How to choose your labor positions - Ruth Health

How to choose your labor positions

Fast facts:

  • Many aspects of labor and childbirth are up to you, from birthing positions to pain management and more.
  • You’ll still have options for labor positions if you receive an epidural.
  • There are many ways to use a hospital bed during labor and delivery beyond lying on your back.
  • How long it’s safe to push during labor depends on the progress you’ve made and your baby’s condition

Whether you’re giving birth for the first time or growing your family, it’s understandable to have some anxiety about labor and delivery.

While you can’t predict exactly how it will unfold, many aspects of the experience such as birthing positions and pain management are up to you. 

To help you honor your preferences and prioritize your comfort on the big day, we’ve compiled answers to commonly asked questions.

What positions can you labor in with an epidural?

About 60-70% of birthing people delivering in a hospital receive an epidural during labor and childbirth. An epidural is a type of anesthesia injected in your lower back. It is typically administered during the first stage of labor as you experience regular contractions.

An epidural reduces feeling in the lower half of the body, so it isn’t possible to use a labor or birthing position that requires full use of leg muscles such as standing or squatting. 

However, you are not confined to laboring flat on your back if you use an epidural. 

Many birthing positions are safe to try with an epidural. You can sit, lean forward, lie on your side, or get on your hands and knees.

You may also find it helpful to use a peanut ball when laboring with an epidural. A peanut ball is similar to an exercise ball but shaped like a peanut, as its name suggests. It sits comfortably between your legs.

What should be noticed when using a hospital bed?

Lying on your back is not the only way to use a hospital bed during labor and delivery. A hospital bed can help you get as comfortable as possible in a variety of laboring positions.

Here’s how to use a hospital bed to your advantage in each position.

  • Standing or leaningRaise the bed to its highest setting, adding a couple of pillows to rest your arms on depending on your height. You can also place a birthing ball on your bed to lean over for additional support.
  • Squatting or lungingUse your hospital bed to support your squat or lunge by setting it to an appropriate height. Make sure someone is nearby to offer more hands-on support if needed.
  • SittingThere are several ways to use a hospital bed in a sitting position. Sit on the edge of the bed with your feet reaching toward the floor, or in the bed with your legs stretched out long or in a cross-legged position. When sitting on the bed, position it on the lowest setting so that your feet can rest on the floor.
  • Hands and kneesA hospital bed can be used in multiple ways for a hands and knees position. Get on all fours on a flattened bed, lower the bottom half of the bed to use as a shelf with your knees on the ground, or raise the top half to lean over with your knees on the flat part of the bed.
  • Side-lyingIf you’re going to use a hospital bed for lying down, it’s ideal to lie on your side. While this doesn’t have gravity working in its favor, it works well with epidurals and fetal monitoring. A pillow or birthing ball while side-lying can help open up the pelvis.

How long is it safe to push during labor?

It’s one of the most common questions about labor, especially for those giving birth for the first time. There isn’t a universal answer. 

If you’ve made progress after several hours of pushing and both you and your baby are feeling good, it’s generally fine to keep at it.

The American College of Obstetricians and Gynecologists considers three or more hours well within a “normal” range, especially if you’re a first-time mom or using an epidural.

A c section becomes a possibility if you’re losing energy after several hours of pushing and aren’t close to delivery. 

The safety of continuing to push also depends on your baby’s condition. If a slow or fast heart rate indicates distress and you still have a ways to go, your birthing team may recommend a c section.

At Ruth Health, we strive to bring you the facts so you can make decisions with ease — the decisions that are best for you. Let us know what other topics you’re interested in learning more about by emailing us at

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