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By: Rachel Canterino, PT, DPT; owner of best beginnings
As a physical therapist, I love my research, and there is expanding new research on better
laboring-birthing positions. I agree with many birth providers and the World Health Organization
(WHO) that encourage women to listen to their body and empower them to choose the position
that feels right, when possible. However, there is blossoming research that some birthing
positions far outweigh others. It all comes down to something called a flexible sacral position
(FSP). These, often upright alignments, take weight off a woman’s sacrum, allow the coccyx (or
tailbone) to be free and SI joints to be flexible, which encourages a more open and optimal pelvic
shape. FSP often lead to better birth outcomes and a safer vaginal birth. Generally, FSPs for
labor include kneeling, standing, squatting, hands and knees, side-lying, or birth-stool
supported seating positions.
As a prenatal and postnatal yoga teacher, I quickly saw that flexible sacral positions often mirror
many yoga asana/poses. Practicing some yoga poses that incorporate flexible sacral positions,
with support and variations, may help support a safer vaginal birth when used during labor.
What Yoga Poses Are the Best at Supporting Labor and Delivery?
These yoga poses can be done with support from a wall, table, chair, birthing stool, or partner,
as well as independently. Practice makes perfect, I encourage you to try these poses prior to
active labor and remember to listen to your body. The best yoga positions for you might change
and if something does not feel good it might not be right for your body.
Yogi Squat or Graland Pose (aka Malasana): toes out, heels in this is a deep squatting
position. Staying active in the hips to keep the weight evenly distributed between the
inside and outside of the feet and allow your hips to sink below knee level. But this is truly
a pose where practice makes perfect so practice this asana prior to labor.
Supported Options:
Blanket or Towel Roll: If you find you can’t get your heels flat, first try
taking your feet wider, but then you can support the ankles with a roll
under your heels
Wall or Partner: Find support from a wall or your partner behind you
Birthing Stool: Rest your hands or forearms on the stool in front of
you.
Low Chair: Straddle sitting on a low chair backwards, or just using a
birthing stool for squat support are also solid options
Table Top Pose (aka Bharmanasana): hands and knees pose, with shoulders over wrists
and hips over knees is a great laboring and birthing position for many women. You can add
gentle swaying movement laterally, circularly or even explore gentle cat-cows
Supported Variations:
Blanket: A blanket under your knees can make things more
comfortable
Yoga Blocks: If you suffer from carpel tunnel irritation blocks under
your hands can make this asana more comfortable
Puppy Pose or Melted Heart: This forearm and knees variation may be
a nice option to give your wrist a break and stretch your shoulders
Thunderbolt Pose: (aka Vajrasana) heel sitting with your hips sitting on your heels,
knees can be in line with your heels or take your knees wide as a variation. Play with
taller kneeling and support as they are often even better tolerated by laboring Mamas!
Supported Options:
Blanket and Towel Roll: A blanket under your knees and a towel roll
under your ankles can make this position significantly more
comfortable.
Birthing Stool: Forearms or hands can support you on the stool,
allowing you to lift your hips off heels while gently leaning forward
Birthing Ball: Kneeling and leaning on a birthing ball is also a variation
with the option to add movement and rocking from side to side
Chair/Partner’s Lap: Support your hands on a chair in a tall kneel, or
forearms on the seat or even your partner’s lap while they sit in the
chair, for a great folded kneeling variation.
Supported Mountain Pose and PARTIAL Standing Forward Fold (aka Tadasnana and
Uttanasana): legs shoulder distance (or wider during pregnancy), gentle bend in the
knees with shoulders gently rolled back and down away from your ears, option to or take
a partial lean forward finding a partial fold with support with your hands resting on your
knees. These two poses are limitless but are screaming for support during labor.
Support Options:
Wall: Standing with your back at the wall in mountain, hand on the
wall in a partial fold gently walking your feet back to find the sweet
spot, even leaning your bottom on the wall and placing hands on a
stable chair for support on both sides.
Chair: Hands on the back of a stable chair fold a little or a lot with
hands on the seat
Counter or Standing desk: forearms or hand supported in a standing
posture
Move: In traditional mountain pose you can try some small or large
pelvic circles, in a partial fold maybe invite a hip sway
You can practice these poses prior to labor. Check out a prenatal yoga class, they should offer
some of these positions every class, and allow your body to gradually build the strength and
flexibility you need to prepare yourself for the use of these FSPs during active labor.
What Are the Top 3 Positive Effect of FSP on Labor and Birth?
Based on research there are some encouraging evidence-based outcomes when utilizing a FSP
for labor and delivery.
1. Shorter second stage of labor: once cervix is 10cm dilated, labor time may be
decreased by an average of 25 minutes
2. Decreased risk of perineal tearing: and less use of instruments such as forceps &
vacuum
3. Improved Neonatal Outcomes: better APGAR scores & decreased NICU referral due
to less pressure on the aorta in the FSP, better preventing asphyxia
What 4 Labor Positions Have a Non-Flexible Sacral Position?
If you tried any of the yoga poses above, you can probably guess the non-flexible sacral
positions. These positions may make birth more challenging, however these positions are more
historically and commonly used, especially in traditional hospital settings. These 4 include the
following:
1. Lying on your back or supine
2. Lying reclined / recumbent
3. Semi-Sitting in bed
4. Lithotomy position: aka supine/reclined with knees bent and feet supported by stirrups or
people
Every position has the right time and place. If you have an epidural a non-flexible sacral position
might be right for you to support that intervention.
As always listen to your body and make sure you and your doctor or midwife are on the same
page with you and your birth hopes and dreams. Information is power and now you know about
flexible sacral positions and how they might assist your labor and delivery. Maybe check out a
prenatal yoga class to help you become stronger and more comfortable with the FSP seen in
common yoga poses. But like all yoga, your body knows what is best! If a pose causes pain,
discomfort or just does not feel right, avoid it or learn modifications that work for you.
LUCK, LOVE and LIGHT
- Rachel @ www.bestbeginningswellness.com
1- Badi MB, Abebe SM, Weldetsadic MA, Christensson K, Lindgren H. Effect of Flexible
Sacrum Position on Maternal and Neonatal Outcomes in Public Health Facilities, Amhara
Regional State, Ethiopia: A Quasi-Experimental Study. Int J Environ Res Public Health. 2022
Aug 5;19(15):9637.
2- Berta M, Lindgren H, Christensson K, Mekonnen S, Adefris M. Effect of maternal birth
positions on duration of second stage of labor: systematic review and meta-analysis. BMC
Pregnancy Childbirth. 2019 Dec 4;19(1):466.
3- Borges M, Moura R, Oliveira D, Parente M, Mascarenhas T, Natal R. Effect of the birthing
position on its evolution from a biomechanical point of view. Comput Methods Programs
Biomed. 2021 Mar;200:105921.
4- Caglioni M, Cantatore F, Valsecchi L, Miglioli C, Dumont R, Rinaldi S, Candiani M, Salvatore
S. Effects of flexible sacrum position at birth on maternal and neonatal outcomes: A
retrospective cohort study. Int J Gynaecol Obstet. 2023 Dec;163(3):911-919.
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