There are many different positions that may be used for pushing. In all positions, keep your chin down and use a rounded back to help your abdominal muscles assist your uterus in pushing your baby.

The following are suggestions of various positions for pushing and some advantages of each. You may be able to speed the progress of the labor if you try positions where gravity assists you (i.e. sitting, or squatting). However, if the baby is delivering quickly, you may be able to slow the stretching of the perineum by trying positions where gravity is neutral (i.e. lying on your side, or getting on your hands and knees). It is important for your comfort to experiment with pushing in different positions.

• Squatting
• Semi-Sitting/Upright
• Sitting
• Hands and Knees
• Lying on Your Side

Squatting

Advantages

• Opens pelvic outlet to its maximum width (up to an extra one-to-two centimeters)
• Takes advantage of gravity
• May require less bearing down
• May enhance the baby's rotation and descent in a difficult birth
• Helpful if you do not feel the urge to push
• If you have difficulty with squatting, try a semi-squatting position on a stool or a stack of pillows. Birthing beds have a squatting bar which may be attached to the bed so that squatting is more comfortable.

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Semi-Sitting/Upright

Advantages

• Some gravity advantage
• Partner should place his/her hands on your lower back and instruct you to push
  toward his or her hand, encouraging you to tilt your pelvis.
• Pelvic tilt allows for greater opening of pelvic outlet
• Good resting position
• Can be used with fetal monitoring
• Vaginal exams are possible in this position

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Sitting

Advantages

• Some gravity advantage
• Good resting position
• Can be used with fetal monitoring
• May lean forward to help relieve backache; a good position for a back rub
• You may consider pushing on the toilet as it is a familiar place to push and offers a firm surface against which to push

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Hands and Knees

Advantages

• Gravity neutral - slows a rapid delivery
• May help relieve backache by bringing the baby forward
• Assists rotation of the baby in a posterior position
• Takes pressure off hemorrhoids

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Lying on Your Side

Advantages

• Gravity neutral - slows a very rapid delivery
• Very good resting position
• Can be used with fetal monitoring
• Vaginal exams are possible in this position
• May be helpful in avoiding episiotomy

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