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Birth Positions: Exploring Your Options

Take a moment to imagine childbirth. What comes to mind?

By: Danielle Santora |

Oct 15, 2026

Maybe you picture yourself lying on your back, legs in stirrups, while a team of people coaches you through each contraction. We’ve seen this image countless times in movies, on TV, and even in childbirth classes. But lying on your back is just one option. Depending on your circumstances, you may be able to move and change positions throughout labor and birth.

Why Your Position Matters When Pushing
Every Pushing Stage Looks Different
Pushing on Your Back: Supine, Semi-Reclined, and Lithotomy
Upright Birth Positions
Side-Lying Birth Position: A Supportive Option With an Epidural
Kneeling and Hands-and-Knees Positions for Back Pain in Labor
So, What Position Should You Give Birth In?
Preparing for Birth With Pelvic Floor Physical Therapy
Common Questions

Why Your Position Matters When Pushing

Labor has three stages. In the first, contractions help your cervix dilate to 10 cm. The second stage is pushing and delivering your baby. In the third, you deliver the placenta.

This post focuses on the second stage. Your position while pushing can affect how much room your pelvis has, how your baby moves down and rotates, how much gravity helps, and how comfortable you feel.

Research suggests that pushing in a position other than lying on your back may lead to:

A shorter pushing stage
A lower chance of needing forceps or a vacuum
Less need for an episiotomy
Fewer abnormal fetal heart rate patterns

If you do have an episiotomy or a tear, our article on what to do about scars from childbirth explains what recovery looks like.

Every Pushing Stage Looks Different

Pushing looks different for everyone. You may feel a strong urge to push, or your team may coach you through it. An epidural can reduce sensation and change which positions feel comfortable. You may also rest while your baby moves down before you actively push. Changing positions along the way is common.

That’s why no single position works best for every birth. Knowing your options helps you find what feels right in the moment.

Prenatal pelvic floor physical therapy can help you practice breathing and coordination for pushing. Learn how we help you prepare for birth.

Pushing on Your Back: Supine, Semi-Reclined, and Lithotomy

Variations: Supine (flat), semi-reclined, lithotomy (legs supported)

Lying on your back gives your birth team easy access to monitor labor and help with hands-on care if needed. It can also be a good resting position when you’re tired, and labor is no small feat.

May be worth trying if: You need to rest, or your team needs hands-on access.

Upright Birth Positions

Variations: Standing, squatting, supported squat, birthing stool

Staying upright lets gravity help your baby move down and gives your pelvis more freedom to move. Squatting bends your hips deeply, which may open up extra space in the pelvis. As we covered in our post questioning common labor positions, the way you position your hips and knees can change how much room your baby has.

If holding a squat feels tiring, try a supported version. Your partner can help, or you can use a squat bar, a labor sling, or a birth ball.

May be worth trying if: You want gravity working with you.

Side-Lying Birth Position: A Supportive Option With an Epidural

Variations: Side-lying, supported side-lying with a pillow or peanut ball

Side-lying lets you rest while still moving a little, and it doesn’t take the balance that standing or squatting does. A pillow or peanut ball between your legs can support your upper leg. When there’s no pressure on your tailbone, it can move more freely, which may give your baby’s head a little more room.

It’s also a great position for your partner to help, offering support and encouragement during contractions.

May be worth trying if: You have an epidural or need to rest.

Kneeling and Hands-and-Knees Positions for Back Pain in Labor

Variations: Upright kneeling, kneeling while leaning over a ball, bed, or partner, hands-and-knees

These positions take pressure off your back and pelvis while gravity still helps. Rocking, swaying, or shifting your hips may also help your baby turn and move down.

May be worth trying if: You’re having back pain during labor.

So, What Position Should You Give Birth In?

There’s no single right answer. The best position for you can depend on whether you’ve had an epidural, how your baby is positioned, how labor is going, and what your care team recommends.

Think of positions as tools in your toolbox. One may feel great early on, and another may help more later. Get to know your options, listen to your body, and keep working with your care team as labor unfolds.

Preparing for Birth With Pelvic Floor Physical Therapy

Beyond Basics Physical Therapy offers pregnancy and postpartum care in NYC. Prenatal sessions can include breathing and pelvic floor coordination to help you prepare for pushing. See us in person in Midtown or Downtown NY, or book a virtual visit.

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