of a hospital bed—to create just enough space for your sacrum to shift and for baby to move more easily.
Why Your Comfort Matters Most
For many birthing people, pushing is the most intense part of labor. Some find they can relax best in restorative positions—like a reclined position in bed—while others push better in upright, active positions like squatting, standing, or on hands and knees.
The key takeaway: The best pushing position is the one YOU choose—not the one you’re pressured into.
If a nurse or provider suggests switching positions and you don’t want to move, a simple statement like, “I’m comfortable here,” can clarify your choice and avoid unnecessary pressure.
Common Pushing Positions in a Hospital Setting
Most people who give birth in a hospital do so in the bed, but that doesn’t mean you’re limited to lying flat. Options include:
✅ On your back (slightly tilted) – Supported with pillows or the bed adjusted for comfort.
✅ Side-lying – Great for resting between pushes, especially with a peanut ball between your legs.
✅ Hands and knees – Can relieve back pressure and help baby rotate.
✅ Kneeling with the head of the bed raised – Uses gravity to your advantage while keeping you supported.
Even if you have an epidural, you can often change positions—with assistance—to keep labor progressing.
You Don’t Have to Stay in One Position
Pushing isn’t a static process. You’ll likely switch positions multiple times, even if you only push for a short time. Small shifts in movement—like rolling to your side, adjusting your hips, or coming up into a half lunge—can subtly change your pelvic space and help baby navigate through the birth canal.
What About Water Birth?
In the water, gravity works differently. You can recline, kneel, or go on hands and knees without worrying about the same sacrum restrictions you might have in bed.
Important note: If you’re giving birth in the water, your hips need to stay submerged. Baby should be born fully underwater and lifted up only once, to keep them safe as they transition from water to air.
Positions for When Baby Needs Extra Help
Sometimes, baby needs a little help finishing their rotation to move under the pubic bone. In those moments, certain “closed hip” positions (where the belly moves closer to the thighs) can open up the lower mid-pelvis and create space.
Techniques like:
Half-lunge positions
Hip shifts (gentle movements to shift the pelvis)
Cook’s counterpressure (gentle tactile pressure on the sitz bones)
…can all help baby navigate the final stretch.
Final Thoughts: Your Birth, Your Choice
There is no single “best” pushing position—only the best position for you in that moment.
✔️ Be open to trying different positions.
✔️ Find a team that supports your choices—all the way through the birth.
✔️ Know that it’s okay to change your plan based on comfort, safety, and how your body feels in labor.
Ultimately, the goal is for you to feel supported, safe, and empowered during one of the most transformative experiences of your life.
Additional Resources
Prenatal Support Courses
Learn the science of pregnancy and birth to take the mystery of labor away! Understand why you are feeling what you feel, and learn strategies to confidently move through pregnancy and birth!
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Workout on-demand with our prenatal fitness workout videos! Each workout is 30-40 minutes to follow along as you exercise at the same time!
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Instructor
GINA
Find comfort and relief from pelvic girdle pain throughout your pregnancy and postpartum period! This program incorporates myofascial sling focused exercises to stabilize across the pelvic girdle joints.
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- On Demand Workout Videos to Follow