Almost every expecting mom I have spoken to wanted to know the best position for labor and birth. You know, the one that's going to put the baby in an optimal birthing position (Occipito-Anterior) and be most comfortable for them. They want to know the crème de la crème of all labor positions and every time I tell them my answer I get this feeling that they want me to be more specific.
My answer to this elusive question is: Any labor position that is changed frequently is the best position. Labor needs steady movement and to not become stagnate in any one position. I'm going to break down some of the best ones I encourage others to rotate between in order to get the baby in an optimal position for birth.
Hands & knees: Is your labor progressing too quickly and you feel like you need to slow it down just a tad? Or maybe you're experiencing outrageous back labor and need help turning a posterior baby. Going on to your hands and knees will gently pull the baby out of your pelvis and allow for it to rotate or slow labor down to avoid tearing.
Squatting: Getting into a squat position promotes strong contractions, rupture of membranes, and rapid descent. Some like it during the transition and it works well for pushing. But because it allows for a rapid descent, tearing is more likely in this position. If you do decide to push in this position, there's no harm in your care provider, partner, or yourself supporting your perineum to help avoid tearing. Or you can switch to a side-lying position for pushing which I'll explain next.
Side-lying: This position allows for you to rest and some enjoy that break after the transition that some can experience. You can put some pillows between your legs to help keep your hips open or a partner can help support your leg that's on top while pushing.
Leaning forward over a couch/ birth ball/ chair: When you are leaning forward you are allowing gravity to work with you. This position also helps to lower the baby into the pelvis but not too quickly. This position is great if you have a partner or support person who can apply hip opening techniques or direct pressure to the back to help relieve pain.
Sitting on the toilet: We don't call this the dilation station for no reason! Similar to the squatting position this helps to rupture the membranes and encourages a rapid descent of the baby which helps you to dilate and keep labor progressing. It's common to sit on the toilet backward with a pillow so you can rest your head or even allow your support person to apply direct pressure to your back if that's what you're needing at that moment.
As you can see there's no one best position for labor. The crème de la crème of labor positions is a few of these combined at different points and stages in your labor. And what works for you may not work for the next mom or even your next pregnancy. Like many things in life, labor is fluid and requires you to fluctuate with it.
I hope you have found this informative and always remember, nothing outside of you has control over you, mama.