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make the most of your water birth with these 7 labour Positions and Comfort Tools
As much as we would like to believe that it doesn't matter which positions we use throughout labour, there's so much more to the anatomy behind which positions are most beneficial for each phase of labour. It's also important to know which ones are to bring comfort, and which actually give baby more room to navigate the various levels of the pelvis.
So which positions and comfort tools are best to use and when?
Let's break it down in a brief and understandable way, starting with:
The Anatomy of Positions
The main reason why it's important to choose the right position for each phase of labour, is to give baby's head the most amount of room as it navigates every level of the pelvis - the top (inlet), mid-pelvis, or bottom (outlet). How you move matters!
For example;
Early labour is about widening the pelvic inlet - you'll want to focus on leg extension, pelvic tucking, and femural external rotation (knees wider than ankles).
Active labour is about helping baby through the mid-pelvis and pelvic floor, so your focus becomes asymetrical movements.
Transition and pushing is about helping baby through the pelvic outlet - the focus becomes leg flexion, pelvic untucking, and femural internal rotation (ankles wider than knees).
The Anatomy of Comfort Tools
Comfort in labour isn't only about easing pain, it's physiological. The real goal is to keep your oxytocin flowing (the hormone that drives your contractions and keeps labour progressing), to find comfort without reaching for synthetic pain medications, and in turn to reduce the chance of a cascade of interventions. The right comfort tools work with your body in a few beautiful ways. Warmth and water immersion in the birth pool help your whole system soften and release more oxytocin. Counter-pressure and massage ease the intensity of each surge and settle your nervous system. A labour comb gives your hands something to grip and press into, drawing your focus out of the pain and into your palms. And a TENS machine uses gentle electrical pulses to interrupt pain signals and encourage your body's own endorphins. Paired with the right positions, these tools help you stay calm, mobile and in your body, so birth can unfold the way it's designed to.
The Physiological Environment
Every labour experience will vary depending on environment, maternal anatomy (mainly bodily mobility and alignment), and other underlying variabilities, but in general, if you've been cleared for a water birth, chances are;
Your mind is ready for the process,
Your environment will/should be peaceful,
And you have no known risk factors that would keep you from having a successful natural water birth.
That said, it's still important to work with your body and baby in the right ways, throughout the process, to help facilitate easier physiological birthing.
Here are our best labour positions and comfort measures/tools for trying at various points in labour, in order to help facilitate fetal descent, bring comfort without the need for pain medications, and make the most out of labouring in the pool....
Early Labour:
1) Walking
Walking is a great distraction at any point in labour, especially early labour, when it’s still somewhat easy to do.
The shifting of the hips and leg extention helps balance and stretch the psoas muscles, helping baby to pass through them.
If the psoas muscles are
quite imbalanced or shortened and early labour is taking longer than anticipated, try curb walking, to help lengthen the psoas muscles.
If you need to stop during contractions, try leaning on your partner’s shoulders and rocking your hips, or doing a lift and tuck for the duration of the contraction.
Accompanying comfort measure would be - Slow dancing with your partner, swaying through each surge to stay upright, moving and connected. A TENS machine (Labour TENS Machine Hire NZ | TensCare Perfect mama+ – Labour and Love) is lovely through early labour too, giving you something to focus on as those first contractions build.
2) Abdominal Lift and Tuck
This position helps shift the pelvis forward and bring baby more direct over the pelvis, to help baby engage.
It will also help direct the contraction to push baby downward rather than toward the sacrum.
When a contraction starts, lift the belly and pull it inward, while tucking the pelvis forward. Do this through 5-10 contractions.
A partner can come behind the birther and help support her, or the birther can lean her back against a wall.
Accompanying comfort measure would be - A TENS machine sits beautifully alongside this, with the pads on your lower back easing the intensity while your partner supports the lift
Active Labour:
3) Labouring on the Toilet
Some people love this position and some people hate it, but it can be very effective for allowing baby to drop further into the pelvis, since the weight of baby is directly on the cervix and pelvic floor, encouraging it to relax.
