Movement is important. It helps keep our bones and joints healthy and can help prevent diseases and conditions such as heart disease, type 2 diabetes and osteoporosis.
Movement becomes even more important during pregnancy, when you become more susceptible to venous stasis, a condition in which blood flow in veins slows down or pools, particularly in the legs or pelvis, rendering you five times more likely to develop a blood clot. The increased risk of developing a blood clot is due to several factors: hormonal changes, increased blood volume and changes in blood clotting mechanisms that occur during pregnancy. These changes help prevent excessive bleeding during childbirth.
While these physiological and hormonal changes help safeguard your labor and delivery, they can also put you at risk for cascading events, beginning with a blood clot and potentially leading to complications such as deep vein thrombosis (DVT) or pulmonary embolism (PE), both of which can be life-threatening. Signs of DVT include sudden swelling in the leg (usually one leg), pain or tenderness, increased warmth, swollen veins that are hard or sore when touched and skin discoloration. These symptoms can occur in the arm or abdomen as well if a blood clot is present there.
Signs of a pulmonary embolism include shortness of breath, chest pain, feeling faint/loss of consciousness or irregular heartbeat, to name a few. Being active, wearing compression stockings and hydration are just a few recommendations to help prevent DVT.
During pregnancy, right up until childbirth, we become hyperfocused on the baby’s movements. Whether you are a first-time mom, a mom with a history of vaginal deliveries or a mom hoping for a vaginal birth after a Cesarean section (VBAC), you often don’t feel at ease until you’re told that your baby is in a cephalic (head-down) position.
On another note, you are advised to pay attention to the movements of the baby in utero to alert you to when there are changes, such as decreased movement, and when to speak with a provider or seek medical care.
During early labor, it is beneficial to walk while you can and make use of the tools available to you—such as the peanut ball or a traditional birthing ball, and positions you can do. As labor progresses, you may receive an epidural, making it difficult or unsafe to use a traditional birthing ball or walk. You may also be in too much pain to even want to move around.
Walking during early labor is believed to help with labor progression and pain relief. Although limited research has been done on this topic, studies so far have not found significant differences in labor progression between walking vs mainly lying in bed during early labor. However, people should not be discouraged from walking and its potential benefits. Even if studies show no major difference in labor progression, walking improves circulation and can ease discomfort, which are both highly beneficial during pregnancy and early labor.
As mentioned earlier, there may come a time when you either can’t or don’t want to walk much. When movement is limited, you can still perform position changes in the hospital bed, at home or in a birthing center and utilize birthing balls (specifically the peanut ball after an epidural). Your nurse, midwife, doula or labor coach may be knowledgeable about a wide variety of positions that can help during labor.
While there is limited clinical research on how position changes affect labor progression, many nurses and patients report positive experiences. The testimonials are countless. The lack of evidence is due to more research needed rather than lack of results. To be able to draw strong conclusions from research, you need a large sample size (many people) and a lot of different types of studies to conduct a systematic review of all the research available on a particular topic.
Position changes can help the baby move down the birth canal or rotate from a less favorable position (e.g., occiput posterior or “sunny side up”) to a more optimal one (occiput anterior, with the back of the baby’s head facing the maternal pelvis).
Spinning Babies and Bundle Birth are two organizations that provide excellent information on labor positions. Spinning Babies, in particular, also offers exercises and resources to help promote optimal fetal positioning, even before labor begins—such as turning a baby in breech position into a vertex (head-down) position.
When it all comes down to it, I don’t know a single nurse who would not try
different positions in an attempt to help with the labor progress in order to avoid a Cesarean section for a patient.
While the evidence may be lacking due to limited research, you have everything to gain when you try different positions and movements in labor and nothing to lose as opposed to simply not trying at all.
Alexia Baker holds an MSN in midwifery. After many years as a certified labor and delivery nurse within the Hackensack Meridian Health network, she now practices as a midwife at Maternal Resources—a thriving boutique-style practice with offices in Hackensack, Jersey City, Hoboken and Howell.
