TOP 4 YOGA POSES to PREPARE & SUPPORT A POSITIVE BIRTH OUTCOME
As a physical therapist, I love my research, and there is expanding new research on better laboring-birthing positions. I agree with many birth providers and the World Health Organization (WHO) that encourage women to listen to their body and empower them to choose the position that feels right, when possible. However, there is blossoming research that some birthing positions far outweigh others. It all comes down to something called a flexible sacral position (FSP). These, often upright alignments, take weight off a woman’s sacrum, allow the coccyx (or tailbone) to be free & SI joints to be flexible, which encourages a more open and optimal pelvic shape. FSP often lead to better birth outcomes and a safer vaginal birth. FSPs for labor include kneeling, standing, squatting, hands & knees, side-lying, or birth-stool supported seating positions.
As a prenatal & postnatal yoga teacher, I quickly saw that flexible sacral positions often mirror many yoga asana/poses. Practicing some yoga poses that incorporate flexible sacral positions, with support and variations, may help support a safer vaginal birth when used during labor.
What Yoga Poses Are the Best at Supporting Labor & Delivery?
These yoga poses can be done with support from a wall, table, chair, birthing stool, or partner, as well as independently. Practice makes perfect, I encourage you to try these poses prior to active labor and remember to listen to your body. The best yoga positions for you might change and if something does not feel good it might not be right for your body. Click on the pose names to see pictures
1- Yogi Squat or Graland Pose (aka Malasana): toes out, heels in this is a deep squatting position. Staying active in the hips to keep the weight evenly distributed between the inside and outside of the feet & allow your hips to sink below knee level. But this is truly a pose where practice makes perfect so practice this asana prior to labor.
Supported Options:
Blanket or Towel Roll: If you can’t get your heels flat first try taking your feet wider, but then you can support the ankles with a roll under your heels
Wall or Partner: Find support from a wall or your partner behind you
Birthing Stool: Rest your hands or forearms on the stool in front of you or use the stool for a low supported squat.
2- Table Top Pose (aka Bharmanasana): hands & knees pose, with shoulders over wrists & hips over knees is a great laboring & birthing position for many women. You can add gentle swaying movement laterally, circularly or even explore gentle cat-cows.
Supported Variations:
Blanket: A blanket under your knees can make things more comfortable
Yoga Blocks: If you suffer from carpel tunnel irritation blocks under your hands can make this asana more comfortable
Puppy Pose or Melted Heart: This forearm & knees variation may be a nice option to give your wrist a break and stretch your shoulders
3- Thunderbolt Pose: (aka Vajrasana) heel sitting with your hips sitting on your heels, knees can be in line with your heels or take your knees wide as a variation. Play with taller kneeling & support they are often even better tolerated by laboring Mamas
Supported Options:
Blanket & Towel Roll: A blanket under your knees & a towel roll under your ankles can make this position significantly more comfortable.
Birthing Stool: Forearms or hands can support you on the stool, allowing you to lift your hips off heels while gently leaning forward
Birthing Ball: Kneeling & leaning on a birthing ball is also a variation with the option to add movement & rocking from side to side
Chair/Partner’s Lap: Support your hands on a chair in a tall kneel, or forearms on the seat or even your partner’s lap while they sit in the chair, for a great folded kneeling variation.
4- Supported Mountain Pose & PARTIAL Standing Forward Fold (aka Tadasnana & Uttanasana) legs shoulder distance (or wider during pregnancy), gentle bend in the knees with shoulders gently rolled back and down away from your ears, option to or take a partial lean forward finding a partial fold with support with your hands resting on your knees. These two poses are limitless but are screaming for support during labor.
Support Options:
Wall: Stand with your back at the wall in mountain, place hands on the wall in a partial fold by gently walking your feet back to find the sweet spot, or place your bottom on the wall & hands on a stable chair for support on both sides of your body.
Chair: Hands on the back or seat of a stable chair fold a little or a lot
Counter or Standing Desk: forearms or hands supported in standing
Move: In traditional mountain pose you can try some small or large pelvic circles, in a partial fold maybe invite a hip sway
You can practice these poses prior to labor. Check out a prenatal yoga class, they should offer some of these positions every class and allow your body to gradually build the strength and flexibility you need to prepare yourself for the use of these FSPs during active labor.
What Are the Top 3 Positive Effect of FSP on Labor & Birth?
Based on research there are some encouraging evidence-based outcomes when utilizing a FSP for labor and delivery.
1- Shorter second stage of labor: Once cervix is 10cm dilated, labor time may be decreased by an average of 25 minutes, based on some research
2- Decreased risk of perineal tearing: Additionally less use of instruments such as forceps & vacuum
3- Improved Neonatal Outcomes: Better APGAR scores & decreased NICU referral due to less pressure on the aorta in the FSP, which better prevents asphyxia
What 4 Labor Positions Have a Non-Flexible Sacral Position?
If you tried any of the yoga poses above, you can probably guess the non-flexible sacral positions. These positions may make birth more challenging, however these positions are more historically and commonly used, especially in traditional hospital settings. These 4 include the following.
1- Lying on your back or in supine
2- Lying reclined / recumbent
3- Semi-Sitting in bed
4- Lithotomy Position: aka supine/reclined with knees bent and feet supported by stirrups or people
Every position has the right time and place. If you have an epidural a non-flexible sacral position might be right for you to support that intervention.
As always listen to your body and make sure you and your doctor or midwife are on the same page with you and your birth hopes and dreams. Information is power and now you know about flexible sacral positions and how they might assist your labor and delivery. Maybe check out a prenatal yoga class to help you become stronger and more comfortable with the FSP seen in common yoga poses. But like all yoga, your body knows what is best! If a pose causes pain, discomfort or just does not feel right, avoid it or learn modifications that work for you.
LUCK, LOVE & LIGHT- Rachel
RESEARCH
1-Badi MB, Abebe SM, Weldetsadic MA, Christensson K, Lindgren H. Effect of Flexible Sacrum Position on Maternal and Neonatal Outcomes in Public Health Facilities, Amhara Regional State, Ethiopia: A Quasi-Experimental Study. Int J Environ Res Public Health. 2022 Aug 5;19(15):9637.
2-Berta M, Lindgren H, Christensson K, Mekonnen S, Adefris M. Effect of maternal birth positions on duration of second stage of labor: systematic review and meta-analysis. BMC Pregnancy Childbirth. 2019 Dec 4;19(1):466.
3-Borges M, Moura R, Oliveira D, Parente M, Mascarenhas T, Natal R. Effect of the birthing position on its evolution from a biomechanical point of view. Comput Methods Programs Biomed. 2021 Mar;200:105921.
4-Caglioni M, Cantatore F, Valsecchi L, Miglioli C, Dumont R, Rinaldi S, Candiani M, Salvatore S. Effects of flexible sacrum position at birth on maternal and neonatal outcomes: A retrospective cohort study. Int J Gynaecol Obstet. 2023 Dec;163(3):911-919.