Here's how to utilize it best: Open the toilet lid, put a pillow on the back of the toilet and sit on the toilet backwards. Put one foot up on a stool and switch feet every few contractions - these asymetrical positions help baby through the pelvic outlet.
Stay here in 20-30 minute intervals.
Accompanying comfort measure would be - Counter-pressure or a firm back or head massage from your support person (a little Body and Belly Oil helps hands glide (Organic Belly Oil NZ | Pregnancy & Postpartum – Labour and Love), or keep your TENS machine going for steady relief
4) Hip Rotations on a Birth ball
This is a good activity to encourage rhythmic labouring, while keeping everything loose and moving.
If sitting on a ball, try doing slow, wide rotations while keeping the body stationary and just moving the lower body.
You can forward lean over a bed in this position for a bit of a rest, or have your birth partner sit behind you on a stool, allowing you to lean back and rest.
Accompanying comfort measure would be - Squeeze a labour comb (Birth Comb NZ | Labour Comb for Natural Pain Relief – Labour and Love) through each surge to draw your focus into your hands, with your TENS machine on for continuous comfort (Labour TENS Machine Hire NZ | TensCare Perfect mama+ – Labour and Love)
5) Side Lying release
This resting position helps to loosen up some of the deep muscles surrounding the pelvis, in order to give baby a bit more room within the pelvis, and can be done at any point in labour.
Lay on your side on a bed, as close to the edge as possible.
You should have a straight spine and will drop your top leg over the side of the bed, with a support person holding you at her pelvis, so you don't fall off the bed. The support person can do massage, counter pressure, and hip squeezes in this position.
Do this for 3 contractions on each side. If contractions slow down in this position, that's okay, they should pick back up when you are done.
Accompanying comfort measure would be - Hip squeezes and counter-pressure from your support person, a labour comb to grip, and your TENS machine ticking along.
Transition and pushing in the Pool:
6) Leaning on the pool edge with one knee up
This is a solid pushing position, which feels well supported, while also keeping the pelvis nice and open.
If you have a cervical lip or baby is in an acynclitic position, leaning into the upright leg, will help push the cervix away, or help baby rotate its way down.
It may help to pull on something while pushing in this position. *The pulling motion helps lengthen the back muscles - nutating the sacrum, to give baby more room in the pelvic outlet.
If one knee up is too uncomfortable, then kneeling with ankles wider than knees would be an alternative - this helps open the outlet of the pelvis.
Accompanying comfort measure would be - Warm water poured over your lower back between surges, gentle head compression, and our Birth Comb to squeeze as you bear down (it’s perfectly safe to use in the pool).
7) Squatting
This can be done while leaning over the edge of the pool, but the easiest is to hold onto a rebozo or scarf wrapped around the support person's shoulders. *The pulling motion helps lengthen the back muscles - nutating the sacrum, to give baby more room in the pelvic outlet.
Hold the squat for the whole contraction and make sure both feet are planted flat, for more stability, to shift the pelvis.
Accompanying comfort measure would be - Warm water poured over your back (if pushing in a pool), a Birth Comb to grip through each surge (Birth Comb NZ | Labour Comb for Natural Pain Relief – Labour and Love), and the deep relaxation of the pool itself, letting the warmth soften everything so you can work with your body.
Trust Your Body, and Keep Moving
There's no single "right" way to labour. These positions and comfort tools are a starting point, not a checklist. Try them, notice what feels good, and let your body guide you. Often the position that feels most instinctive is exactly the one your baby needs.
The more you practise these positions with your birth partner before labour begins, the more natural they'll feel on the day. Your partner will know how to support you, and you'll both feel more confident, calm and connected when it counts.
If you'd like to go deeper, our Bestselling Labour Positions and Comfort Measures guides walk you through each phase of labour step by step, so you can feel truly prepared for your birth.
Happy Birthing!
By Dee (Labour and Love) and Chelsea (Pathways Prenatal)
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