Move It, Move It! How Movement Impacts Labor and Childbirth

How To Have a Pain-Free Childbirth Experience

One of the many reasons I am an advocate of homebirth, and why I’m dedicating my career to promoting and supporting this birth experience is that homebirth allows you, the laboring woman, complete freedom of movement. No matter how accommodating the hospital or birthing center is, there is simply no way to reproduce the variety and range of movement that is facilitated in your own home spaces. 

Think about it for a moment: you have stairs, chairs (rocking and stationary), couches to drape across, counters to lean on, sidewalks or forest paths to ramble down, and possibly swings? Yes, a woman I know labored on her backyard swingset. Something about that movement felt right to her! I’ve definitely NEVER seen a swing in a birth center… And the sad truth is that most hospitals, and even many birthing centers, restrict your movement during labor even more than their mere physical limitations would require.

But you might be asking, why does this matter? Why do I need to move around during labor anyway? Well, freedom of movement during labor can have a profound impact on “presentation”. That is: the way that the baby’s head approaches the cervix, and the way that the baby is positioned in the uterus and birth canal.

What is “Presentation” and Why Does Position Matter in Childbirth?

Any woman who’s ever been told that her labor “failed to progress” or “stalled out”, or was told that she was “stuck” at some undesirable number of centimeters of dilation needs to know about presentation and positioning. Most of you have probably heard of the extreme malpositions (breech, shoulder dystocia, etc) But there are also some more subtle variations that can have a profound effect on labor patterns and progression.

A baby’s head and a woman’s cervix work together during labor a little bit like a key in a lock. The smallest part of the baby’s head (the back, at the top–the occipital bone) fits perfectly into the cervix and aids dilation and descent through a hormonal feedback loop (which we’ll talk about in another post!). If baby’s head is cocked to one side or the other, this is called an “asynclitic presentation”. Basically just “off center” If baby’s hand or elbow is on their head or cheek, or their arm is over their head, this can also impede the “key in the lock” goal. This would be called a “compound presentation.” If baby is turned around so that their face is forward, and the top or front of the head is against the cervix, this is called “Posterior presentation” Any of these less than ideal presentations can cause a slow-to-progress labor, often paired with unpredictable contractions of varying strengths and lengths. Picture a fussy, fitful labor pattern that doesn’t seem to progress in a linear fashion towards birth.

How Can I Optimize Fetal Positioning?

Well, you may have guessed it by now, but the way you move during labor can have a big impact on fetal position. Understanding the physiology of the uterus and the pelvic area (bone, muscle, and tendon) can help you understand how the movements and positions of YOUR body can affect the position of your baby’s body– and head! 

When you move or position your body in intentional ways during labor, you can usually coax baby into an optimal position for birth. Visualizing the physical process of labor and delivery can help you respond to various cues along the way, as you and your baby work together to be born. Understanding how to position or move to open the inlet of the pelvis in early labor, and the outlet later on can help facilitate labor contractions that are working to move baby through the birth canal. Understanding what a certain contraction pattern is signaling may clue you in to the need for some stair-climbing that can jiggle an asynclitic head into position. If you know what to expect, the words “stuck shoulders” can simply send you into a kneeling straddle, instead of a panic.

Freedom of Movement Contributes to an Empowered Birth Experience.

That’s the bottom line. As a midwife, my goal is to use knowledge and education to empower you in this process of pregnancy and birth, rather than encourage fear and a dependency on any “expert”. I want to work with you, to help you be aware of the stages and changes during labor so you can accomplish this goal of working with your baby and your body to have the peaceful, holistic, informed birth experience you deserve.