Many people don’t realize it, but the right labor position can minimize trauma and help prevent injuries such as hip separation, low back trauma, and tailbone pain. As a physical therapist specializing in women’s health, I deal with trauma and injury from labor and delivery on a day-to-day basis.
I see women struggling to take care of their children because of the pain that they still have, months after the delivery of their babies. I treat women suffering from postpartum perineal tears, which are tears that occur in the area between the vagina and rectum, severe back pain, abdominal separation and disc herniation, displaced bones, organ prolapses and many other conditions. This pain may or may have not been present during the pregnancy, but the labor process has either brought it to the surface or has created a new injury.
HOW TO CHOOSE THE BEST LABOR POSITION
Physical therapists are uniquely equipped to make recommendations for birthing. We understand the pelvic floor muscles, the abdominal muscles and what positions pose a threat to the body. I developed a chart (see below) to outline different birth positions along with recommendations for how to avoid exacerbating an old injury and to prevent a new injury from occurring. You can share the chart with your doctor or midwife to determine which birth position will help you prevent a perineal tear or if have a pre-existing low-back disk bulge or herniation.
These recommendations are mostly upright labor positions that use gravity to get the baby out and maintain the spine in optimal alignment. There are some positions that are considered to be safer than others. For example, the side-lying position is the go-to position if you have a preexisting condition such as hipbone separation. I highlight the side-lying position because I find this position to be the easiest on the pregnant woman’s body. Practice the different positions with your birth partner before the big day so that everyone is well versed on how to do them.
Excerpted from Ending Pain in Pregnancy by Isa Herrera, MSPT, CSCS. Ending Pain in Pregnancy offers women techniques to manage chronic vaginal, pelvic, sexual and lower back pain during and post pregnancy, as well as during birth. The book also includes information on optimal labor positions and TENS therapy for natural pain relief. The best part is all the techniques in the book can be done at home.
………………………………………………………………………………………………………..
Isa Herrera, MSPT, is a physiotherapist and clinical director at Renew Physical Therapy Center in New York City, where she specializes in pre- and post-natal care and pelvic floor issues. Her new book, Ending Pain in Pregnancy helps women stay strong and pain free while preparing and recovering from labor and delivery. Visit her website for more information or to order the book.
Hi! Thank you for all the information. I’ve been searching for months on what will be my best labor/delivery positions. Iam 34 weeks pregnant and I am suffering from heriniatee disc/ lumbar radiculopathy, s1,s2,L4,L5,,,,Can you provide me a picture that will suite for my condition during labor/delivery?
Thank you so much,,,,,I highly appreciate it.
Hi Michelle: I’ll ask the author, Isa Herrera, to respond to your question. I have a copy of her book, Ending Pain in Pregnancy, to give away and can send that to you if you want to send me your address. You can email me at peggyomara@peggyomara.com. Thank you for your comment.
Hi Michelle,
In know this post is from a few years ago but I am in the exact same situation now. I have the same herniated discs and was wondering if you got an answer and how your delivery/recovery was? I am very worried.. Thanks in advance
Hi Michelle, I have posted 2 pictures on my site that will show you the 2 positions that are recommended in the above chart. For your condition it would be side-lying and all fours. The goal is to unweigh the lumbar spine. I wish you all the luck in the world. Best, Isa
All Fours Labor Positions
Side Lying Position
Hi cud u Plz tell me which position is suitable for me..am 26 weeks pregnant with bulging disc l3-l4 and l4- l5…with sciatic pain…any information would be helpful…thank you…even am searching for this since my pregnancy…