A woman gives birth and holds a man's hand.
Variations of a hands-and-feet or kneeling position during labor could help advance the process. (For Spectrum Health Beat)

Should you remain in bed during labor? Should you move around? Does it really make a difference?

In years past, women would typically remain in bed during labor. While this obviously worked, we now know that using upright positions in labor can actually shorten the process.

By taking a more upright position, a woman can shorten the first stage of labor by more than an hour, on average, and also reduce the likelihood of delivering via C-section.

The upright position will use gravity to help the baby come down through the birth canal.

The baby needs to be in a head-down position for a vaginal birth. For the delivery to go as smooth as possible, the proper part of the baby’s head also needs to lead.

Some suggestions for helpful labor positions:

Slow dancing

Yes, I’m serious! Assemble a playlist of your best slow-dance songs and be ready.

Why would this position—or technique, really—be so good? Think about what’s happening when you are slow dancing. You are swaying your hips.

When you do this, it helps the baby continue down the birth canal. You put your arms around your partner’s neck, he puts his hands about the small of your back.

This is a great opportunity for your partner to apply some pressure to your lower back. A simple back rub will do, too.

Hands and knees

This can be accomplished by leaning over a birth ball, remaining on your hands and knees. In another variation, you would face the head of the bed and lean forward on your knees, your hands over the top of the bed.

The hands-and-knees position can be used to help turn a baby out of a posterior position (when the baby’s spine is facing mom’s spine). Posterior babies are born vaginally all the time, although for moms this can mean tougher pushing, as this path is more complex for the baby.

Sitting

You can sit on the edge of the bed or a couch, or you can use the birth ball. Again, this uses natural gravity to your advantage and also gives mom a chance to rest.

Some moms like firm chairs, some prefer the softer birth ball. You can also use these items as you sit in the shower, getting the added benefit of hydrotherapy.

I’ve even seen moms sit backward in a chair, which can help relieve back pressure. This also leaves your back accessible to a helpful partner, who can apply ice or heat or provide a nice massage.

Walking

Walking moves the hips, which again helps baby descend. While there’s no consensus that walking will shorten labor time, many people agree it helps the process along.

It can also give mom the added energy she needs to continue with labor.

Squatting

When you squat, you lower your pelvis as you bend your knees. This opens the diameter of your pelvis, which can provide up to 1-2 centimeters more room for baby.

Squatting is a great position for pushing. Some moms really like this position in labor.

Birth ball

The birth ball gives you a number of options for positions, including sitting, leaning or side-lying with a special birth ball called a peanut ball.

Keep in mind that what works for one mom might not work for the next.

There are even moms who face unique situations that require them to remain in bed during labor. Just one example of this: an epidural.

Speak to your nurse or your OB provider if you have any questions.

The American College of Obstetricians and Gynecologists has said that frequent changes of position during labor is appropriate as long as it doesn’t conflict with treatment or cause complications.

I always tell the partners in our childbirth classes that they should encourage moms to try different positions on the hour. This can change things up and help protect a laboring mom from strains and injury.