Labor and Delivery: Positioning Modifications for Pain

At E&E we constantly get asked questions on use of different positions during labor and delivery. Below is a brief summary on how to position yourself for success while taking into consideration some of the most common painful orthopedic conditions.

We talk about this a lot, but the best treatment is PREVENTION. If you are thinking about getting pregnant or experiencing pain early in pregnancy, the earlier you fix it, the better. We can’t state it enough on how the pregnancy guide can prevent and fix so many of the bodily pain issues encountered by pregnant women.

Also, be sure to check out our full Labor and Delivery blog post for more L&D prep.

POSITIONING ADVICE FOR PAINFUL CONDITIONS:

Herniated disk

• 1st stage (labor)-

  • TRY:

    • Walking

    • Rest with lumbar support

    • Maintain arch in low back in all positioning choices. 

  • AVOID:

    • Squatting

• 2nd stage (pushing)- 

  • TRY:

    • Open glottis pushing (make noise and don’t hold your breath)

    • Semi-reclined with lumbar support

    • Sidelying

    • Hands and knees position

  • AVOID:

    • Rounding your spine 

Spondylolisthesis (moderate to severe spinal instability)

• (1st and 2nd stage)

  • AVOID:

    • Any position that severely increases the arch in the low back

SI dysfunction/pain

• 1st stage (labor)- 

  • AVOID:

    • Walking if it is very uncomfortable

    • Lying on your back with your knees bent if your legs aren’t supported

• 2nd stage (pushing)- 

  • TRY:

    • Any position where your legs are symmetrically supported

    • Head of the bed elevated and lying on your back with pillows under knees

    • Hands/knees

    • Upright kneeling

  • AVOID:

    • Lying on your back with your legs up in the “stirrups”

    • Lying on your back with legs unsupported

Pubic symphysis pain/SPD

• 1st and 2nd stage

  • TRY:

    • Side lying if legs can be closer together

    • Head of the bed elevated and lying on your back with pillows under knees

    • Hands/knees

    • Upright kneeling

  • AVOID:

    • Side lying if legs are far apart

    • Squatting

    • Lying on your back with your legs up in the “stirrups”

Coccyx dysfunction/pain

• 1st and 2nd stage

  • TRY:

    • ANY position where the tailbone is free to move (ex. side lying, squatting, etc.)

  • AVOID:

    • head of the bed elevated

    • lying on your back (pressure on tailbone)

  Need more help?

  Find a pelvic PT here  or here

  Schedule an E&E Online Wellness Session

Good luck mama! Send us a message if you have questions specific to you!

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