-By Bushra Hatahet, UK-Trained Clinical Midwife
One of the biggest misconceptions about labour is that birth happens best while lying in bed. In reality, your body is designed to move.
Movement during labour is one of the most powerful, evidence-based ways to help your baby descend, rotate and navigate the pelvis. Every step you take, every position you change into and every sway of your hips can create subtle changes within your pelvis that may help labour progress naturally.
There is no single “perfect” birth position. The best position is often the one that feels right at that moment.
As labour progresses, your body will usually guide you. You may instinctively want to stand, walk, kneel, sway, squat or lean forwards. These natural movements are your body’s way of helping your baby find the easiest path through the pelvis.
Your pelvis is an incredible structure made up of several bones connected by strong ligaments and joints.
During pregnancy, hormones such as relaxin soften these ligaments slightly, allowing tiny movements within the pelvis. These movements are only a few millimetres, but they can make a meaningful difference to the amount of space available for your baby.
Rather than being a rigid tunnel, the pelvis is dynamic. Its shape changes subtly depending on how you move.
Your baby travels through three important areas during labour:
Each part has a different shape, and your baby makes a series of gentle movements and rotations to fit through each one.
Understanding these three levels helps explain why changing position throughout labour can be so effective.
The pelvic inlet is the entrance to your pelvis.
It is widest from side to side, which is why most babies enter the pelvis with their head turned slightly to one side rather than looking directly forwards.
This is completely normal.
As labour begins, your baby’s head starts to engage into the pelvis before gradually descending with each contraction.
Movement that helps open the pelvic inlet includes:
These movements encourage your baby to settle comfortably into the pelvis.
The midpelvis is the narrowest part of the birth canal.
This is often where your baby needs to rotate into the ideal position for birth.
Sometimes labour appears to slow slightly here while your baby completes this important movement. This is a normal part of labour and often simply means your baby is working hard to find the easiest route.
If your baby is facing your abdomen (occiput posterior or “back-to-back”), rotation may take longer and contractions may be felt more strongly in your back.
Changing positions regularly can create subtle differences in the dimensions of the pelvis, giving your baby more opportunities to rotate.
Helpful movements include:
• • Asymmetrical lunges
The pelvic outlet is the final opening through which your baby is born.
As your baby’s head reaches the pelvic floor, it begins the final movements needed for birth.
The head extends beneath the pubic bone before gently being born.
One fascinating feature of the pelvis is that the outlet can become larger depending on your position.
When you kneel, squat, lean forwards or use hands-and-knees, your sacrum—the large triangular bone at the base of your spine—is free to move backwards.
This creates additional space at the pelvic outlet, giving your baby a little more room during the final stage of labour.
Even a small increase in space can make a significant difference.
Many people don’t realise that the tailbone is designed to move during birth.
As your baby’s head descends, the sacrum and coccyx (tailbone) gently move backwards, increasing the size of the pelvic outlet.
If you are lying flat on your back, this movement is more restricted because your body weight presses the sacrum into the bed.
This is one reason why upright, kneeling, side-lying and forward-leaning positions are often encouraged whenever it is safe to do so.
Gravity is one of your greatest allies during labour.
When you are upright, gravity works with your contractions to encourage your baby to move down into the pelvis.
This doesn’t mean you must stay standing throughout labour.
Even short periods spent walking, sitting upright, kneeling or changing position can help your baby continue descending.
Remember, labour is not a test of endurance. It is perfectly normal to alternate between movement and rest.
Walking encourages gentle movement through the pelvic joints while allowing gravity to assist your baby’s descent.
You don’t need to walk long distances.
Simply moving around your room or corridor between contractions may be enough to encourage progress.
Standing allows your body to move freely.
Many women instinctively sway their hips, rock from side to side or lean into their birth partner.
These movements relax the pelvic floor, reduce tension and encourage your baby to rotate naturally.
Leaning forwards takes pressure away from your lower back while allowing your abdomen to hang freely.
You might lean over:
This position is especially helpful if you are experiencing back labour.
A birth ball encourages gentle pelvic movement.
You can:
These movements help relax the pelvic floor while encouraging your baby’s descent.
If you have an epidural, you can still use movement to your advantage.
A peanut ball placed between your knees while lying on your side helps keep the pelvis open and encourages your baby to rotate and descend despite reduced mobility.
Changing sides regularly with the peanut ball is often recommended.
Kneeling while leaning over the bed or birth ball allows your sacrum to move freely.
This position combines gravity with increased pelvic mobility and is often very comfortable during active labour.
Side-lying is an excellent position for both labour and birth.
It allows you to:
Many women also choose this position for the birth itself.
Squatting creates one of the largest openings at the pelvic outlet.
Benefits include:
Because it requires energy, many women prefer to squat during the later stages of labour or while pushing.
Support from a birth partner, squat bar or birthing stool can make this position much more comfortable.
Sometimes medical circumstances mean birth needs to occur in a semi-reclined position, particularly with an epidural or continuous monitoring.
If this is the safest option, your midwife can still optimise your position by encouraging regular side changes, adjusting the bed and using a peanut ball where appropriate.
Lying flat with your legs supported in stirrups (the lithotomy position) is generally reserved for situations where additional medical assistance is needed, such as an assisted birth with forceps or ventouse, certain obstetric emergencies or complex perineal repairs.
For uncomplicated births, it is usually not the first choice because it can reduce the available space within the pelvis and works against gravity.
Labour is an active, dynamic process.
Your body is incredibly intelligent and will often guide you towards the movements and positions that feel most helpful.
Don’t worry about finding the “perfect” position. Instead, aim to keep changing position regularly, resting when you need to, and working with your body rather than against it.
Every woman labours differently, and every baby follows their own unique path through the pelvis.
Your role is not to force labour to happen—it’s to create the best environment for your baby to move, rotate and be born.
Your midwife will support you in finding positions that are both safe and effective, helping you make the most of your body’s remarkable design.
If you are looking for calm expertise and genuine continuity of care, let’s talk.
