Walk, Move Around, and Change Positions Throughout Labor and Birth
Moving can help with the pain and it helps the baby move down safely through the pelvis. It does, but why?
Physiologic labor
Physiologic labor is labor that is powered by our innate capacity of giving birth and being born. Physiologic labor is orchestrated by hormones of both you and your baby, and moving during labor is a safe and healthy coping strategy that supports this normal biology. Moving allows for labor to progress optimally without interfering the natural flow of hormones, to the benefit of both you and your baby.
When the normal biology of birth unfolds without interference, our brain releases both more oxytocin and endorphins in response to pain to help cope with the intensity. More oxytocin creates more powerful labor surges that move our baby down, and labor is propelled by this hormonal feedback loop until our "cocktail glass" spills over with catecholamine for pushing. (This ending is more fun to watch.)
Hormones also protect our baby during physiologic labor. Endogenous oxytocin is analgesic for the baby too and catecholamines protect their brain during pushing when it naturally receives less oxygen; it helps maintain glucose supply to the heart and brain, and it helps prepare their lungs for breathing.
Moving allows for labor to progress optimally without interfering the natural flow of hormones, to the benefit of both you and your baby.
Moving creates space
As labor progresses, what we feel can be our guide to moving a certain way or getting into a certain position. Most people say that moving helped them experience less pain. Moving can relax muscles we may otherwise tense up; it can distract from the pain, and it allows for your baby's head to navigate your pelvis better, which can ease the pain too.
It is helpful to remember that our pelvises are not fused. If you have experienced symphysis pubis dysfunction (SPD) or sciatica during your pregnancy, you know this. You also know that certain movements, exercises, balancing techniques, and bodywork can help alleviate the pain. Labor is no different. So what does moving do in labor?
Inlet
Our pelvis is divided into three areas: the inlet, the mid-pelvis, and the outlet. A baby will begin its journey through the pelvis by engaging, meaning getting into the inlet. The most space here is from side to side, hip bone to hip bone. Instinctively, when we are having labor surges, we may walk, sway, stand –sometimes on tippy-toes which naturally flattens the low back creating more space, tuck our tailbone (posterior tilt), or sit with feet touching and knees out which makes the hip bones flare open.
Mid-pelvis
Being guided by our bones and our soft tissues, a baby will move deeper into the pelvis by tucking its chin and rotating. Having engaged into the pelvis in a somewhat sideways position (for most people), a baby will need to rotate to face our sacrum (ideally) to be born. To allow space for this, we often intuitively resort to positions like standing or kneeling while circling or swaying our hips. Resting with a pillow in between our knees feels better than knees wide open or legs together. The most space in this station is in the diagonal so any movement and position that opens the pelvis diagonally will help, like putting one foot up on a stair or stool, walking up and down stairs, or doing lunging stretches.
Outlet
After the mid-pelvis rotation is complete, the head passes through the pelvis ending with the nape of the neck resting under the pubic bone before the head comes down further, extends and starts to crown. The most space in the pelvis at this phase of labor is front to back. Most of us will naturally prefer to kneel, be on hands and knees, stand, hang, or get in a neutral squat. Some of us want to arch our backs and rotate our knees in and our feet out. The latter is more and more used as a "trick" to open the outlet when pushing is difficult but I have seen many people do this naturally. They are opening the outlet and their body knows this.
Moving can shorten labor
As you see, moving can help with the smooth progression of physiologic labor, both hormonally and mechanically. Moving in response to pain signals our brain to release the hormones needed for optimal physiologic labor processes for us and our baby. Moving itself alleviates pain. Moving is also an innate response to what our body and our baby need for making space and allowing rotation. All of this can lead to a shorter labor, with fewer interventions, and more satisfaction with the birth experience.
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