Your labour, your way

If you’ve chosen a natural, unmedicated birth, it’s normal to feel a little nervous – labour comes with pain, and medication can make it easier to manage.

That said, there are many benefits to going without medication. You stay fully in control, more alert, and can move freely to find the best birthing position. Techniques like breathing and visualisation are completely natural, meaning no side-effects for you or your baby. You’re also less likely to need interventions like a catheter. Most of all, many moms feel a strong sense of empowerment and amazement at what their body can do.

The most important thing to know about labour, according to Dr. Calvin Makgato, an obstetrician and gynaecologist at Mediclinic Vereeniging, is that there’s no single "best" position for labour and birth. Everyone is different, so you’ll need to find what feels most comfortable for you. However, certain positions may be necessary for monitoring you or your baby.

During the first stage of labour, when your cervix is opening and contractions become more frequent, you can try different positions to see what helps. You might lie on your side, sit with your feet up, relax in the bath, walk around, stand in the shower, or lean forward while rocking and swaying.

By the time you reach the second stage of labour, your cervix will have dilated fully. This is when you will start to actively push to deliver your baby. Dr Makgato recommends staying in an upright position during this stage of labour, because it improves the flow of blood, delivering more oxygen to the baby than if you were lying down. It also helps your uterus contract more strongly and efficiently.

“This helps your baby get into a better position for birthing,” Dr Makgato explains. Standing helps open your pelvis, making it easier and more comfortable to push. Walking or staying upright also uses gravity to your advantage and can help take your mind off the intensity of contractions.

Climbing stairs can help if labour has slowed down. The movement encourages your baby to shift position and helps open your pelvis, allowing your baby to move down. This puts pressure on your cervix, which can help it dilate. Lunges can have a similar effect, but it’s best to do them with a midwife’s guidance. If you’re too tired for lunges or stairs, try sitting on a yoga ball. Gently move your hips in circles or rock forward and backward to keep things progressing.

Squatting is another helpful stretch during labour since it opens the pelvis and can help things progress. If you're in a lot of pain, your midwife might suggest this position so she can assist with pain relief. She may massage your back and hips, apply a double hip squeeze (pressing the top of your hipbones), or use counter pressure (pushing steadily on your lower back or hips to ease discomfort).

It might seem counterintuitive, but keeping your knees together and your feet apart can also help open the pelvis.

If you’re still feeling pain, especially in your lower back, ask your partner or midwife to try a seated knee press. This is similar to a double hip press, but they’ll press down just below your kneecaps while facing you.

Keep switching positions and trying different techniques. A little distraction can also help; your partner could read to you, for example. Using a warm compress on your lower back may ease discomfort, and alternating with a cool cloth can provide extra relief.

Breathing techniques for labour

Dr Makgato suggests using different breathing techniques during each stage of labour:

First stage of labour

Cleansing breath

1. Take a deep breath in, fully expanding your lungs.
2. Slowly exhale, releasing all the air.
3. Do this at the start of a contraction and again when it ends.

Abdominal breathing

1. Breathe in slowly through your nose with your mouth closed.
2. Let your abdominal wall rise as far as possible.
3. Exhale through your mouth, allowing your abdominal wall to drop.
4. Keep your chest still and place your hands on your diaphragm to feel it expand and relax.

Second stage of labour

Breath holding for pushing
 

1. During a contraction, take a deep breath in.
2. Tuck your chin to your chest.
3. Hold your breath while pushing downward on your diaphragm and abdominal cavity to help push the baby out.