When it comes to labor positions, giving birth while standing up is not a new idea. While a standing delivery is not commonplace in the U.S., there is documentation of people throughout history giving birth standing up or in other natural positions.
So is it easier to give birth standing up? Some women believe that it is. For that reason and several others, standing when you go into labor and delivery may be an option that you want to consider for your labor and delivery.
Should You Give Birth Standing Up?
Many people in labor are encouraged to give birth lying on their backs or in a semi-sitting position. A 2019 study published in the International Journal of Nursing Sciences reported that 68% of people giving birth in the United States currently go through the birthing process lying on their backs. Other common positions include side-lying or lying on the back with the head and chest elevated. Standing and other traditional upright positions are far less common, accounting for less than a third of all deliveries.
But you have a choice when it comes to the birthing position that is right for you. You can advocate for yourself regarding birth position and it's an important topic to discuss when choosing your doctor or midwife. In making the best choice for you, it's important to consider both the advantages and drawbacks of standing up while giving birth.
Advantages of a Standing Birth
Based on a 2017 Cochrane Systematic Review, giving birth in traditional upright positions, such as standing, squatting, sitting, and kneeling, might have several advantages over the more restricted positions. Giving birth standing may affect your labor and delivery in the following ways:
- An upright birth position might prevent the need for forceps or vacuum-assisted delivery.
- If you are allowed to stand, you can move around more freely during the first stage of labor, which might ease your labor pains.
- Standing could put you in the best position to aid the natural process (physiology) of labor and the second stage of delivery.
- Standing helps to align your baby to your pelvic curves and could facilitate the baby's natural rotations as the they descend.
- Standing may help the natural urge to bear down and push in the second stage of labor after full dilation and effacement of your cervix.
- The force of gravity may facilitate the progress of the baby down the pelvis and out of the birth canal.
- The position could decrease the need for an episiotomy or a Cesarean section.
- This position may maximize the space in your pelvis, which will aid the descent and natural rotation of the baby.
- Upright birth positions might offer better blood flow to your baby because big blood vessels are not compressed from lying on your back.
A 2021 computer analysis of the biomechanical processes involved in labor and delivery acknowledges that the data on the optimum maternal positions during labor and birth is still evolving and that no ideal position exists. However, authors of the report noted that standing and other vertical positions offered better alignment of the body and pelvis to provide a wider opening for the baby.
Trying various positions during labor might reduce pain and make you feel more comfortable. Standing and other upright positions, rather than lying in bed, might also speed up your labor and delivery.
Disadvantages of a Standing Birth
Because every labor is unique, you may find that standing up to give birth is not the right choice for you. The potential disadvantages of standing to deliver your baby include the following:
- Although doctors previously thought there may be a greater tendency to tear perineal tissues during upright delivery, a study of 246 people giving birth found that there was no association between labor position and perineal trauma.
- It is harder for attendants to manage the birth of your baby because of limited access to your perineum.
- It is more difficult to stand or walk around if you are getting intravenous fluids, you have a bladder catheter, or you need continuous fetal monitoring.
- Standing might be tiring and therefore hard to sustain for the entire labor and delivery.
- There may be an increased risk for greater blood loss, according the Cochrane study referenced above.
- You can't get an epidural for pain relief because you won't be able to stand or walk safely.
You are unlikely to be able to stand to labor and give birth if you have a high risk pregnancy or develop complications and need to be monitored throughout your labor and delivery.
Tips for Giving Birth Standing Up
If a standing delivery is the right choice for you, there are various ways to manage standing as your primary position during your labor and delivery. One of these tips may help:
- You can walk around during the first stage of labor in between your contractions.
- Hold on to a wall, your partner, or other labor support for stability during contractions.
- You can move back to your labor bed or a chair when you are tired or you and your baby need intermittent monitoring.
- During your second stage of labor when it's time to push your baby out, you can move from standing to another upright position, such as squatting, kneeling over a chair or the bed, or kneeling on all fours.
Lastly, remember that you can take charge during your labor and delivery. Women are being encouraged to move and change to positions they find comfortable throughout the birthing process. You might find the option of standing or taking other upright positions during your labor and delivery appealing. Discuss birth positions and the benefits and risks with your doctor or midwife when you talk about your birth plan as you approach your due date.