Pros and Cons of Giving Birth Standing Up

Husband with wife in labor

Women giving birth while standing up is not a new or strange idea. There are documentations of women throughout history giving birth standing up or in other natural positions. For several reasons, standing when you go into labor and delivery is one of several birthing positions you can consider safe for you and your baby.

Standing During Labor and Delivery

There are advantages to standing to labor and give birth. However, less than ten percent of women in the United States currently go through the birthing process standing or in other traditional upright positions.

In a survey reported in 2014 in the Journal of Perinatal Education, 2014, the majority of women are now constrained to giving birth lying on their backs or in a semi-sitting position. This change came with the advancement in technology, monitoring, and interventions in obstetrics.

How to Manage Standing to Give Birth

You can try various ways to manage standing as your primary position during your labor and delivery. For example:

  • 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.

According to a 2017 review in the European Journal of Obstetrics and Gynecology and Reproductive Biology the data on the optimum maternal positions during labor and birth is still evolving.

The Advantages of Standing

Based on a 2012 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 can affect your labor and delivery in the following ways:

  • Pregnant woman standing
    Standing puts you in the best position to aid the natural process (physiology) of labor and the second stage of delivery.
  • If you are allowed to stand, you can move around more freely during the first stage of labor, which can ease your labor pains.
  • There is better blood flow to your baby because big blood vessels are not compressed from lying on your back.
  • The force of gravity facilitates the progress of the baby down the pelvis and out of the birth canal.
  • Standing helps to align your baby to your pelvic curves and facilitates his natural rotations as he descends.
  • It maximizes the space in your pelvis, which will aid the descent and natural rotation of the baby.
  • Standing can help the natural urge to bear down and push in the second stage of labor after full dilation and effacement of your cervix.
  • It might prevent the need for forceps or vacuum assisted delivery.
  • The position could decrease the need for an episiotomy or a cesarean section.

According to the Mayo Clinic, trying various positions during labour 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 for Women to Give Birth Standing Up

The potential disadvantages of standing to deliver your baby include:

  • Standing might be tiring and therefore hard to sustain for the entire labor and delivery.
  • You can't get an epidural for pain relief because you won't be able to stand or walk safely.
  • 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.
  • It is harder for attendants to manage the birth of your baby because of limited access to your perineum.
  • There is a greater tendency to tear perineal tissues during delivery.
  • There is an increased risk for greater blood loss, according the Cochrane study referenced above.

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.

Comfort During Labor

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.

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Pros and Cons of Giving Birth Standing Up