The study concludes that although the effects of ambulatory labor on the progress of labor is still under investigation, the ability to walk to the bathroom and change positions in bed are compelling enough as reasons in support of semi recumbent positions, movement during labor, and walking epidurals.
Erica Lyon, Director of RealBirth, a center that offers childbirth classes and support to pregnant women and mothers in New York City, explains some of the disadvantages to birthing in a recumbent position. "It's just basic physics. When you're lying down, you aren't using gravity to work with the contractions to birth the baby. You lose the efficiency of the contractions."
Women may also feel less in control, continues Lyon. "To have your feet completely off the ground and not be able to see what's going on, may make women feel even more vulnerable than they already feel."
Benefits of Upright Labor
Laboring in active positions such as walking, squatting, or on a birthing ball has several potential advantages. As Lyon points out, laboring in an upright position means that the baby is being drawn down by gravity. Simply being upright can help the body maximize the power of contractions. With more efficient contractions, delivery time may be reduced.
Alliman adds that a woman should try several positions during labor. "The combination of gravity and changing positions frequently helps the baby's head move lower in the pelvis and into the best position for birth." For example, when a laboring woman is on a birthing ball or squatting, her pelvic opening is one to two centimeters larger than when she is lying down, says Alliman.
Women who deliver in nonrecumbent positions also tend to have less vaginal tearing and episiotomies. "This is because of less stress on the vaginal opening [and your back] in these positions," Alliman explains.
Another bonus of nonrecumbent positions is that a woman's backbone is more aligned and her blood circulation is better, adds Lyon.